Among psoriasis patients, the recorded prevalence of psoriatic arthritis has varied widely due to study design. The highest prevalence has been observed in hospital-based clinic patients, reflecting a referral bias of more severe cases. In community-based psoriasis cohorts, the prevalence is much lower at <10%. In a recent community-based study using the new CASPAR (ClASsification of Psoriatic ARthritis) criteria, the cumulative 20-year incidence of psoriatic arthritis is 7.5%. Forty-one percent of the arthritis cases were identified concurrently with onset of skin disease. The remainder developed arthritis at a mean of 7 years after the onset of psoriasis.
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