Rheumatol Int (2007) 27:993–994 DOI 10.1007/s00296-007-0353-2 123 LETTER TO THE EDITOR Bone loss in patients with psoriatic arthritis and psoriasis vulgaris Murat Zinnuroflu · Aylin Sepici Dinçel · Murat Orhan Öztao · Funda Kosova · Vesile Sepici Received: 6 February 2007 / Accepted: 25 March 2007 / Published online: 28 April 2007 © Springer-Verlag 2007 Dear Editor, Biochemical markers of bone turnover have proven be of value to predict the rate of bone turnover, bone loss and the risk of osteoporotic fracture and so to help in the prevention and treatment of metabolic bone diseases [1, 2]. Amino ter- minal crosslinked telopeptides of collagen I (NTX) have shown higher diagnostic eYcacy than the traditional serum like urinary pyridinoline or deoxypyridinoline [3]. Reduced bone mass and higher bone resorption markers has been demonstrated in studies on both rheumatologic and some skin diseases [4]. Psoriatic arthritis (PSA) is an inXammatory arthritis that aVects 6–42% of patients with psoriasis. A lot of clinical, laboratory and functional parameters have been utilized for evaluating the patients with rheumatoid arthritis. But there are few studies for the validation of these indices or some new versions to use in patients with PSA [5, 6]. In this study, we aimed to investigate the biochemical parameters of bone resorption, which are known to be more sensitive in patients with PSA and psoriasis vulgaris (PSV). The study participants (10 PSA, 19 PSV and 14 controls) were randomly selected from the patients attending the Dermatology and Physical Medicine and Rehabilitation clinics of Medical School Hospital of Gazi, Ankara, Turkey (Table 1). Informed consent was obtained from patients and controls. Ten patients were diagnosed with PSA according to the clinical and laboratory Wndings [7]. The including criteria were inXammatory arthritis associated with psoriasis, no evidence of rheumatoid factor and at least a 6-months gap after the diagnosis. Five of the patients were receiving methotrexate (doses ranged from 7.5 to 15 mg for a week) and nine of them were on regular nonsteroid anti-inXamma- tory drug (NSAID) treatment. None of the patients pre- sented spondylitis or sacroiliitis, all of them had arthritis in various peripheral joints. The exclusion criteria were; using treatments, which aVects bone metabolism (like corticoster- oids, thyroxin, hormone replacement therapy antiresorptive agents, calcium and vitamin D except methotrexate) present or in the previous six months’ period and/or having dis- eases, which may aVect bone metabolism. The activity of PSA was assessed by the following indices; swollen joint count, tender joint count, duration of morning stiVness (as minutes) and laboratory activity parameters. Nineteen patients were diagnosed as PSV due to typically chronic erythematous plaques covered by silvery white scales on various sides of body and absence of other skin and rheu- matologic diseases. All of the patients were using topical treatment for skin lesions. One of them was receiving NSAID for myofascial pain. None of the patients were using disease modifying antirheumatic drugs. Serum NTX (sNTX) and urine NTX (uNTX) levels (nmol BCE/mmol Cr) were measured using an enzyme- linked immunosorbent assay (ELISA). All urinary concen- trations were expressed as a ratio to urinary creatinine. In M. Zinnuroflu (&) · V. Sepici Department of Physical Medicine and Rehabilitation, Gazi University Medical Faculty, 06500 Beoevler, Ankara, Turkey e-mail: muratz@gazi.edu.tr; muratzinnuroglu@yahoo.com A. S. Dinçel · F. Kosova Department of Medical Biochemistry, Gazi University Medical Faculty, Ankara, Turkey M. O. Öztao Department of Dermatology, Gazi University Medical Faculty, Ankara, Turkey