Criteria

CASPAR (ClASsification of Psoriatic ARthritis) criteria[2]

Inflammatory articular disease (joint, spine, or entheseal) with ≥3 points from the following 5 categories (current psoriasis score 2 points; all others 1 point):

  1. Evidence of current psoriasis, a personal history of psoriasis, or a family history of psoriasis in a first- or second-degree relative

  2. Typical psoriatic nail dystrophy

  3. A negative test for rheumatoid factor (not the latex test)

  4. Either current or historical dactylitis

  5. Radiographic evidence of juxta-articular new-bone formation appearing as ill-defined ossification near joint margins (periostitis) on plain films of the hand or foot.

These classification criteria are used for epidemiologic and research studies.

American College of Rheumatology classification of severe psoriatic arthritis (PsA)[50]

Diagnosis of severe PsA defined by the presence of one or more of the following items:

  • Erosive disease

  • Elevated markers of inflammation (ESR, CRP) attributable to PsA

  • Long-term damage that interferes with function (i.e., joint deformities)

  • Highly active disease that causes a major impairment in quality of life

  • Active PsA at many sites including dactylitis, enthesitis

  • Function-limiting PsA at a few sites

  • Rapidly progressive disease.

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