Clinical characteristics and comorbidities in psoriatic arthritis: Experience from a single rheumatology centre in Malaysia

Abstract

Aim of the work: To evaluate the clinical features and associated comorbidities of psoriatic arthritis (PsA) patients from a single rheumatology centre in Malaysia. Patients and methods: 247 PsA patients in rheumatology clinic, Raja Permaisuri Bainun Hospital were included. Clinical and laboratory data were retrieved from the medical record. Results: The mean age was 56 ± 13.5 years, 56.1% were female, and 38.9% were Indians. The onset of psoriasis and PsA was significantly earlier among Malays (P < 0.01) whilst Indians had longer disease duration (P < 0.05). The mean duration of progression from psoriasis to PsA was 8.7 years. Alcohol and nail dystrophy were common among Indians (P < 0.05). Plaque psoriasis was the commonest subtype (81%) in nails (pitting, 42.5%; ony cholysis, 20.7%), scalp (35.6%) and limbs (32.8%). Pustular psoriasis and onycholysis were common in males (P = 0.05 and 0.002, respectively) whilst scalp psoriasis in females (P < 0.05). Peripheral arthritis was the highest (92.7%) compared to axial (8.1%); 14.6% had both. 38.9% were oligoarthritis and mostly asymmetrical (35.6%). 24% had enthesitis, 14.6% dactylitis, and 0.8% uveitis. 52.2% had hypertension, followed by dyslipidemia (44.1%), diabetes mellitus (34%), obesity (30%), ischemic heart disease (9.7%), cancer (2.4%), and tuberculosis (0.4%). No significant relationship between the pattern of arthritis and these comorbidities (P > 0.05). Conclusion: PsA was more prevalent in Indians. Malays have younger disease onset. Pustular psoriasis and onycholysis were common in males, while scalp psoriasis in females. Asymmetrical oligoarthritis and plaque psoriasis were the commonest pattern and psoriasis subtype respectively. Comorbidities were not associated with the pattern of arthritis in PsA patients.