Traitement biologique et rhumatisme psoriasique
Recension documentaire pour les dermatologues
Résumé
Dans les cabinets de dermatologie achalandés, l’évaluation clinique du rhumatisme psoriasique qui s’ajoute au fardeau traditionnel composé de discussions concernant le diagnostic et les options de prise en charge du psoriasis représente parfois un défi professionnel. Il est à noter que, les données laissent entendre que les dermatologues ont de la difficulté à évaluer le rhumatisme psoriasique chez leurs patients atteints de psoriasis. Une étude d’évaluation de la prévalence du rhumatisme psoriasique dans les cliniques de dermatologie a révélé que près d’un tiers des patients atteints de psoriasis en plaques étaient également atteints de rhumatisme psoriasique. De plus, environ 40 % de ces patients avaient récemment fait l’objet d’un diagnostic de rhumatisme psoriasique, bien qu’ils n’eussent jamais fait l’objet d’un tel diagnostic auparavant. Cette constatation laisse entendre que les dermatologues ne détectent peut-être pas tous les cas de rhumatisme psoriasique. Les dermatologues sont particulièrement bien placés pour établir précocement un diagnostic de rhumatisme psoriasique et prévenir ainsi l’aggravation des affections rhumatismales. Le psoriasis se manifeste habituellement de 7 à 12 ans avant le rhumatisme psoriasique, puisque 64,5 % des patients visés par un diagnostic de rhumatisme psoriasique avaient déjà fait l’objet d’un diagnostic de psoriasis. Aux fins de comparaison, seulement 19,4 % des patients ont fait l’objet d’un diagnostic de rhumatisme psoriasique avant le diagnostic de psoriasis. Un retard d’à peine 6 mois dans la manifestation des symptômes par rapport à la visite initiale chez le rhumatologue a été associé à une aggravation de l’érosion des articulations périphériques et à une détérioration de la capacité physique à long terme.
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