Physical trauma is associated with the onset of psoriatic arthritis among those with psoriasis

By Elin Aslanyan

Wednesday, July 8, 2015

Research presented at the annual meeting of the European League Against Rheumatism (EULAR 2015) in Rome suggests that physical trauma greatly increases the risk of developing psoriatic arthritis (PsA) in those with psoriasis.

“The study of more than 70,000 psoriasis patients suggests the risk of psoriatic arthritis (PsA) may increase as much as 50% among [psoriasis patients] exposed to physical trauma, especially a deep trauma to bones and/or joints.”

Up to 30% of patients with psoriasis have psoriatic arthritis. “This is an important finding because the baseline risk is so high that any change in that risk is going to have a large effect on the absolute risk (of PsA),” explains senior study author Thorvardur Love, MD, PhD, an assistant professor of rheumatology at the Landspitali University Hospital in Reykjavik.”

The study data was collected between 1993 and 2013, and compared 15,416 psoriasis patients exposed to trauma with 55,230 unexposed patients. The study concluded that “trauma that involves a deep injury to bone or joint substantially increases PsA risk – 46% for bone trauma and 50% for joint trauma. Nerve or skin traumas do not. According to background information, smaller studies had linked trauma to PsA leading to the idea of what’s called a “deep Koebner” phenomenon playing a role in PsA. This is akin to a “superficial” Koebner phenomenon in skin psoriasis, where a psoriatic lesion often appears in the same area where a skin injury occurred. But, in this case, a “deep” injury provokes PsA in the joint.

While the researchers cannot make any recommendations for behavior change “at this early stage” to reduce the risk of PsA in psoriasis, Dr. Love says the study provides clues to further research into the causes of PsA.”

Research summary and analysis adapted from Rheumatology Network - (


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