**3. Results**

Of the 64 patients with PsA who were enrolled, 49 were male and 15 were female patients. The patient characteristics are shown in **Table 1**. The mean age ± SD of the patients was 55.5 ± 12.9 years (range, 27–80 years), and the mean age at the onset of first symptoms was 36.2 ± 15.7 years (range, 3–70 years). The mean age of the onset of psoriasis (skin lesion) and the osteoarticular lesion was 36.2 years and 47.0 years, respectively. The mean time interval between the onset of skin and osteoarticular lesions was 11.3 years (range, 0–39 years). Regarding the CASPAR criteria, the percentage of confirmed items was 100% for current psoriasis, followed by rheumatoid factor negativity (92.4%), nail lesions (34.8%), juxta-articular new bone formation (25.8%), and dactylitis (16.7%); the mean CASPAR score was 3.75 points (range, 3–6 points).

Regarding the onset patterns of PsA, the skin leading type was dominant in 48 cases (75%), with 10 cases of the osteoarticular leading type (15.6%), followed by 6 cases of the simultaneous type (9.4%). The mean time interval between the presentation of the two different lesion types was 14.2 ± 10.2 years (range, 0.3–39.4 years) in the skin leading type and 4.5 ± 3.3 (range, 0.1–15.1 years) in the osteoarticular leading type. A statistically significant difference (p < 0.001) was observed between the


#### **Table 1.**

*Characteristics of patients with psoriatic arthritis.*

two types (**Table 2**). In addition, no statistically significant difference was observed between the patient's sex and age.

Axial joints were affected in 29% of those in the skin leading group and 60% of the patients in the osteoarticular leading group, although there was no statistically significant difference in the distribution patterns of the affected axial joints (p = 0.16). Axial lesions were observed in a total of 21 cases (53%), with the sacroiliac joints the most affected joints in 14 cases (22%), followed by the thoracic spine in 10 cases (16%), lumbar spine in 9 cases (14%), and cervical spine in 7 cases (11%) (**Table 3**).

Peripheral joints were affected in 92% of the patients in the skin leading type and 100% of the patients in the osteoarticular leading type, without a statistically significant difference (p = 0.99). Regarding the peripheral joint lesions, 53 cases (83%) were observed in the upper extremity and 30 cases (47%) in the lower extremity. In the upper extremity, the joints that were first affected joint were the finger joints in 39 cases (61%), followed by shoulder joints in 22 cases (34%), wrist joints in 12 cases (19%), and elbow joints in 7 cases (11%). In the lower extremity, the joints that were first affected were the toe joints in 12 cases (19%), followed by knee joints in 11 cases (17%), hip joints in 7 cases (11%), and ankle joints in 4 cases (6.3%) (**Table 4**).

Enthesitis was observed in 15 of the total cases (23%). The most affected tendons were the Achilles' and plantar tendons, both with 8 cases (13%), followed by the quadriceps tendon in 6 cases (9.4%) and patellar tendon in 2 cases (3.1%) (**Table 5**).

In our study, the prevalence of obesity was determined to be 55%. Regarding other comorbid lifestyle-related diseases, hypertension was observed in 27 cases (42%), diabetes mellitus in 12 cases (19%), dyslipidemia in 11 cases (17%), and chronic


#### **Table 2.**

*The onset patterns of psoriatic arthritis.*


#### **Table 3.**

*The distribution pattern of axial lesions.*
