Diagnostic algorithm for psoriatic arthritis in clinical practice of dermatologist

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


The study was carried out in 103 patients with psoriasis, who had the consultation of dermatologist and rheumatologist. Answers for 6 questions mPEST (Psoriasis Epydemiology Screening Tool) modified questionnaire were estimated, each positive answer corresponded to 1, PEST ≥ 3 was suggested the presence of psoriatic arthritis (PsA), PEST < 3 was considered the absence of PsA. All the patients were examined by rheumatologist, the gold standard was CASPAR (ClASsification criteria for Psoriatic Arthritis) criteria. If necessary the instrumental tests were performed: roentgenography, ultrasound examination, magnetic resonance imaging (MRI) and laboratory tests. At PEST ≥ 3 diagnosis of PsA was suspected in 60 (58.2%) of 103 patients. Diagnosis of PsA was confirmed by CASPAR criteria in 47 (45.6%) patients. mPEST less than 3 was in 43 (41.7%) of 103 patients. Diagnosis of PsA was absent by CASPAR criteria in 29 (67.4%) patients. Newly diagnosed PsA was in 32 (52.4%) of 61 patients. Any rheumatic disease, mainly PsA, can develop with psoriasis. mPEST questionnaire in most cases reveals PsA in early stage, however, its isolated use is insufficient to establish an accurate diagnosis, it requires a clear diagnostic algorithm of the disease, including consultation of rheumatologist, clinical and instrumental examination.

Full Text

Restricted Access

About the authors

Maria N. Chamurlieva

Peoples Friendship University of Russia

Email: mchamurlieva@mail.ru
117198, Moscow, Russia
Postgraduate at the Department of Clinical Micology and Dermato-venerology Postgraduate Training Faculty

T. V Korotaeva

Research Institute of Rheumatology

115522, Moscow, Russia

E. Yu Loginova

Research Institute of Rheumatology

115522, Moscow, Russia

E. A Batkaev

Peoples Friendship University of Russia

117198, Moscow, Russia


  1. Gelfand J.M., Gladman D.D., Mease P.J., Smith N., Margolis D.J., Nijsten T. Epidemiology of psoriatic arthritis in the population of the United States. J. Am. Acad. Dermatol. 2005; 53(4): 573.
  2. Garg A., Gladman D. Recognizing psoriatic arthritis in the dermatology clinic. J. Am. Acad. Dermatol. 2010; 63(5):733-48.
  3. Taylor W., Gladman D., Helliwell P., Marchesoni A., Mease P., Mielants H. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthr. Rheum. 2006; 54(8): 2665-73.
  4. Coates L., Helliwell P. Validation of minimal disease activity criteria for psoriatic arthritis using interventional trial data. Arthr. Care Res. 2010; 62(7): 965-9.
  5. Логинова Е.Ю, Коротаева Т.В. Ранний псориатический артрит. Научно-практическая ревматология. 2008; 6: 47-55.
  6. Красненко С.О, Логинова Е.Ю, Коротаева Т.В, Смирнов А.В. Сравнительная характеристика данных магнитно-резонансной томографии, рентгенологического и клинического исследования кистей и стоп у больных с ранним псориатическим артритом. Научно-практическая ревматология. 2013; 2: 149-53.
  7. Ibrahim G., Buch M., Lawson C., Waxman R., Helliwell P. Evaluation of an existing screening tool for psoriatic arthritis in people with psoriasis and the development of a new instrument: the Psoriasis Epidemiology Screening Tool (PEST) questionnaire. Clin. Exp. Rheumatol. 2009; 27(3): 469-74.
  8. Gladman D.D., Schentag C.T., Tom B.D., Chandran V., Brockbank J., Rosen C. Development and initial validation of a screening questionnaire for psoriatic arthritis: the Toronto Psoriatic Arthritis Screen (ToPAS). Ann. Rheum. Dis. 2009; 68(4): 497-501.
  9. Tinazzi I., Adami S., Zanolin E.M., Caimmi C., Confente S., Girolomoni G., et al. The early psoriatic arthritis screening questionnaire: a simple and fast method for the identification of arthritis in patients with psoriasis. Rheumatology (Oxford). 2012; 51(11): 2058-63. doi: 10.1093/rheumatology/kes187
  10. Thomas C.L., Finlay A.Y. The ‘handprint’ approximates to 1% of the total body surface area whereas the ‘palm minus the fingers’ does not (letter). Br. J. Dermatol. 2007; 157(5): 1080-1.
  11. Fredriksson T., Pettersson U. Severe psoriasis-oral therapy with a new retinoid. Dermatologica. 1978; 157(4): 238-44.
  12. Walsh J.A., Callis Duffin K., Krueger G.G., Clegg D.O. Limitations in screening instruments for psoriatic arthritis: a comparison of instruments in patients with psoriasis. J. Rheumatol. 2013; 40(3): 287-93.
  13. Coates L.C., Aslam T., Al Balushi F., Burden A.D., Burden-Teh E., Caperon A.R., et al. Comparison of three screening tools to detect psoriatic arthritis in patients with psoriasis (CONTEST study). Br. J. Dermatol. 2013; 168(4): 802-7.
  14. Haroon M., Kirby B., FitzGerald O. High prevalence of psoriatic arthritis in patients with severe psoriasis with suboptimal performance of screening questionnaires. Ann. Rheum. Dis. 2012; 72(5): 736-40.
  15. Mease J. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinic. Am. Acad. Dermatol. 2013; 69(5): 729-35.
  16. Canete J., Dauden E., Queiro R. Recommendations for the Coordinated Management of Psoriatic Arthritis by Rheumatologists and Dermatologists: A Delphi Study. Actas Dermosifiliogr. 2014; 105(3): 216-32.



Abstract - 39

PDF (Russian) - 0


Article Metrics

Metrics Loading ...



Copyright (c) 2016 Chamurlieva M.N., Korotaeva T.V., Loginova E.Y., Batkaev E.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies