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Abstract Number: 575

Association Of Psoriasis and Psoriatic Arthritis With Systemic Lupus Erythematosus

Ashwini Shadakshari1, Jianghong Yu1 and Andras Perl2, 1Medicine/Rheumatology, SUNY Upstate Medical University, Syracuse, NY, 2Dept of Medicine, SUNY Upstate Medical University, Syracuse, NY

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: SLE and psoriatic arthritis

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Session Information

Session Title: Systemic Lupus Erythematosus - Clinical Aspects I - Renal, Malignancy, Cardiovascular Disease

Session Type: Abstract Submissions (ACR)

Background/Purpose: There is a paucity of literature on the prevalence of psoriasis (Ps) and psoriatic arthritis (PsA) in patients with systemic lupus erythematosus (SLE). To determine whether there are overlaps among these autoimmune diseases, we investigated the prevalence of Ps and PsA in patients with SLE.

Methods: We examined the prevalence of Ps and PsA in 445 patients with SLE based on history, physical examination, laboratory and radiological studies performed between 01/01/1990 and 07/31/12. A diagnosis of psoriasis was made by a dermatologist or rheumatologist while the diagnosis of PsA was made on the basis of CASPER criteria (Arth Rheum 2006; 54: 2665). The diagnosis of SLE was based on ACR criteria (Arth Rheum. 1997; 40: 1725). Prevalence of SLE diagnostic criteria were compared between SLE patients with and without Ps (SLE/Ps+ and Ps-) and with and without PsA (SLE/PsA+ and PsA-). Statistical analyses were performed with chi-square test using Graphpad Prism software with p<0.05 considered significant.

Results: Among 445 patients with SLE, 23 (5.1%) had Ps, out of which 20, (4.5%) patients had PsA. In the general population, the prevalence of Ps and PsA are estimated to be 2% (Rev Bras Reumatol. 2012; 52: 630) and 0.25% (Rev Bras Reumatol. 2012;52:98), respectively. Therefore, the prevalence of PsA, but not Ps, was increased in SLE patients (p < 0.0001). The prevalence of malar rash, discoid rash, photosensitivity, and arthritis were increased while antiphospholipid antibodies were less common in SLE patient with concurrent Ps and PsA (Table 1). There was no significant association of Ps or PsA with seizures, psychosis, oral ulcers, serositis, proteinuria, anemia, leucopenia, thrombocytopenia, hemolytic anemia, anti-Sm, or anti-DNA.

Table 1. Prevalence of SLE diagnostic criteria in patients with (SLE/Ps+) and without psoriasis (SLE/Ps+) as well as in patients with (SLE/PsA+) and without psoriatic arthritis (SLE/PsA+) in a cohort of 445 SLE subjects. The data were analyzed with chi-square test.

 

 

Malar Rash

Discoid Rash

Photosensitivity

Arthritis

APLA

SLE/Ps+

Present

11

4

13

21

1

 

Absent

12

19

10

2

22

SLE/Ps-

Present

118

21

142

211

108

 

Absent

304

401

280

211

314

p value

 

0.0409

0.0118

0.025

0.0001

0.021

 

 

 

 

 

 

 

SLE/PsA+

Present

10

4

12

20

1

 

Absent

10

16

8

0

19

SLE/PsA-

Present

119

21

143

213

108

 

Absent

306

404

282

212

317

p value

 

0.0341

0.0043

0.0156

 <  0.0001

0.038

Conclusion: PsA has increased prevalence in patients with SLE. Subjects with overlapping Ps and PsA may represent a distinct clinical entity within SLE.


Disclosure:

A. Shadakshari,
None;

J. Yu,
None;

A. Perl,
None.

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