ABSTRACT
To observe the clinical features, laboratory profile, associations and comorbidities of psoriasis in a segment of Pakistani population. This cross-sectional descriptive study was carried out at PAF base hospital, Sargodha from January 2010 to December 2010. One hundred consecutive patients with a diagnosis of psoriasis were included in the study. The diagnosis was confirmed by one of the consultant dermatologists. Pretested, especially designed questionnaire was filled by all the participating patients. Information regarding age, sex, duration of disease, clinical type and severity of disease, nail and joint involvement, koebnerization, associated diseases, and hematological profile including hemoglobin level, blood ESR, uric acid level and its association with joint involvement were recorded. Out of the 100 consecutive patients included in the study, 71 were males and 29 were females. Mean age of onset was 39.8 years. 88 patients had chronic plaque psoriasis, 8 had guttate and 4 had erythrodermic psoriasis. 46 patients had some sort of joint involvement and 29 patients had some sort of nail involvement. Only 14 patients gave history of koebnerization. Only 10 patients had associated skin disease while 15 patients had some associated medical disease. Mean hemoglobin levels were 13.25 gm/dl. Mean ESR was 22.6 mm/h. Rise in serum uric acid level was significantly associated with psoriatic arthritis. Pakistani patients with psoriasis are more likely to have a lower hemoglobin and a raised ESR. Rise in serum uric acid level is associated with joint involvement
ABSTRACT
To describe the clinical patterns of arthritis in psoriasis. Cross-sectional, observational study. Combined Military Hospital, Kharian Cantonment, Pakistan, from January to December 2007. One hundred consecutive patients with psoriasis reporting to dermatology outpatient department were included. Pregnant ladies [due to X-ray hazard] and rheumatoid factor positive patients were excluded. The demographic profile of patients was recorded. Psoriatic arthritis was diagnosed on the basis of Moll and Wright criteria. Standardized examination of axial and peripheral joints was made. The severity of psoriasis was assessed by PASI score. The presence of a clinical type of psoriatic arthritis, enthesitis, dactylitis, and nail changes were noted. X-ray films of involved joints were taken. A statistical analysis using chi-square test and student's t-test were done where applicable. The mean age of patients was 39.8+15.8 years. Seventy one percent were males and 29% were females. Forty six percent of the patients gave a history of joint involvement and fulfilled the Moll and Wright criteria. The mean PASI score in non-arthritic patients was 26.8 +/- 34.8 and in psoriatic arthritis patients it was 28.4 +/- 41.2, p=0.08. Thirteen patients [28.2%] had predominantly axial disease, while the rest had predominantly peripheral disease. Single joint involvement [monoarthritis] was the commonest clinical presentation. Nail involvement was seen in 29% of the patients without arthritis while in patients having arthritis, nail involvement was 74% [p=0.001]. Joint involvement is common in psoriatic patients. However, the criteria of diagnosis lack consensus