Psoriatic Arthritis — SCE Dermatology MCQ

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HardInflammatory DermatosesPsoriatic ArthritisSCE Dermatology

A 40-year-old man with psoriasis and psoriatic arthritis affecting his distal interphalangeal joints is being assessed for biologic therapy. According to NICE/BAD, what validated tool should be used to assess psoriatic arthritis severity alongside dermatological assessment?

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Correct answer: E — PsARC or DAPSA

PsARC (Psoriatic Arthritis Response Criteria) and DAPSA (Disease Activity in Psoriatic Arthritis) are validated tools for assessing psoriatic arthritis severity and treatment response, alongside PASI/DLQI for skin assessment. NICE biologic guidelines require assessment of both skin and joint disease. DAS28 is designed for rheumatoid arthritis and may underestimate psoriatic arthritis severity (it does not assess DIP joints or enthesitis). BASDAI is for axial spondyloarthropathy. CASPAR criteria are diagnostic, not severity assessment tools. Multidisciplinary assessment with rheumatology is essential.

Reference: NICE TA199 2023 Biologics for PsA; BAD 2020 Psoriasis Guidelines