title: Quantitative and Qualitative Changes of Bone in Psoriasis and Psoriatic Arthritis Patients.
abstract: Psoriatic arthritis (PsA) is a chronic inflammatory disease characterized by periarticular bone loss and new bone formation. Current data regarding systemic bone loss and bone mineral density (BMD) in PsA are conflicting. The aim of this study was to evaluate bone microstructure and volumetric BMD (vBMD) in patients with PsA and psoriasis. We performed HR-pQCT scans at the ultradistal and periarticular radius in 50 PsA patients, 30 psoriasis patients, and 70 healthy, age- and sex-related controls assessing trabecular bone volume (BV/TV), trabecular number (Tb.N), inhomogeneity of the trabecular network, cortical thickness (Ct.Th), and cortical porosity (Ct.Po), as well as vBMD. Trabecular BMD (Tb.BMD, p = 0.021, 12.0%), BV/TV (p = 0.020, -11.9%), and Tb.N (p = 0.035, 7.1%) were significantly decreased at the ultradistal radius and the periarticular radius in PsA patients compared to controls. In contrast, bone architecture of the ultradistal radius and periarticular radius was similar in patients with psoriasis and healthy controls. Duration of skin disease was associated with low BV/TV and Tb.N in patients with PsA. These data suggest that trabecular BMD and bone microstructure are decreased in PsA patients. The observation that duration of skin disease determines bone loss in PsA supports the concept of subclinical musculoskeletal disease in psoriasis patients.
authors.affiliation: Department of Internal Medicine 3 and Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany.|St. Vincent Hospital, Medical Department II, The VINFORCE Study Group, Academic Teaching Hospital of Medical University of Vienna, Vienna, Austria.
authors.forename: Roland
authors.initials: R
authors.lastname: Kocijan
authors.affiliation: Department of Internal Medicine 3 and Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Englbrecht
authors.affiliation: Department of Internal Medicine 3 and Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany.|St. Vincent Hospital, Medical Department II, The VINFORCE Study Group, Academic Teaching Hospital of Medical University of Vienna, Vienna, Austria.
authors.forename: Judith
authors.initials: J
authors.lastname: Haschka
authors.affiliation: Department of Internal Medicine 3 and Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Simon
authors.affiliation: Department of Internal Medicine 3 and Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Arnd
authors.initials: A
authors.lastname: Kleyer
authors.affiliation: Department of Internal Medicine 3 and Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Finzel
authors.affiliation: Department of Internal Medicine 3 and Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kraus
authors.affiliation: St. Vincent Hospital, Medical Department II, The VINFORCE Study Group, Academic Teaching Hospital of Medical University of Vienna, Vienna, Austria.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Resch
authors.affiliation: St. Vincent Hospital, Medical Department II, The VINFORCE Study Group, Academic Teaching Hospital of Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Muschitz
authors.affiliation: Institute of Medical Physics, Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Engelke
authors.affiliation: Department of Dermatology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Sticherling
authors.affiliation: Department of Internal Medicine 3 and Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rech
authors.affiliation: Department of Internal Medicine 3 and Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Schett
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism; D015519:Bone Density; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000378:metabolism
keywords: BONE MICROSTRUCTURE; BONE MINERAL DENSITY; COMPUTED TOMOGRAPHY; PSORIASIS; PSORIATIC ARTHRITIS