A recent study identified gender disparities in disease presentation in psoriatic arthritis patients, with women more likely to present with polyarthritis and men more likely to present with oligoarthritis. Men were also at greater risk of nail involvement and hyperuricemia.
Psoriasis is a polymorphic disease with a varied clinical presentation. Though the disease typically starts with skin manifestations, in many cases, joint issues may be followed by the diagnosis of skin rashes. Apart from the skin, psoriasis may affect almost any part of the musculoskeletal system. Thus, it may cause either oligoarticular or polyarticular peripheral arthritis or axial arthritis, mainly involving inflammatory back pain.
Additionally, it may cause many other health issues, like nail lesions, uveitis, and inflammatory bowel disease. Due to the varied presentation of the disease, it is vital to understand disparities in disease presentation in various population groups, including those between men and women.
Psoriatic Arthritis Presentation Differs Among Genders
This retrospective study was conducted as a single-center study at the rheumatology department of Amiens University Hospital, France. It compared the disease history of 132 patients who sought consultation and/or required day hospitalization or conventional hospitalization over a 4-month period. The gender ratio of the study was 1:1. Results of the study were published in the Journal of Clinical and Translational Research.
The average age of male patients was 55 years, and the average age of female patients was 54.5 years. Men were more likely to abuse alcohol. Women were significantly more likely than men to be obese (39.4% vs. 24.2%, respectively). Women were more likely to experience mood disorders (1.7 times more than men).
Several Disparities Noted
The study found significant gender disparities, though these disparities were consistent with the literature. The polyarticular form, obesity, enthesitis, and more extensive prescription of synthetic and biologic DMARDs were much more common in females. On the other hand, men were more likely to develop the oligoarticular form, psoriatic nail dystrophy, radiological axial involvement, and chronic hyperuricemia (five gout cases were reported in men and none in women). The study also found that the HLA-B*27 allele seems to increase the risk of axial PsA, though the test was not performed in all patients.
The Bottom Line
The study confirmed the early findings mentioned in the literature. However, it had some limitations, including its retrospective and monocentric design. In the future, more extensive studies are needed to explore gender disparities, as this would help provide better medical care to people of different genders.
Menis, J., Doussiere, M., Touboul, E., Barbier, V., Sobhy-Danial, J.-M., Fardellone, P., Fumery, M., Chaby, G., & Goëb, V. (2023). Current characteristics of a population of psoriatic arthritis and gender disparities. Journal of Clinical and Translational Research, 9(2), 84–92. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10075088/