Handbook of Psoriasis and Psoriatic Arthritis

124 Pages·2016·2.44 MB·English

by  Richard Warren

Richard Warren · Alan Menter
Handbook of
Psoriasis and
Psoriatic Arthritis
Richard Warren · Alan Menter
Handbook of
Psoriasis and
Psoriatic Arthritis
Richard Warren, MBChB, Alan Menter, MD
FRCP, PhD Division of Dermatology
Baylor University Medical Center
The University of Manchester
Dallas, Texas, USA
Salford Royal Foundation Hospital
Manchester, UK
Handbook of
Psoriasis and
Psoriatic Arthritis
Editors Contributors
Richard Warren, MBChB, FRCP, PhD Matthias Augustin, MD
The University of Manchester Laura Coates, MD, PhD
Salford Royal Foundation Hospital Musaab Elmamoun, MBBS, MRCP
Manchester, UK Paul Emery, MD, FRCP
Oliver Fitzgerald, MD, FRCP, FRCPI
Alan Menter, MD Kenneth B Gordon, MD
Division of Dermatology Rebecca I Hartman, MD, MPH
Baylor University Medical Center Alexa B Kimball, MD, MPH
Dallas, Texas, USA Marc Alexander Radtke, MD
Eric Ruderman, MD
Laura Savage, MD
Zenas Yiu, MBChB, MRCP
ISBN 978-3-319-18226-1 ISBN 978-3-319-18227-8 (eBook)
DOI 10.1007/978-3-319-18227-8
Springer Cham Heidelberg New York Dordrecht London
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Contents
Editor biographies ix
Abbreviations xi
1 Introduction 1
Zenas Yiu, Richard Warren, and Alan Menter
Disease overview and epidemiology 1
Prognosis, morbidity, and mortality 3
Associated comorbidities 3
Therapeutics 4
References 5
2 Pathogenesis of psoriasis and psoriatic arthritis 7
Laura Coates, Laura Savage, and Paul Emery
Pathophysiology of psoriasis 7
Etiology 8
Pathophysiology of psoriatic arthritis 10
Etiology 10
Environmental factors 11
Inflammatory pathways in psoriatic arthritis 11
References 13
3 Clinical presentation of psoriasis and psoriatic arthritis 17
Rebecca I Hartman and Alexa B Kimball
Psoriasis 17
Psoriatic arthritis 21
References 25
4 Diagnosis and evaluation of psoriasis and
psoriatic arthritis 27
Eric Ruderman and Kenneth B Gordon
History 27
Joint exam 29
Entheseal exam 30
V
VI • CONTENTS
Examination for dactylitis 31
Axial evaluation 31
Nail changes 32
Laboratory testing 33
Radiographic evaluation 34
Other imaging modalities 35
Putting it all together: the diagnosis of psoriatic arthritis 36
Classification of psoriatic arthritis: criteria for identification 38
Classification of psoriatic arthritis: CASPAR criteria 39
Measurement of psoriatic arthritis for research: composite
disease activity scores 40
Conclusions 41
References 41
5 Treatment of psoriasis 43
Matthias Augustin and Marc Alexander Radtke
Strategies for psoriasis management: treatment goals and
targeted treatment 43
Topical therapy 45
Systemic therapy 55
Biologics 62
Adjuvant therapies 71
Drug therapies in development 73
Guidelines for management of psoriasis 78
References 80
6 Treatment of psoriatic arthritis 85
Musaab Elmamoun and Oliver Fitzgerald
Treatment goals 85
Treatment strategy 86
Treatment options for therapy in psoriatic arthritis 87
Non-steroidal anti-inflammatories 87
Corticosteroids 89
Synthetic disease-modifying antirheumatic drugs 89
Biologic disease-modifying antirheumatic drugs 91
Other approved biologic disease-modifying antirheumatic drugs 93
CONTENTS • VII
Therapies in development 94
Surgery 95
Quality of life in psoriatic arthritis 96
References 97
7 Quality of life in psoriasis 101
Matthias Augustin and Marc Alexander Radtke
Background 101
Health-related quality of life: a multidimensional concept 102
Measurement of quality of life 103
Factors influencing the quality of life of a patient 103
Concept of cumulative life course impairment 110
Conclusions for psoriasis management 111
References 113
Editor biographies
Richard Warren, MBChB, MRCP, PhD, is a Clinical Senior Lecturer
and Honorary Consultant Dermatologist. He graduated from Liverpool
University with a first class honours degree in Pharmacology and gained his
Medical degree, with honours, one year later. He was awarded The J Hill
Abram prize – highest mark in Medicine; and the Reginald Dora Goodrick
prize – highest mark in Surgery. His work in Dermatology has focused
on: pharmacogenetics (forming the basis of his PhD thesis), the genetic
susceptibility to psoriasis and more recently biological therapies and their
use in the treatment of psoriasis. For his work into the pharmacogenetics
of methotrexate he has received national and international awards from
the British Association of Dermatologists (BAD) and American Academy
of Dermatology. He is widely published in the field of dermatology with
numerous abstracts, papers and book contributions including The Lancet,
