Aysun AKSOY, Birgul OZKESICI KURT
Rheumatology Quarterly - 2026;4(2):93-101
Objectives: Psoriatic arthritis (PsA) affects approximately one-fifth of psoriasis patients. Given that cutaneous symptoms typically precede joint involvement, dermatologists hold a critical position for early recognition of PsA. Methods: A 30-item structured survey, developed by study authors, was distributed to members of the Turkish Society of Dermatology. This study aims to investigate the current clinical practices, barriers to early recognition, and the factors influencing referral patterns for PsA among dermatologists. Results: Eighty dermatologists participated in the survey. While most respondents inquired about PsA-related symptoms (85%), the utilization of validated screening tools was remarkably low (8.7%). A positive correlation was found between the dermatologists' self-reported competency in assessing PsA-related symptoms and performance of physical examinations (r = 0.667, P = .001). Significant barriers to the early recognition of PsA included a lack of sufficient time in outpatient visits (61.3%) and patient under-reporting (60.0%). Most dermatologists (93.8%) preferred dual-efficacy treatments for their patients with a suspicion of PsA. Initiation of systemic treatment by dermatologists prior to rheumatology consultation was significantly associated with longer waiting times in the rheumatology referral pathway (P = .008). Conclusion: This study demonstrates that standardized screening tools for the early diagnosis of PsA are not routinely integrated into dermatology practice of our study participants, while inquiries about joint and back pain are common. A trend was observed where prolonged waiting periods for rheumatological evaluations coincided with dermatologists initiating systemic treatment independently. Improving screening strategies, musculoskeletal assessment skills of dermatologists, patient awareness, and access to rheumatology care are essential for optimizing clinical practice.
