Dactylitis Indicates a Severe PsA Phenotype Save

A recent study analyzed the impact of dactylitis in disease-modifying antirheumatic drug (DMARD)-naive early psoriatic arthritis (PsA) and found that DMARD-naive PsA patients with dactylitis (dactylitic PsA) have a greater burden of disease than those without dactylitis. 

The study included 177 PsA patients - of whom 81 had dactylitis (dactylitic PsA; 46%).  Such patients had:

• higher tender joint count (p<0.01),
• swollen joint count (SJC) (p<0.001) and
• C reactive protein (CRP) (p<0.01)

Dactylitis was more often found in the toes (68%) than fingers (32%).

Dactylitis was frequently associated with more ultrasound (US) synovitis and erosions (p<0.001 and p<0.001, respectively). Synovitis by US was found in 54% of dactylitis. No substantial correlations were seen with US enthesitis.

Dactylitis portends a more severe disease phenotype independently associated with an increased disease burden. Therefore, finding dactylitis early helps in risk stratification of PsA.