Psoriasis Screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

There are no established guidelines for the screening of cutaneous psoriasis. The national psoriasis foundation recommends screening patients already affected with psoriasis for psoriatic arthritis (PsA). The CASPAR criteria may be used to screen patients for psoriastic arthritis.

Screening

CASPAR (Classification criteria for psoriatic arthritis) criteria

Patients with psoriasis should be screened for the presence of PsA, since early detection and aggressive treatment appear to prevent joint damage.
Patients with psoriasis should be monitored for the development of PsA.^[1]
The simplest approach is to use the newly developed CASPAR (Classification criteria for psoriatic arthritis) criteria.
The CASPAR criteria consists of established inflammatory articular disease with at least 3 points from the following features:^[2]
- Current psoriasis
- History of psoriasis (unless current psoriasis was present)
- Family history of psoriasis (unless current psoriasis was present or there was a history of psoriasis)
- Dactylitis
- Juxtaarticular new bone formation
- Rheumatoid factor negativity
- Nail dystrophy

Current psoriasis is given a score of 2 and all other features are given a score of 1.
A score greater than equal to 3 warrants referral to a rheumatologist.

Psoriasis Epidemiology Screening Tool (PEST)

Another questionnaire exists for psoriatic arthritis, called the Psoriasis Epidemiology Screening Tool (PEST).^[3]

References

↑ Mease PJ, Kivitz AJ, Burch FX, Siegel EL, Cohen SB, Ory P, Salonen D, Rubenstein J, Sharp JT, Tsuji W (2004). "Etanercept treatment of psoriatic arthritis: safety, efficacy, and effect on disease progression". Arthritis Rheum. 50 (7): 2264–72. doi:10.1002/art.20335. PMID 15248226.
↑ Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H (2006). "Classification criteria for psoriatic arthritis: development of new criteria from a large international study". Arthritis Rheum. 54 (8): 2665–73. doi:10.1002/art.21972. PMID 16871531.
↑ "Psoriasis Epidemiology Screening Tool (PEST): A Report from the GRAPPA 2009 Annual Meeting | The Journal of Rheumatology".

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[pmid15248226-1] Mease PJ, Kivitz AJ, Burch FX, Siegel EL, Cohen SB, Ory P, Salonen D, Rubenstein J, Sharp JT, Tsuji W (2004). "Etanercept treatment of psoriatic arthritis: safety, efficacy, and effect on disease progression". Arthritis Rheum. 50 (7): 2264–72. doi:10.1002/art.20335. PMID 15248226.

[pmid16871531-2] Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H (2006). "Classification criteria for psoriatic arthritis: development of new criteria from a large international study". Arthritis Rheum. 54 (8): 2665–73. doi:10.1002/art.21972. PMID 16871531.

[urlPsoriasis_Epidemiology_Screening_Tool_(PEST):_A_Report_from_the_GRAPPA_2009_Annual_Meeting_|_The_Journal_of_Rheumatology-3] "Psoriasis Epidemiology Screening Tool (PEST): A Report from the GRAPPA 2009 Annual Meeting | The Journal of Rheumatology".

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