Natural History, Prognosis, and Socioeconomic Aspects of Psoriatic Arthritis.

Although early reports suggested psoriatic arthritis was, with the exception of arthritis mutilans, a relatively mild arthritis, later studies have challenged this view. The burden of skin disease adds to disability and impaired quality of life. Patients in secondary care manifest increased morbidity and mortality, mainly owing to cardiovascular disease. A subset of patients, primarily men with oligoarticular disease, demonstrates low levels of joint involvement without disability. The socioeconomic impact of the disease is significant. We require more information on the impact of early diagnosis and treatment on outcome, according to phenotype, to guide policy.