SCREENING OF PSORIATIC ARTHRITIS IN PATIENTS OF PSORIASIS USING CASPAR CRITERIA

Authors

  • Laila Irshad Registrar Dermatology CMH Gujranwala
  • Moizza Tahir PEMH Rawalpindi
  • Sidiqua Javaid PEMH Rawalpindi
  • Rabia Mughal CMH Rawalpindi
  • Saadia Jabeen CMH Gujranwala
  • Muhammad Ali Nasir CMH Quetta

Keywords:

Arthritis, Psoriatic, Psoriasis, Cross-Sectional Study, Epidemiology, Diagnosis

Abstract

Background: Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis. Psoriasis patients are more likely to have PsA with prevalence ranging from 6‒41%. It is associated to various morbidities and irreversible joint damage. PsA can cause joint degradation and disability if left untreated. So, it's critical to recognize and intervene early. This study aimed to determine the prevalence of subclinical PsA in psoriasis patients using CASPAR criteria. Methods: This was a cross-sectional study conducted in Dermatology Department of Tertiary Care Hospital Gujranwala from 1 December 2023-31 May 2024. All psoriasis patients were enrolled & evaluated for PsA. Inclusion criteria was psoriasis patients of any type, severity and either sex between the ages of 18-70 years. While those with pregnancy or other forms of arthritis were excluded. Data was collected using a pre-designed questionnaire based on CASPAR criteria. Statistical analysis was conducted using SPSS version 23. Results: Thirty-eight patients were included. Of whom 29 (76.32%) were having subclinical PsA according to CASPAR criteria. In PsA group, psoriasis duration was long (median 9.0 years) and PASI scores were higher (median 7.0) than non-PsA group (median 2.0 years and median 7.0). Both differences were statistically significant (p=0.00, p=0.003). Age (p=0.756) and gender (p=0.18) did not differ significantly. Nine (23.7%) were affected by psoriatic nail dystrophy, which is similar to juxta-articular new bone (23.7%). Conclusions: CASPAR criteria is an effective criteria for early diagnosis of subclinical PsA. This study also highlighting the importance of early detection to prevent permanent joint damage and comorbidities.

References

1. World Health Organization. Global report on. Glob Rep Psoriasis [Internet]. 2016;978:1–26. Available from: http://www.who.int/about/licensing/copyright_form/index.html%0Ahttp://www.who.int/about/licensing/

2. Ogdie A WP. The Epidemiology Psoriatic Arthritis. Physiol Behav. 2017;176(3):139–48.

3. Rech J, Sticherling M, Stoessel D, Biermann MHC, Häberle BM, Reinhardt M. Psoriatic arthritis epidemiology, comorbid disease profiles and risk factors: Results from a claims database analysis. Rheumatol Adv Pract. 2020;4(2):1–9.

4. Hagenström K, Müller K, Garbe C, Augustin M. Prevalence of psoriasis and psoriatic arthritis in Germany - analysis of claims data. J Dtsch Dermatol Ges. 2024;22(1):45–54.

5. D’Agostino MA, Said-Nahal R, Hacquard-Bouder C, Brasseur JL, Dougados M, Breban M. Assessment of peripheral enthesitis in the spondylarthropathies by ultrasonography combined with power Doppler: A cross-sectional study. Arthritis Rheum [Internet]. 2003 Feb 1 [cited 2024 Nov 26];48(2):523–33. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/art.10812

6. Zabotti A, Tinazzi I, Aydin SZ, McGonagle D. From Psoriasis to Psoriatic Arthritis: Insights from Imaging on the Transition to Psoriatic Arthritis and Implications for Arthritis Prevention. Curr Rheumatol Rep [Internet]. 2020 Jun 1 [cited 2024 Nov 28];22(6):1–9. Available from: https://link.springer.com/article/10.1007/s11926-020-00891-x

7. Coates LC, Conaghan PG, Emery P, Green MJ, Ibrahim G, MacIver H, et al. Sensitivity and specificity of the classification of psoriatic arthritis criteria in early psoriatic arthritis. Arthritis Rheum. 2012;64(10):3150–5.

8. Montes de Oca Pedrosa A, Oakley A, Rogers J, Rangaitaha Epiha M. PASI vs PO-PASI: Patient-Oriented PASI (PO-PASI) is comparable to clinician score PASI. Australas J Dermatol. 2022;63(1):e67–70.

9. Congi L, Roussou E. Clinical application of the CASPAR criteria for psoriatic arthritis compared to other existing criteria. Clin Exp Rheumatol. 2010;28(3):304–10.

