ORIGINAL ARTICLE R. Queiro á C. Sarasqueta á J.C. Torre á T. Tinture I. LoÂpez-Lagunas Comparative analysis of psoriatic spondyloarthropathy between men and women Received: 17 May 2001 /Accepted: 23 July 2001 / Published online: 24 August 2001 Ó Springer-Verlag 2001 Abstract This study analyzed gender-related dierences in a cohort of patients with psoriatic spondyloarthrop- athy SpA) We performed a retrospective cross-sectional study of 100 patients mean age 4814 years; 63 men, 37 women), diagnosed as having psoriatic SpA on the basis of ESSG criteria. All patients were studied ac- cording to a standard protocol, and HLA-B27 and Cw status were analyzed in the study population and their frequencies compared to that of 177 healthy blood do- nors. The clinical features of PsSpA were compared between men and women by univariate analyses. Twenty-three patients showed isolated axial disease M:F ratio 3.6:1), 36 had polyaxial disease M:F ratio 1:1), and 41 showed oligoaxial pattern M:F ratio 1.7:1). HLA-B27 was correlated with male sex P=0.002) and isolated axial disease P=0.016). Univariate analysis showed female sex to be correlated with lower comple- ment levels P<0.05), erosive disease P=0.05), higher swelling joint count P=0.002), and higher scores on the Health Assessment Questionnaire-Speci®c for SpA P<0.05). The HLA-B27 antigen seems to be a de®ned genetic risk factor only in men with psoriatic SpA. The extent of the spondylitic process is quite similar between the two, although women show poorer functional performance and more aggressive peripheral disease. Keywords Psoriatic spondyloarthropathy á HLA-B27 á Psoriasis á Gender analysis Introduction The spondyloarthropathies SpA) are a group of medi- cal conditions which occur frequently in men [1]; with the exception of psoriatic arthritis PsA) and entero- pathic arthropathy the number of men with SpA clearly exceeds that of aected women [1]. Although the HLA- B27 antigen is the strongest genetic risk factor for SpA, it is unclear whether these gender-related dierences regarding the sex distribution of these conditions are due entirely to the presence of this genetic marker [2, 3]. On the other hand, disease expression in SpA may dier in men and women, although the ®ndings of several studies are con¯icting, and no consistent picture has yet emerged [3, 4]. For example, studies in the ®eld of PsA suggest that, in psoriatic spondyloarthropathy PsSpA), and irrespective of HLA status there are gender-related dierences in the expression of the disease [4]. In the present study we examined whether the clinical expression of PsSpA diers between men and women, and, if so, whether these dierences are due in part to HLA status. Patients and methods To analyze the clinical features and gender-related dierences in PsSpA this retrospective cross-sectional study reviewed the clinical records of 100 patients 63 men, and 37 women, mean age 4814 years) diagnosed according to the criteria of the European Spondyloarthropathy Study Group [5]. The majority of these pa- tients were included in a previous report detailing their main clin- ical, immunological, and radiological data [6]. The mean duration of psoriasis was 178 years and that of arthritis 127 years. The Rheumatol Int 2001) 21: 66±68 DOI 10.1007/s002960100135 R. Queiro &) Rheumatology Unit, Hospital San Agustin, Camino de Heros 4, 33400 AvileÂs-Asturias, Spain E-mail: ruquei@mixmail.com C. Sarasqueta Clinical Epidemiology Unit, Hospital Nuestra Sra, de Aranzazu, San Sebastian-Basque Country, Spain J.C. Torre Rheumatology Unit, Hospital Monte Naranco, Oviedo-Asturias, Spain T. Tinture Rheumatology Unit, Hospital San Agustin, Aviles-Asturias, Spain I. LoÂpez-Lagunas Internal Medicine Service, Hospital San Agustin, Aviles-Asturias, Spain Present address: R. Queiro C/Marcelino FernaÂndez 7, 3°B, 33010, Oviedo-Asturias, Spain