Background. Widespread pain from fibromyalgia syndrome (FMS) is observed in patients with psoriatic arthritis (PsA). We hypothesized that there is increased frequency of FMS in patients with PsA that contributes to fatigue and pain. Method. We prospectively enrolled patients with PsA based on the Classification criteria for Psoriatic Arthritis and healthy subjects were used as controls. The frequency of FMS was determined using London Fibromyalgia Epidemiologic Study Screening Questionnaire (LFESSQ) and Symptoms Intensity scale (SIs). Results. 34 PsA patients and 44 controls fulfilled the inclusion criteria. Median age of PsA patients was 52 years with 53.33% females. Median age of controls was 50.5 years with 59% females. FMS was present in 53.33% of PsA patients compared to 4.54% of the controls ( ), based on LFESSQ. 37.50% of PsA had FMS compared to 6.66% of controls ( ) based on SIs. There was a significant correlation between LFESSQ and SIs in the psoriatic group ( ). 76.66% of PsA patients complained of fatigue compared to 40.90% of controls, but the mean fatigue score between the two groups was comparable (5.03 versus 5.18). Conclusion. FMS-associated pain and fatigue are significantly more frequent in patients with PsA compared to controls. 1. Introduction Chronic inflammatory arthritis which includes diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and other forms of spondyloarthritis (SpA) are characterized by joint inflammation leading to joint destruction. Despite significant progress in the treatment of joint inflammation with the availability of biologics, pain that is either related or unrelated to disease activity persists in many patients causing substantial impairment of physical function and quality of life [1, 2]. Chronic widespread non-articular pain from fibromyalgia syndrome (FMS) is observed in patients with several rheumatic diseases: rheumatoid arthritis (57%), systemic lupus erythematosus (40%), and Sj？gren’s syndrome (47%) [3–5]. FMS has also been recently noted in patients with Granulomatosis with Polyangiitis [6]. Pain from FMS has been thought to be secondary to central sensitization [4]. Such pain processing may be due to dysfunctional nervous system responses to physical or psychosocial stressors [7, 8]. Treatment is centered on pain control and behavioral changes that are mostly supportive. Fibromyalgia seen in patients with inflammatory arthritis has been controversially termed secondary fibromyalgia and attributed to underlying inflammation. Proinflammatory cytokines
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