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Psoriasisarthritis: Relevantes für die dermatologische Praxis

Psoriatic arthritis: important aspects for the dermatological practice

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Zusammenfassung

Hintergrund

Die Psoriasisarthritis ist die wichtigste „Komorbidität“ der Psoriasis und für die dermatologische Praxis in vielfältiger Weise relevant.

Fragestellung

Betrachtet wird die Relevanz einer Gelenkbeteiligung bei Psoriasispatienten für die dermatologische Praxis.

Methode

Es erfolgte die Auswertung von in PubMed®-gelisteten Publikationen (PubMed®, Bethesda, MD, USA) in englischer, deutscher oder französischer Sprache zur Psoriasisarthritis.

Ergebnisse

Die Psoriasisarthritis betrifft zwischen 6 und 42 % der Psoriasispatienten und manifestiert sich in der Regel mehrere Jahre nach Beginn der Hautsymptome. Im Rahmen der Diagnostik haben sich Fragebögen als Screeninginstrumente bewährt. Eine frühzeitige Therapie mit DMARDs („disease modifying anti-rheumatic drugs“) führt zu besonders guten Langzeitergebnissen, weil strukturelle Gelenkschäden und Funktionsverluste verhindert werden können. Hierfür stehen immer mehr systemische Therapien zur Verfügung, die auch für die Behandlung der Psoriasis zugelassen sind.

Schlussfolgerungen

In den letzten Jahren ist es zunehmend unkomplizierter geworden, alle klinischen Facetten der Psoriasis und der Psoriasisarthritis im Rahmen einer Monotherapie effektiv und sicher zu behandeln. Dermatologen kommt insbesondere bei der für die Prognose entscheidenden frühzeitigen Diagnosestellung eine Schlüsselrolle zu. Für die Therapieentscheidung des Dermatologen sind außerdem das Vorhandensein sowie die Ausprägung der Psoriasisarthritis ausschlaggebend.

Abstract

Background

Psoriatic arthritis is the most important “comorbidity” of psoriasis, which impacts the work of dermatologists in many ways.

Objective

The relevance of joint involvement in psoriasis patients for the practicing dermatologist is considered.

Methods

An analysis of publications listed in PubMed® (Bethesda, MD, USA) on the topic of psoriatic arthritis in English, German, or French was carried out.

Results

Psoriatic arthritis affects between 6 and 42% of psoriasis patients, often occurring several years after the onset of psoriasis of the skin. Questionnaires represent validated tools to screen for psoriatic arthritis. Timely initiation of treatment using disease-modifying antirheumatic drugs (DMARD) results in particularly good long-term outcomes, as structural joint damage and functional loss can be prevented. To achieve this goal, increasing numbers of systemic treatment methods are becoming available, which are also approved for the treatment of psoriasis.

Conclusion

In recent years it has become increasingly less complicated to effectively and safely treat all clinical facets of psoriasis and psoriatic arthritis within the framework of monotherapy. Dermatologists are important sentinels when it comes to early diagnosis, which in turn is decisive for the long-term prognosis. The presence and extent of psoriatic arthritis are key criteria in the therapeutic decision-making of dermatologists.

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Authors and Affiliations

  1. Service de Dermatologie et Vénéréologie, Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, 1211, Genève, Schweiz

    Wolf-Henning Boehncke

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  1. Wolf-Henning Boehncke
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Correspondence to Wolf-Henning Boehncke.

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Interessenkonflikt

W.-H. Boehncke hat Honorare als Berater und/oder Referent erhalten von AbbVie, Almirall, Amgen, BMS, Celgene, Janssen, Leo, Lilly, Novartis und UCB.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patienten zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.

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Boehncke, WH. Psoriasisarthritis: Relevantes für die dermatologische Praxis. Hautarzt 72, 946–952 (2021). https://doi.org/10.1007/s00105-021-04892-4

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