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Chandran V, Gottlieb A, Cook RJ et al. Arthritis Rheum 2009;61:1235–42.

Although the skin and joints are regularly assessed through a number of methods in patients who have psoriasis or psoriatic arthritis, it is not clear how reproducible the results from these examinations are. To investigate this issue, the current investigators met and performed a combined physical examination on 20 patients (each investigator assessed 10 patients) to determine the agreement between the tests.

 

Modern anti-tumor-necrosis-factor agents are highly effective for treating cutaneous psoriasis and psoriatic arthritis (PsA). However dermatologists primarily take care of the patients with substantial skin disease and arthritis symptoms, whereas rheumatologists often see patients who present primarily with joint disease and limited skin disease. Should the dermatologist always refer the patients with PsA to a rheumatologist and vice versa? One of the arguments to do so was that rheumatologists are not adequately trained to quantify skin changes whereas the dermatologist cannot assess joint involvement. The current study documents that this inference is wrong.

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