Toronto Psoriatic Arthritis Screen 2 Utilized as a Screening Tool for Psoriasis

In a recent study published in Journal of Cutaneous Medicine and Surgery, researchers aimed to evaluate the skin-specific questions from the Toronto Psoriatic Arthritis Screen, version 2 (ToPAS 2) utilized for the diagnosis of psoriasis, finding questions related to family history, prior diagnosis, and rash consistent with images of psoriasis were most discriminatory.

The ToPAS 2 questionnaire was administered to participants prior to meeting with dermatologists for an examination for psoriasis. Backward selection regression models were used to create two scoring indexes based off the ToPAS 2 skin-related questions. The first index consisted of all five skin-related questions from ToPAS 2, while the second index only consisted of three out of the five questions. Additionally, researchers performed a statistical analysis using receiver operating characteristic (ROC) curves as a measurement for performance.

The study consisted of participants aged 18 years or older who were recruited from Dermatology and Family Medicine clinics. Of the 258 participants, 32 were diagnosed with psoriasis following a dermatologist examination. The indexes presented high specificity between 82% to 92%, sensitivity between 69% to 84%, and a negative predictive value greater than 95% when diagnosing for psoriasis. The authors noted that the discriminatory power of these models were shown as 0.823 for index 1 and 0.875 for index 2.

The authors confirmed that these results highlighted that the skin-related questions from ToPAS 2 presented discriminatory value in detecting psoriasis. This is especially true for questions relating to family history, a prior diagnosis of psoriasis by a physician, or a comparison of rashes consistent with plaque psoriasis images.

“This study is a valuable step in developing a screening tool for psoriasis,” the authors concluded.

Reference
Taylor JH, Deo M, Sutton M, et al. Assessment of the Toronto Psoriatic Arthritis Screen 2 as a screening tool for psoriasis. J Cutan Med Surg. Published online November 29, 2021. doi:10.1177/12034754211061085