title: Assessment of osteoporosis in psoriasis with and without arthritis: correlation with disease severity.
abstract: BACKGROUND
  The most frequent extracutaneous association with psoriasis is arthritis. Because proinflammatory cytokines are increased in psoriasis, patients with this disease may be more prone to osteoporosis than the healthy individuals.
  
  
  METHODS
  We evaluated 50 patients with psoriasis, with or without psoriatic arthritis (PsA), for the presence and degree of osteoporosis by performing dual energy x-ray absorptiometry (DEXA) and obtaining serum osteoprotegrin (OPG) levels. In addition, we correlated these results with the extent of skin and joint disease. Psoriasis area and severity index (PASI) was determined in all 50 patients with psoriasis, and total joint score (TJS) was recorded in the 16 patients who also had PsA. Results of DEXA and serum OPG were also obtained for 20 healthy individuals who served as controls.
  
  
  RESULTS
  Osteoprotegrin level was significantly increased in psoriasis patients (with or without PsA) vs. controls. However, DEXA revealed that PsA patients had a higher degree of osteoporosis in the femur neck and wrist. In PsA patients, TJS correlated positively with both disease duration and PASI but correlated negatively with Z score of the femur.
  
  
  CONCLUSIONS
  Psoriasis patients with or without arthritis may suffer from osteoporosis as evidenced by significantly increased serum OPG. Prolonged and extensive cutaneous disease is an important risk factor for the development and severity of PsA. Patients with a greater number of affected joints are at higher risk of osteoporosis.
authors.affiliation: Departments of Dermatology, Venereology, and Andrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. annosah74@hotmail.com
authors.forename: Enas A S
authors.initials: EA
authors.lastname: Attia
authors.forename: Ayman
authors.initials: A
authors.lastname: Khafagy
authors.forename: Sameh
authors.initials: S
authors.lastname: Abdel-Raheem
authors.forename: Sahar
authors.initials: S
authors.lastname: Fathi
authors.forename: Abeer A
authors.initials: AA
authors.lastname: Saad
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015535:Arthritis, Psoriatic / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D010024:Osteoporosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D053244:Osteoprotegerin / Q000097:blood; D011565:Psoriasis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D014953:Wrist / Q000000981:diagnostic imaging; D055815:Young Adult
chemical_list: D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human