title: Ultrasound study of entheses in psoriasis patients with or without musculoskeletal symptoms: A prospective study.
abstract: OBJECTIVE
  To estimate the prevalence of ultrasonographic enthesitis in psoriasis patients with or without musculoskeletal symptoms and to investigate their evolution under systemic treatments given for the cutaneous symptoms.
  
  
  METHODS
  Prospective bi-centre (rheumatology and dermatology) study over 6months, including psoriasis pts requiring systemic treatment, with or without musculoskeletal symptoms and/or psoriatic arthritis (PsA). Clinical assessment (M0 and M6) included: BASDAI, HAQ, SPARCC, PASI and nail disease. US assessment (M0 and M6) with Grey Scale and PD of 10 entheses was performed by one trained rheumatologist blinded to clinical and biological data, scoring morphological, structural lesions and PD signal.
  
  
  RESULTS
  Complete data were obtained on 340 entheses in 34 patients. Twenty-two were asymptomatic (PsO) and 12 symptomatic (PsA). They received conventional treatment and/or biologics.
  US abnormalities were found in 97.1% total population and in 86.4% PsO patients. 95/340 enthesitis were observed, 57/220 in PsO vs 38/120 in PsA (P=0.258). Neither group had PD signal. Presence of 24/90 enthesitis in patients with nail disease vs 33/130 without (P=0.831). AT M6: Twenty-three patients were assessed. US morphological (thickness and hypoechogenicity) abnormalities were improved in PsO (n=13) (P=0.021) and PsA patients (n=10) (P=0.164) with a significant decrease of BASDAI, HAQ, SPARCC.
  
  
  CONCLUSIONS
  We observed a high frequency of US enthesitis in psoriasis patients, with or without musculoskeletal symptoms, requiring systemic treatment. At 6months, US morphological abnormalities were likely to improve. Further studies would be interesting to validate our data and to assess their potential impact on PsA development.
authors.affiliation: Department of Rheumatology, University Hospital of Nice, Nice, France. Electronic address: acquacalda.e@chu-nice.fr.
authors.forename: Emilie
authors.initials: E
authors.lastname: Acquacalda
authors.affiliation: Department of Rheumatology, University Hospital of Nice, Nice, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Albert
authors.affiliation: Department of Dermatology, University Hospital of Nice, Nice, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Montaudie
authors.affiliation: Department of Clinical Research and Innovation, University Hospital of Nice, Nice, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Fontas
authors.affiliation: Department of Rheumatology, University Hospital of Nice, Nice, France.
authors.forename: Agnes
authors.initials: A
authors.lastname: Danre
authors.affiliation: Department of Rheumatology, University Hospital of Nice, Nice, France.
authors.forename: Christian Hubert
authors.initials: CH
authors.lastname: Roux
authors.affiliation: Department of Rheumatology, University Hospital of Nice, Nice, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Breuil
authors.affiliation: Department of Dermatology, University Hospital of Nice, Nice, France.
authors.forename: Jean Philippe
authors.initials: JP
authors.lastname: Lacour
authors.affiliation: Department of Dermatology, University Hospital of Nice, Nice, France; Inserm, U1065, Centre Méditerranéen de Médecine Moléculaire (C3M), team 12, Nice, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Passeron
authors.affiliation: Department of Rheumatology, University Hospital of Nice, Nice, France.
authors.forename: Liana Euller
authors.initials: LE
authors.lastname: Ziegler
mesh_terms: D000328:Adult; D015535:Arthritis, Psoriatic / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000150:complications / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000209:etiology*; D013997:Time Factors; D014463:Ultrasonography
keywords: Biological therapies; Psoriasis; Psoriatic arthritis; Subclinical enthesitis; Ultrasonography