Similar rates of new psoriatic arthritis diagnoses in a dedicated psoriatic disease triage clinic, regardless of referral route.

Abstract

Objectives: To describe the findings from a dedicated psoriatic disease (PsD) triage clinic, including new PsA diagnosis rates, the characteristics of psoriasis (PsO) patients referred by general practitioners (GPs) vs dermatologists and the utility of the Psoriasis Epidemiology Screening Tool (PEST).

Methods: A single-centre, cross-sectional study of consecutive PsO patients with arthralgia referred by either GPs or dermatologists to the PsD Triage Clinic underwent clinical, laboratory and imaging evaluations as appropriate. Patient characteristics were compared by referral route and by PEST scores using a Wilcoxon signed-rank test for continuous variables and a chi-squared test for categorical variables.

Results: Of 158 patients [mean age 49 years (s.d. 14), 63% female], 28% were diagnosed with PsA, with similar rates across referral sources. Dermatology-referred patients had more metabolic comorbidities and more DMARD exposure (P < 0.05), whereas GP-referred patients were more often female and had a family history of PsA (P < 0.05). Overall, PEST demonstrated limited sensitivity (56.8%) and specificity (41.4%) for PsA. Patients with a PEST score ≥3 were older, had higher BMI and more entheseal tenderness than those with a PEST score <3.

Conclusions: A PsD triage clinic facilitated early PsA diagnosis in nearly one-third of referred patients, irrespective of GP or dermatology clinic referral routes.