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Psoriatic Arthritis

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Psoriatic arthritis affects patients who suffer from a skin rash called psoriasis. This condition affects about 15% of patients with psoriasis. It is a type of arthritis where any joint in the body can be affected. There are treatments available today, that can help a majority of patients.

What is Psoriasis?

Psoriasis is a skin condition that causes red patches of skin along withdry, scaly, silver colored scales. It can occur on any part of the body.

What is Arthritis?

Arthritis is a painful condition where the joints become inflamed and the bones rub over each other. This causes pain and discomfort with movement and in many cases, limits joint movement to a great extent.

What is Psoriatic Arthritis?

Psoriatic arthritis is a condition where the joints in the body become inflamed and sore. It is a form of arthritis that affects patients suffering from psoriasis. In this condition, the joints develop swelling, stiffness as well as become painful. In some cases, the tendons also become inflamed and stiff. A few people develop uveitis, that is, a condition that causes redness and inflammation of the eye.

People with psoriatic arthritis often suffer from fatigue and constant exhaustion. The severity of the condition varies person to person. In some people, the condition damages the joints to an extent that it causes permanent disability. There is no cure for psoriatic condition, however, treatments available focus on controlling the symptoms and preventing further damage to the joints.

Types of Psoriatic Arthritis

There are five types of psoriatic arthritis that includes:

  • Asymmetric arthritis that affect 70% patients. The symptoms are usually mild and does not affect the same joints on both sides of the body. usually less than 3 joints are affected in this case.
  • Symmetric arthritis occurs in 25% patients. The condition is similar to rheumatoid arthritis and turns into a disabling condition in about 50% of the cases.
  • Arthritis mutilans affects 5% patients. It is a severe, deforming form of arthritis that can lead to severe joint damage.
  • Spondylitis affects the neck and spine leading to stiffness.
  • Distal interphalangeal predominant occurs in 5% of patients that leads to inflammation and stiffness of joints at the ends of the fingers and toes.

Symptoms of Psoriatic Arthritis

The most common symptoms of psoriatic arthritis include:

  • Pain and stiffness in and around the affected joints
  • Swelling due to inflammation of the joints and tendons around the fingers and toes
  • Pitting, thickening and discoloration of the nails
  • Swelling of the Achilles tendons or soles of the foot leading to pain in the foot
  • Stiff neck, stiff back or buttock pain due to swelling of the spine
  • Inflammation of the tendons attached to the bone leading to pain in the chest, knees, elbows, hips, etc.

Psoriatic arthritis can affect other parts of the body too. It can lead to inflammation of the membrane covering the eye as well as around the pupil, leading to conjunctivitis and uveitis.

Causes of Psoriatic Arthritis

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The immune system attacks the healthy cells and tissues of the body that causes inflammation of the joints as well as skin. What triggers this attack is still unknown. The reason may be some people have a genetic role in development of the condition, in some, a family history of psoriasis or arthritis. Environmental factors, physical trauma or viral and bacterial infection too can trigger development of psoriatic arthritis.

Diagnosis of Psoriatic Arthritis

There is no test that helps diagnose psoriatic arthritis. The symptoms are similar to rheumatoid arthritis, and therefore, the doctor has to consider physical examination, medical history, blood tests and X-rays to diagnose the condition. The doctor may carry out the following tests:

  • Close examination of joints for swelling, tenderness; fingernails for pitting, discoloration, etc.
  • X-ray
  • MRI
  • Rheumatoid factor (RF test) to determine presence of RF antibody in the body. if the test is negative, it means the person may have psoriatic arthritis and not rheumatoid arthritis.
  • Joint fluid tests to check for presence of uric acid crystals. If this test is positive for uric acid crystals, it means the patient has gout instead of psoriatic arthritis.

Treatment for Psoriatic Arthritis

Treatments aim at reducing and controlling the inflammation. The treatments include use of:

  • Nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen
  • Disease-modifying antirheumatic drugs that limit the joint damage like methotrexate, sulfasalazine, etc.
  • Biological response modifiers that target specific cells of the immune system like infliximab
  • TNF-alpha inhibitors that helps reduce pain, morning stiffness and swelling of joints.
  • The doctor may also recommend steroid injections for very painful joints.
  • A damaged joint may require joint replacement surgery.

The treatment for psoriasis on the skin includes:

  • Use of steroid based creams and lotions
  • Tar-based ointments
  • Light therapy
  • Retinoid tablets

Self-care for Psoriatic Arthritis

Psoriatic arthritis limits one’s ability to move and lift heavy objects. Thus, making it very difficult to carry out daily tasks. Thus, one should make sure they carry out recommended exercises regularly to maintain the flexibility of the joints. Apply hot and cold packs to relieve the joint inflammation. Maintain  healthy weight to reduce the pressure on the joints, thus, reducing the pain and increasing mobility.

Psoriatic arthritis can affect one’s emotions and confidence. It takes a toll on one’s social life, professional life as well as relationships. One should make sure they take timely treatment and join groups that help them find support to overcome this condition. Timely medical help and following the treatment properly will make sure the symptoms do not flare up and affect one’s life completely.

Written by: Saptakee sengupta
Date last updated: March 29, 2015