Full Papers
A new instrument for the screening of psoriatic arthritis among psoriatic patients
G. De Marco1, A. Marchesoni2, M. Manara3, P. Gisondi4, L. Idolazzi5, R. Ramonda6, S. Piaserico7, A. Cauli8, M.A. Cimmino9, V. Tomatis10, C. Salvarani11, R. Scrivo12, A. Zanetti13, G. Carrara14, C.A. Scirè15, A. Cattaneo16
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, UK.
- Rheumatology of Humanitas San Pio X, Milano, Italy. marchesoni@tiscali.it
- Department of Rheumatology, ASST Gaetano Pini-CTO, Milano, Italy.
- Department of Medicine, Section of Dermatology and Venereology, University Hospital of Verona, Italy.
- Rheumatology Unit, Department of Medicine, University Hospital of Verona, Italy.
- Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Italy.
- Dermatology Unit, Department of Medicine-DIMED, University of Padova, Italy.
- Rheumatology Unit, Department of Medical Sciences and Public Health, University of Cagliari and Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy.
- Department of Internal Medicine DI.M.I, Research Laboratory and Academic Division of Clinical Rheumatology, University of Genova, IRCCS Policlinico San Martino, Genova, Italy.
- Department of Internal Medicine DI.M.I, Research Laboratory and Academic Division of Clinical Rheumatology, University of Genova, IRCCS Policlinico San Martino, Genova, Italy.
- Azienda USL-IRCCS di Reggio Emilia and University of Modena and Reggio Emilia, Italy.
- Rheumatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Italy.
- Epidemiology Research Unit, Italian Society of Rheumatology, Milan, Italy.
- Epidemiology Research Unit, Italian Society of Rheumatology, Milan, Italy.
- Epidemiology Research Unit, Italian Society of Rheumatology, Milan, and School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.
- UOC Dermatologia, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy.
CER17729
2025 Vol.43, N°1
PI 0028, PF 0033
Full Papers
PMID: 39480505 [PubMed]
Received: 29/03/2024
Accepted : 03/06/2024
In Press: 25/10/2024
Published: 23/01/2025
Abstract
OBJECTIVES:
The purpose of this study was to evaluate the performance of a dermatologist-filled-in 7-item questionnaire (called HERACLES) as a screening tool for psoriatic arthritis (PsA) in patients with psoriasis.
METHODS:
This study was performed in Italy in seven dermatology centres cooperating with rheumatology centres. Adults with psoriasis were consecutively recruited up to a calculated number of 750. They were invited to fill in the following questionnaires used for PsA screening: ToPAS, PASE, PEST, and EARP. The dermatologists, in addition to standard demographic and clinical data, scored each participant using a new 7-item questionnaire. All participants were later evaluated by the rheumatologists for a diagnosis of PsA. The performance of the various questionnaires was compared using receiver-operating-characteristic (ROC) area-under-the-curve (AUC) analysis.
RESULTS:
Of the 759 enrolled psoriatic patients, 524 (280 males and 244 females) were suitable for data analysis. PsA was diagnosed in 73 (13.9%) participants. PsA and non-PsA patient characteristics were comparable, except for arthritis-related features which were often more prevalent in the PsA group. The ROC AUC of the HERACLES instrument was 0.775 (CI: 0.722-0.828), similar to that of the other questionnaires (ToPAS 0.757; PASE 0.730; PEST 0.741; and EARP 0.739). For the HERACLES instrument, a score value of 2 yielded a sensitivity of 92% and a specificity of 47%.
CONCLUSIONS:
In this study, a dermatologist-filled-in questionnaire proved to be not inferior to patient-administered PsA screening tools and to be feasible. It might be an alternative (or additional) tool to screen psoriatic patients for rheumatology referral.
