Psoriatic Arthritis is one of the major complications that’s associated with psoriasis. Notably, a relapsing inflammatory skin disease. In fact, an estimated 30 percent of people with Psoriasis Symptoms will go on to develop psoriatic arthritis.
In particular, another type of inflammatory disease that’s caused by both genetic and environmental factors. Psoriatic Arthritis usually appears in people between the ages of 30 to 50, but can begin as early as childhood. Men and women are equally at risk.
Children with psoriatic arthritis are also at risk to develop uveitis (inflammation of the middle layer of the eye). Approximately 15% of people with psoriasis develop psoriatic arthritis.
At times, the Psoriatic Arthritis can appear before the skin disorder.
What is Psoriasis?
Arthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.
Important to realize, it is an immune-mediated disease. Especially that which causes raised, red, scaly patches appearing on the skin. Psoriasis typically affects the outside of the elbows, knees or scalp, though it can appear on any location. Some people report that psoriasis is itchy, burns and stings.
The exact etiology of psoriatic arthritis is unclear. Genetic, immunologic and environmental elements are thought to play a role. Psoriasis and psoriatic arthritis have familial clustering.
The disease is much more likely to occur in first-degree relatives of affected individuals than in the general population or in spouses. Psoriatic arthritis is an inflammatory disease with articular and extra-articular features.
Eventually, the onset of arthritis is usually insidious, but it can occur acutely.
Five general patterns of psoriatic arthritis
- Arthritis of the distal interphalangeal joints
- Destructive (mutilans) arthritis
- Symmetric polyarthritis indistinguishable from rheumatoid arthritis
- Asymmetric oligoarthritis
Terms used to describe specific types of Psoriatic Arthritis Include;
- Oligoarticular: This is a form of mild psoriatic arthritis that affects four or fewer joints in your body.
- Polyarticular: This is a more severe form of psoriatic arthritis and it affects at least four of your joints.
- Spondylitis: This term is used to describe inflammation of the spinal column, which can make the joint motion in your neck and lower back difficult and painful.
- Enthesitis: This is a condition that involves inflammation at the sites where your tendons or ligaments insert into your bones. This may affect areas of your body like the spine, pelvis, ribs, and bottoms of the feet.
- Dactylitis: This form of arthritis refers to the development of inflammation or swelling in your fingers and toes. Dactylitis can cause your fingers or toes to look like sausages and it may lead to hand or foot deformities.
Is Psoriatic Arthritis a Serious Disease?
In a word, the answer is yes. This condition can cause permanent joint and tissue damage if it’s not treated right away.
According to researchers at the University of Rome in Italy, “More than half of all patients with this type of arthritis exhibit progressive erosive arthritis. Associated with severe functional impairment and psychosocial disability.” Studies show that destructive changes to your bones usually appear within a few months from the onset of Psoriatic Arthritis symptoms.
So, seeking medical treatment right away is extremely important. You may be wondering if psoriasis and psoriatic arthritis are related? It’s true that many people who develop psoriatic arthritis have a family history of psoriasis. And having psoriasis is the single greatest risk factor for the development of this type of arthritis.
But, if you have a severe case of psoriasis, that doesn’t necessarily mean that you will have a severe case of psoriatic arthritis. On the other hand, some people have only mild psoriasis symptoms, but experience pain in their joints as a result of psoriatic arthritis.
And in some cases, people develop psoriatic arthritis and don’t experience any skin changes or symptoms of psoriasis at all. There are many different types of psoriatic arthritis and the type will help your doctor to determine the best treatment plan for you.
More Fast Facts you should know about it
To enumerate, Psoriatic arthritis is a form of arthritis that affects some people who have psoriasis. Surprisingly, it is a disease in which scaly red and white patches develop on the skin. And also caused by the body’s immune system going into overdrive to attack the skin.
Some people with psoriasis can also develop psoriatic arthritis, manifested by painful, stiff and swollen joints. Like psoriasis, the symptoms flare and subside, vary from person to person, and even change locations in the same person over time.
Additional facts about Psoriatic Arthritis include;
- It is chronic arthritis: Whereas, in some people, it is mild, with just occasional flare-ups. In other people, it is continuous and can cause joint damage if it is not treated. Early diagnosis is important to avoid damage to joints.
- Typically occurs in people with skin psoriasis: But it can occur in people without skin psoriasis, particularly in those who have relatives with psoriasis.
- Mainly affects the large joints: Especially those of the lower extremities, distal joints of the fingers and toes, and also can affect the back and sacroiliac joints of the pelvis.
- Physical activity helps maintain joint movement: Whereas, for most people, appropriate treatments will relieve pain, protect the joints, and maintain mobility.
What are the Main Causes of Psoriatic Arthritis?
In the first place, it can affect any joint in the body, and it may affect just one joint, several joints or multiple joints. For example, it may affect one or both knees. Affected fingers and toes can resemble swollen sausages, a condition often referred to as dactylitis.
Psoriatic arthritis in the spine, called spondylitis, causes stiffness in the back or neck, and difficulty bending. Psoriatic arthritis also can cause tender spots where tendons and ligaments join onto bones. This condition, called enthesitis, can result in pain at the back of the heel, the sole of the foot, around the elbows or in other areas. Enthesitis is one of the characteristic features of psoriatic arthritis.
As a matter of fact, recent research suggests that persistent inflammation from psoriatic arthritis causes joint damage later. Therefore, early and accurate diagnosis is essential. Fortunately, treatments are available and effective for most people.
To say nothing of, the main causes of psoriatic arthritis remains unanimous. Whereas, of those with psoriatic arthritis, 40% have a family member with psoriasis or arthritis, suggesting heredity may play a role. Psoriatic arthritis can also result from an infection that activates the immune system.
How is Psoriatic Arthritis diagnosed?
