Assessment of osteoporosis in psoriasis with and without arthritis: correlation with disease severity

ABSTRACT

To assess osteoporosis in psoriatic and psoriatic arthritis [PsA] patients, by dual energy x ray absorptiometry [DEXA], and measuring serum osteoprotegrin [OPG] level, and to correlate findings with the extent of both skin and joint manifestations. Fifty psoriatic patients [16 of them had arthritis] were assessed by psoriasis area and severity index [PASI]. Total joint score was used to assess joint manifestations in PsA patients. DEXA were done for all patients and 20 healthy controls. Laboratory assessment of erythrocyte sedimentation rate, serum calcium, rheumatoid factor, and OPG was done. Fifty OPG level was significantly increased in both psoriatic and PsA patients in comparison to controls. However, PsA patients had more significant osteoporosis in neck of femur and wrist as detected by DEXA. In PsA patients, total joint score was positively correlated with disease duration and extent of skin involvement [area score of PASI] and negatively correlated with Z score of femur. Psoriatic patients with or without arthritis could suffer from osteoporosis as evidenced by significantly increased OPG. Prolonged and extensive cutaneous disease is an important risk factor for the development and severity of PsA