title: Psoriatic Disease: Clinical Staging.
abstract: In 2006, the introduction of the concept "psoriatic disease" (PsD) extended the traditional idea of a condition confined to skin and joints. Now we consider PsD a systemic condition, in which the increased activity of tumor necrosis factor acts as the most potent engine for a series of molecular interactions. These lead not only to the genesis of skin and joint symptoms, but also to other clinical aspects such as inflammatory bowel disease, eye involvement, and metabolic syndrome. The blocking of a precise molecular target has dramatically modified therapeutic strategies, making possible adequate control of all the clinical aspects of the condition. Therefore, an expanded clinical staging of patients could now be considered in order to ensure the best therapeutic approach and prognosis.
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist. rscarpa@unina.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Scarpa
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist.
authors.forename: Francesco
authors.initials: F
authors.lastname: Caso
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist.
authors.forename: Luisa
authors.initials: L
authors.lastname: Costa
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist.
authors.forename: Rosario
authors.initials: R
authors.lastname: Peluso
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist.
authors.forename: Angelo
authors.initials: A
authors.lastname: Spanò
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist.
authors.forename: Ennio
authors.initials: E
authors.lastname: Lubrano
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist.
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Puente
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist.
authors.forename: John M H
authors.initials: JM
authors.lastname: Moll
mesh_terms: D015897:Comorbidity; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D011237:Predictive Value of Tests; D011379:Prognosis; D011565:Psoriasis / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000628:therapy; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: DISEASE-MODIFYING ANTIRHEUMATIC DRUGS; INFLAMMATORY BOWEL DISEASES; METABOLIC SYNDROME; PSORIATIC ARTHRITIS; PSORIATIC DISEASE; TUMOR NECROSIS FACTOR-A BLOCKERS