According to the National Foundation on the above Arthritis, delaying treatment for psoriatic arthritis for as little as six months. And can result in permanent joint pain and damage. This is why it’s imperative that people who show the symptoms receive treatment as soon as the signs develop.
To say nothing of, to diagnose arthritis, rheumatologists look for swollen and painful joints. Such as certain patterns of arthritis, and skin and nail changes typical of psoriasis. Additionally, X-rays often are taken to look for joint damage. Including, MRI, ultrasound or CT scans can be used to look at the joints in more detail.
Blood tests may be done to rule out other types of arthritis that have similar signs and symptoms.
Including, gout, osteoarthritis, and rheumatoid arthritis. In patients with psoriatic arthritis, blood tests may reveal high levels of inflammation and mild anemia but labs may also be normal.
Anemia is a condition that occurs when the body lacks red blood cells or has dysfunctional red blood cells.
How is Psoriatic Arthritis Medically treated?
Treating psoriatic arthritis varies depending on the level of pain, swelling, and stiffness. Those with very mild arthritis may require treatment only when their joints are painful. And may stop therapy when they feel better.
Non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin or Advil) or naproxen (Aleve) are used as initial treatment. If arthritis does not respond, disease-modifying anti-rheumatic drugs may be prescribed. These include;
- sulfasalazine (Azulfidine),
- methotrexate (Rheumatrex, Trexall, Otrexup, Rasuvo),
- cyclosporine (Neoral, Sandimmune, Gengraf), and
Sometimes combinations of these drugs may be used together. The anti-malarial drug hydroxychloroquine (Plaquenil) can help. But, it usually is avoided as it can cause a flare of Arthritis. Azathioprine (Imuran) may help those with severe forms of psoriatic arthritis.
What is the Biological Treatment of Psoriatic Arthritis?
There are several biologic type medications available to treat psoriatic arthritis via infusion or injection.
- The TNF Inhibitors such as adalimumab (Humira), etanercept (Enbrel), golimumab (Simponi), certolizumab (Cimzia) and infliximab (Remicade) are also available and can help arthritis as well as the skin psoriasis.
- Secukinumab (Cosentyx), a new type of biologic injection, was recently approved to treat arthritis and also can be helpful in treating psoriasis.
- Ustekinumab (Stelara) is a biologic injection given in your doctor’s office that is effective in treating arthritis and psoriasis.
- Abatacept is given to patients who have not responded to one or more DMARDs or other biologic drugs. Abatacept may be used alone or in combination with DMARDs.
- For swollen joints, corticosteroid injections can be useful. Surgery can be helpful to repair or replace badly damaged joints.
Psoriatic Arthritis FAQs & Answers
As a matter of fact, many people with arthritis develop stiff joints and muscle weakness due to lack of use. Proper exercise is very important to improve overall health and keep joints flexible.
This can be quite simple. Walking is an excellent way to get exercise. A walking aid or shoe inserts will help to avoid undue stress on feet, ankles, or knees affected by arthritis.
An exercise bike provides another good option, as well as yoga and stretching exercises to help with relaxation. Below are more questions and answers;
What is the Broader Impact of Psoriatic Arthritis?
On one hand, the impact of arthritis depends on the joints involved and the severity of symptoms. Fatigue and anemia are common. Some patients also experience mood changes. Treating arthritis and reducing the levels of inflammation helps with these problems.
On the other hand, people with psoriasis are slightly more likely to develop high blood pressure, high cholesterol, obesity or diabetes. Maintaining a healthy weight and treating high blood pressure and cholesterol are also important aspects of treatment.
What is Reactive Arthritis?
Reactive arthritis refers to a form of peripheral arthritis often accompanied by one or more extra-articular manifestations. And that appears shortly after certain infections of the genitourinary or gastrointestinal tracts.
The majority of affected individuals have inherited the HLA B27 gene. Caused by Shigella, Salmonella, and Campylobacter microorganisms. As well as by venereally acquired genitourinary infections, usually Chlamydia trachomatis.
Reactive arthritis typically begins acutely two to four weeks after venereal infections or bouts of gastroenteritis. Most venereally acquired cases of reactive arthritis occur in young men. Cases following foodborne enteric infections affect both genders equally.
What are Giant Cell Arteritis (GCA)?
Giant Cell Arteritis or temporal arteritis is a systemic inflammatory vasculitis of unknown etiology that occurs in older persons and can result in a wide variety of systemic, neurologic, and ophthalmologic complications. On one hand, GCA is the most common form of systemic vasculitis in adults with typical onset at the 60 or above.
On the other hand, GCA usually affects the superficial temporal arteries. Hence the term temporal arteritis. And has shown to involve medium- and large-sized vessels.
What is Polymyalgia Rheumatica?
Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness, especially in the shoulders and hip girdles. Symptoms of polymyalgia rheumatica usually begin quickly and are worse in the morning. Most people who develop polymyalgia rheumatica are older than 65. It rarely affects people under 50.
About 20 percent of people with polymyalgia rheumatica also have signs and symptoms of giant cell arteritis. About half of the people with giant cell arteritis may also have polymyalgia rheumatica. The exact cause of polymyalgia rheumatica is unknown. Genetics and environmental factors seem to play a role.
Some people with arthritis find it easier to move in the water. If this is the case, swimming or walking laps in the pool offers activity without stressing joints. Many people with the condition also benefit from physical and occupational therapy to strengthen muscles, protect joints from further damage, and increase flexibility.
Much like the diet and natural treatment for psoriasis, treating psoriatic arthritis naturally involves making dietary and lifestyle changes, and using pain-relieving and anti-inflammatory agents like turmeric and Epsom salt. Although seeking medical attention for psoriatic arthritis is extremely important, as the disease can cause permanent joint damage.
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