10. Deike M, Brinks R, Meller S, Schneider M, Sewerin P. Risk of psoriatic arthritis depending on age: Analysis of data from 65 million people on statutory insurance in Germany. RMD Open. 2021;7(3):1–5.

11. Ejaz A, Iftikhar A, Iftikhar N. Patterns of psoriatic arthritis. J Coll Physicians Surg Pakistan. 2009;19(9):553–6.

12. Sultan N, Chaudhry AA, Rehman S, Butt G, Aman S, Shaukat S, et al. Frequency of psoriatic arthritis in patients of psoriasis presenting to Dermatology Department, Mayo Hospital, Lahore. J Pakistan Assoc Dermatologists. 2020;30(2):331–5.

13. El-Sherif SM, Gaweesh T, Genedy RM. Diagnosis of subclinical psoriatic arthritis in patients with psoriasis using CASPAR criteria: a sonographic study. Egypt Rheumatol Rehabil [Internet]. 2022;49(1). Available from: https://doi.org/10.1186/s43166-022-00158-6

14. Fragoulis GE, Nikiphorou E, McInnes IB, Siebert S. Does Age Matter in Psoriatic Arthritis? A Narrative Review. J Rheumatol. 2022;49(10):1085–91.

15. Çinar N, Bodur H, Eser F, Gül Ü, Gönül M, Oğuz ID. The prevalence and characteristics of psoriatic arthritis in patients with psoriasis in a Tertiary hospital. Arch Rheumatol. 2015;30(1):23–7.

16. Egeberg A, Skov L, Zachariae C, Gislason GH, Thyssen JP, Mallbris L. Duration of psoriatic skin disease as risk factor for subsequent onset of psoriatic arthritis. Acta Derm Venereol. 2018;98(6):546–50.

17. Umezawa Y. Psoriatic arthritis. J Dermatol. 2021;48(6):741–9.

18. Hioki T, Komine M, Ohtsuki M. Diagnosis and Intervention in Early Psoriatic Arthritis. J Clin Med. 2022;11(7):1–11.

19. Ogdie A, Bekele D, Duarte-garcía A. Population-Based Study. 2023;1–13.

20. Pouw JN, Jacobs ME, Balak DMW, Van Laar JM, Welsing PMJ, Leijten EFA. Do Patients with Psoriatic Arthritis Have More Severe Skin Disease than Patients with Psoriasis Only? A Systematic Review and Meta-Analysis. Dermatology. 2022;238(6):1108–19.

21. Zhong H, Yang H, Mao Z, Chai X, Li S. Impact of moderate-to-severe psoriasis on quality of life in China: a qualitative study. Health Qual Life Outcomes [Internet]. 2021;19(1):1–9. Available from: https://doi.org/10.1186/s12955-021-01902-w

22. Coates LC, Wallman JK, McGonagle D, Schett GA, McInnes IB, Mease PJ, et al. Secukinumab efficacy on resolution of enthesitis in psoriatic arthritis: Pooled analysis of two phase 3 studies. Arthritis Res Ther. 2019;21(1):1–13.

23. D’Agostino MA, Said-Nahal R, Hacquard-Bouder C, Brasseur JL, Dougados M, Breban M. Assessment of peripheral enthesitis in the spondylarthropathies by ultrasonography combined with power Doppler: A cross-sectional study. Arthritis Rheum. 2003;48(2):523–33.

24. Saeed M, Zaman T, Rashid T, Jahangir M. Evaluation of joint involvement in patients of psoriasis: An observational study. J Pakistan Assoc Dermatologists. 2008;18(1):6–8.

25. Geng Y, Song Z, Zhang X, Deng X, Wang Y, Zhang Z. Improved diagnostic performance of CASPAR criteria with integration of ultrasound. Front Immunol. 2022;13(October):1–8.

Published

2026-05-21

How to Cite

1.
Irshad L, Tahir M, Javaid S, Mughal R, Jabeen S, Nasir MA. SCREENING OF PSORIATIC ARTHRITIS IN PATIENTS OF PSORIASIS USING CASPAR CRITERIA. J Ayub Med Coll Abbottabad [Internet]. 2026 May 21 [cited 2026 May 22];37(4). Available from: https://jamc.ayubmed.edu.pk/index.php/jamc/article/view/14308

Issue

Vol. 37 No. 4 (2025): 37-4

Section

ORIGINAL ARTICLE

License

Copyright (c) 2026 Laila Irshad, Moizza Tahir, Sidiqua Javaid, Rabia Mughal, Saadia Jabeen, Muhammad Ali Nasir

Creative Commons License

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

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.