Six Domains: One Disease

Welcome to Six Domains: One Disease, on this website you will find further information about Psoriatic Arthritis (PsA), its diagnosis and management.

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PsA is characterised by the presence of up to six different ‘domains’1, an understanding of which is vital in order to ensure correct and timely diagnosis.
This website aims to differentiate and drive understanding of PsA as a heterogeneous disease, distinct from Rheumatoid Arthritis (RA), requiring treatment and management to address the six domains.

PsA in the UK; the facts

Expert opinion
Dr. Laura Savage discusses the role of the dermatologist in the management of PsA, and the importance of communication between dermatology and rheumatology practices.
“At each touch point with the patient, the nurse, the doctor, the physician's associate should be vigilant for the signs and symptoms of new or inadequately managed psoriatic arthritis and escalate their observations and concerns either to the consultant or directly to the rheumatologists”

Living with PsA

“My joints, fingers and wrists started to stiffen up, about seven years later I got to the point where my life was so badly affected that I couldn’t really play cricket or golf anymore…it was a helpless feeling, things were getting steadily worse, work was becoming a problem; the first half an hour to 45 minutes in the morning was really bad until things warmed up.”
Charles, PsA patient

“PsA is a painful inflammatory disease which is closely associated with psoriasis; approximately one third of psoriasis patients experience painful joints, nail disease, swollen tendons, and numerous other complications which come with a diagnosis of PsA. The disease poses a significant impact on a patient’s quality of life, and with no definitive guidelines to support diagnosis, it is important that patients and doctors alike recognise the six domains of PsA in order to ensure effective management of the disease.”
Helen McAteer, Chief Executive of the Psoriasis Association

Expert opinion
Dr. Laura Coates discusses some of the challenges with diagnosing PsA and explains the importance of the six domains in managing the disease.
“I have patients who have involvement of all six domains at different times of their disease, and others who will have only one or two depending on how PsA presents, so it’s really important to think about which domain is present in each patient.”

1. Coates LC, et al. Arthritis Rheumatol 2016;68:1060–71.

The information on this site is intended for healthcare professionals in the United Kingdom / Ireland and is not intended for the general public.