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Abstract Psoriatic arthritis (PsA) is an inflammatory arthritis that belongs to seronegative spondyloarthritis category of inflammatory arthropathies with a number of characteristic clinical features. PsA is typically associated with psoriasis and psoriatic skin disease and has both peripheral articular manifestations (including synovitis,dactylitis and enthesitis) and axial skeletal involvement The most striking feature in PsA is the abundant overexpression of proinflammatory cytokines especially IL23,IL17, TNF alpha,IL6 and IL 13. Musculoskeletal ultrasound (MSUS) has been used for several years to assess joint pathology and may have utility in assessing disease activity in patients with inflammatory joint disease including PsA. Aim: To assess the relation of presence of interleukin 23 in the skin with the musculoskeletal inflammatory process (joints and enthuses) in order to evaluate its possible role in both pathogenesis and early predication of psoriatic arthropathy. Patients& Methods: This study was conducted on forty psoriatic patients. They were classified into two groups, twenty psoriatic patients with musculoskeletal manifestations and twenty patients with skin manifestations.They were subjected to: history taking, clinical examination, skin biopsy and musculoskeletal ultrasound (MSUS) over DIP and knees Results: IL23 is present in psoriatic lesions and there is positive correlation with presence of musculoskeletal manifestations decteted by MSUS. Conclusion: IL23 plays an important pathogenic role in psoriatic skin, joints and enthuses and it has a possible role in inducing arthritis.MSUS is very sensitive in early prediction of psoriatic arthropathy |