Facts about Psoriatic Arthritis
Psoriatic arthritis is a form of an inflammatory arthritis that affects millions of people.
Sometimes individuals will have psoriasis as an initial condition, and then they will present with psoriatic arthritis.
Like lupus, psoriatic arthritis occurs when the immune system attacks healthy cell tissues which causes the joints to get inflamed and the skin to make many cells.
There are five different types of Psoriatic Arthritis.
Symmetric Psoriatic Arthritis:
This type of arthritis affects the same joints on opposite sides of the body. It can be disabling and can cause varying degrees of progressive, and destructive disease and loss of function in 50% of people with arthritis. This type of arthritis is very similar to rheumatoid arthritis.
Asymmetric Psoriatic Arthritis:
This usually involves one to three joints in the body. It does not affect matching pairs of joints on opposite sides of the body.
This arthritis involves primarily small joints in the fingers and toes closest to the nail.
Distal Interphalangeal Predominant (DIP)
DIP is also called Osteoarthritis which is a chronic disease that causes the deterioration of joint, cartilage and bone.
This arthritis affects the spinal column and may cause inflammation and stiffness in the neck, lower back, spine vertebrae or pelvic region making motion more difficult.
Spondylitis can attack connective tissue, such as ligaments, or cause arthritic disease in the joints of the arms, hip, legs or feet.
Psoriatic arthritis affects men and women equally and approximately 10-30 % of people with Psoriasis develop psoriatic arthritis. Psoriatic arthritis usually starts between the ages of 30-50 years old.
Triggers for Psoriatic Arthritis:
Genetic factors, along with a compromised immune system plays a role in determining who will develop it. Up to 40% of people with Psoriatic arthritis have a family history of skin or joint disease. Having a parent with psoriasis triples the chance for someone to get psoriasis. This in turn, increases the chance of having psoriatic arthritis.
Injuries to the skin such as a skin infection, skin inflammation or excessive scratching can trigger psoriasis
Sunlight may aggravate their symptoms
Streptococcal infections can cause plaque psoriasis
Certain medications such as Lithium used to treat bipolar disorder
Beta blockers, drugs used to treat high blood pressure
Antimalarials, drugs to treat malaria
Pain and swelling in hands, wrists, elbows, shoulders, knee, ankles, feet and spine
Inflammation in other areas of the body including the eyes
Pitted and discolored nails
Severe swelling in the fingers and toes
Pain in the lower back
Skin patches on your skin that flake
This arthritis can be inherited so the Doctor may ask about a health history of the individual being treated as well as their relatives. Your Doctor will also ask when and how the pain started, location of the pain, stiffness and other symptoms and how they affect daily life. The doctor will also probably ask about any medical problems that could be causing these symptoms and a list of current medications being taken.
Your rheumatologist will check for swelling and inflammation of the joints. He/she will look for signs of psoriasis on the skin or abnormalities on the fingernails and toenails. Psoriasis isn't always visible, it can hide on the scalp, behind the ears, in the belly button and in the grooves between the buttocks.
Treatments consist of moist heat or cold compresses twice daily
NSAIDS such as Ibuprofen, celebrex, voltaren, motrin, naproxen
If there is little to no improvement or if there are permanent changes, visible on an x-ray, a disease modifying drug called antirheumatic or biologic drug will be added to help prevent long term joint damage.
There is no cure for psoriatic arthritis but it can be managed well with the help of your Rheumatologist and you working together on finding ways to make your arthritis more controllable.