Recognizing psoriatic arthritis in the dermatology clinic.

Dermatologists care for patients with psoriasis in whom there exists an inherent risk of psoriatic arthritis, a condition with potential for causing joint damage and subsequent disability. Most patients have psoriasis for years before the development of psoriatic arthritis, and there may be a significant proportion of psoriasis patients with joint involvement that are cared for by the dermatologist. With the absence of a diagnostic measure, the criterion standard for recognizing or monitoring psoriatic arthritis remains the clinical assessment. Recognition of psoriatic arthritis in the psoriasis patient--and the dermatologist's ability to differentiate it from other types of arthritis--provide an opportunity to improve patient outcomes through early recognition and facilitation of intervention in collaboration with a rheumatologist.