Asymptomatic erosive peripheral psoriatic arthritis: a frequent finding in Italian patients

SIR, Painless spondylitis [1], sacroiliac joint involvement[2] and enthesitis [3] have been well described in patientssuffering from psoriatic arthritis (PsA). Two years ago we firstdescribed the occurrence of two cases of asymptomatic erosivepsoriatic polyarthritis [4]. That report demonstrated that inthe peripheral joints the inflammatory process of PsA can alsoinduce bone damage without occurrence of pain, swelling andother clinical signs of arthritis. Furthermore, we showed thatsilent PsA can occur in a destructive manner