Psoriatic arthritis is chronic inflammatory arthritis that occurs in some patients with psoriasis, but it can occur in people without psoriasis too. Psoriasis is a skin disease that causes a red, scaly rash. Most people develop psoriasis first and are later diagnosed with psoriatic arthritis, but the joint problems can sometimes begin before skin lesions appear.
In America, nearly 7.5 million have psoriasis, and about 30% of them would develop psoriatic arthritis. The symptoms of the disease can be mild or severe. Psoriatic arthritis can start at any age, but often appears between 30 and 50 years old. Men and women are at equal risk of developing the condition.
There are five types of psoriatic arthritis. It is important to know which type of psoriatic arthritis you have so that it can be treated properly. These five types are:
- Symmetric psoriatic arthritis
Symmetric means it affects joints on both
sides of the body at the same time. This type of arthritis is similar to
- Asymmetric psoriatic arthritis
This is often a mild type of psoriatic
arthritis. It’s called asymmetric because it doesn’t appear in the same joints
on both sides of the body.
- Distal psoriatic arthritis
This type causes inflammation and stiffness
near the ends of the fingers and toes, along with changes in toenails and
This refers to pain and stiffness in the
spine and neck.
- Arthritis mutilans
This type is considered the most severe form of psoriatic arthritis. It can cause deformities in the small joints at the ends of the fingers and toes, or even destroy them almost completely.
The cause of psoriatic arthritis is currently unclear. Your immune system attacks your joints and skin unreasonably. Experts believe that a combination of factors play a role in the development of the disease. These risk factors include:
Psoriatic arthritis runs in families. About
40% of people with psoriatic arthritis have one or more relatives with the
Although anyone can develop psoriatic arthritis, it occurs most often in adults
between the ages of 30 and 50.
Factors in the environment may trigger the disease for those with a tendency to have psoriatic arthritis, including virus, extreme stress, or an injury.
About 30% of people with psoriasis would develop
Joint pain and stiffness are the typical symptoms of psoriatic arthritis. Other signs and symptoms include:
- Swelling and tenderness in joints
- Swollen fingers and toes
- Painful muscles and tendons
- Scaly skin patches
- Nail fitting
- Reduced range of motion
- Eye pain or redness
Diagnosing psoriatic arthritis can be difficult because its symptoms frequently resemble those of other types of inflammatory arthritis.
First, your doctor may check your family and medical history and do a physical exam. During the exam, your doctor will closely examine your joints, check your fingernails and press on the soles of your feet to look for signs and symptoms typical of psoriatic arthritis.
As for tests, there is no single test that can
confirm the diagnosis of psoriatic arthritis. But some tests can rule out other
causes of joint pain, such as rheumatoid arthritis or gout.
Imaging tests, including X-rays and MRI, can help pinpoint changes in the joints by producing detailed images of tissues in your body.
Lab tests that can help with the diagnosis of psoriatic arthritis include:
RF is an antibody that’s often present in
the blood of people with rheumatoid arthritis, but it’s not usually in the
blood of people with psoriatic arthritis. So, this test can help your doctor rule
out rheumatoid arthritis.
Your doctor can remove a small sample of
fluid from one of your affected joints using a needle. Uric acid crystals in
your joint fluid may indicate that you have gout rather than psoriatic
There exists no cure for psoriatic
arthritis. Treatment options now are focused on controlling inflammation in
your affected joints to prevent joint pain and disability. Treatment varies
based on the level and area of pain, swelling and stiffness. General treatment
choices involve medications and surgery.
that may work in treating psoriatic arthritis
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin or Advil) or naproxen (Aleve), to reduce pain and inflammation
- Disease-modifying antirheumatic drugs (DMARDs), including methotrexate (Trexall), and leflunomide (Arava), to slow the progression of psoriatic arthritis and save the joints and other tissues from permanent damage
- Immunosuppressants to tame your immune system and control the inflammation, such as azathioprine (Imuran, Azasan) and cyclosporine (Gengraf, Neoral)
- Biologics, including TNF inhibitors, secukinumab (Cosentyx) and ustekinumab (Stelara) to reduce signs and symptoms of the disease
procedures that can be used to treat psoriatic
- Steroid injections
This type of medication reduces
inflammation quickly and is sometimes injected into an affected joint.
- Joint replacement surgery
Joints that have been severely damaged by
psoriatic arthritis can be replaced with artificial prostheses made of metal
Regarding lifestyle, you should take care of your joints in daily life and maintain a healthy weight by proper diet and regular exercise.
Keyword: psoriatic arthritis.