Nature Genetics, and The Journal of Investigative Dermatology. He is cur-
rently the EU Editor in Chief for the journal Dermatology and Therapy. He
has been an invited plenary speaker at major national and international
dermatology meetings and is a member of The International Psoriasis
Council. He currently chairs the BAD guideline group for methotrexate
and is a member of the BAD biologics committee and research subcommit-
tee. In 2012, he was the expert panel member on the National Institute for
Health and Clinical Excellence guideline group for psoriasis. He co-lead one
of the two workstreams involved in the recent (2013) successful funding
from the Medical Research Council stratified medicine grant (value £7
million) – Psoriasis Optimisation of Relevant Therapies (PSORT). He co-
established a clinic for patients with severe psoriasis and psoriatic arthritis
in 2010 with Dr Hector Chinoy, which has received wide acclaim and is
used as a national exemplar.
Alan Menter, MD, was born in England and is a graduate of the Medical
School of the University of Witwatersrand, South Africa. He completed
his dermatology residency at Pretoria General Hospital at the University
of Pretoria, also in South Africa, and two fellowships in London at Guy's
Ix
x • EDITOR BIOGRAPHIES
Hospital and St John's Hospital for Diseases of the Skin. A fellowship
with the University of Texas Southwestern Medical Center in Dallas
brought Menter to the United States. Since then, he has held several
positions within the UT and Baylor University Dallas systems. In 1992,
he was appointed Chairman of the Division of Dermatology at Baylor
University Medical Center and still holds that position. In 2007, he was
appointed Director of the Baylor Research Center and in 2010, Program
Director of the newly formed Dermatology Residency Program at Baylor
University Medical Center.
Dr Menter has a long-held interest in psoriasis and psoriatic disease
research. In 1994, he co-authored the first gene discovery for psoriasis,
published in Science in 1994. His research on psoriasis has examined
everything from ultraviolet phototherapy and biologic therapy to the
mapping of genetic patterns to predict if a person is at risk of developing
psoriasis pharmacogenomics. In August 2004, Dr Menter helped found
the International Psoriasis Council to raise international awareness of
psoriasis as a serious autoimmune disease that can significantly impact
quality of life. His clinical practice includes more than 1600 patients on
systemic and biologic therapy.
Dr Menter held the position of clinical director of the National Psoriasis
Foundation Gene Bank from 1996 to 2002. His resume lists some 300+
articles, four books and 19 book chapters. He serves as a member of the
editorial board for several medical journals, including the Journal of Clinical
Dermatology and Clinical and Experimental Dermatology. He is chair of
research for Dermatology at Baylor Research Institute, as well as clinical
professor of dermatology at the University of Texas Southwestern Medical
School in Dallas and professor at Texas A&M Health Science Center, College
of Medicine. Dr Menter has been listed in the Best Doctors in America
since 1994 and Who’s Who in Medicine and Healthcare since 1996. He
also represented the South African National Rugby team, the Springboks,
in 1968. In 2013, Dr Menter received the Lifetime Achievement Award
from the National Psoriasis Foundation. In March 2015, he received the
Dermatology Foundation annual Clark W. Finnerud award at the American
Academy of Dermatology 2015 meeting in San Francisco.
Abbreviations
ACR20 American College of Rheumatology 20 response rate
AS Ankylosing spondylitis
ASAS Assessment of Spondyloarthritis International Society
CASPAR Classification of Criteria for Psoriatic Arthritis
CCP Cyclic citrullinated peptides
CRP C-reactive protein
DIP Distal interphalangeal
DISH Diffuse idiopathic skeletal hyperostosis
ESR Erythocyte sedimentation rate
GRAPPA Group for the Assessment of Psoriasis and
Psoriatic Arthritis
GWAS Genome-wide association studies
HIV Human immunodeficiency virus
HLA Human leukocyte antigen
IBD Inflammatory bowel disease
IL Interleukin
LEI Leeds Enthesitis Index
MEI Mander Enthesitis Index
MRI Magnetic resonance imaging
mSASS The modified Stoke Ankylosing Spondylitis
Spinal Score
NAPSI Nail Psoriasis Severity Index
OA Osteoarthritis
OMERACT Outcomes Measures in Rheumatology
PsA Psoriatic arthritis
PsARC Psoriatic Arthritis Response Criteria
RA Rheumatoid arthritis
RANKL Nuclear factor kappa-B ligand
RF Rheumatoid factor
SpA Spondyloarthritis
TNF Tumor necrosis factor
VA Veterans Affairs
xI