Psoriatic Arthritis
What is it?
Psoriatic arthritis is a form of arthritis that occurs in people who have psoriasis of the skin or nails. Psoriasis is a skin condition that causes flare-ups of a red, scaly skin rash on various areas of the body, especially the elbows and knees, and thickened, pitted
nails.
Who gets it?
People usually develop psoriatic arthritis between the ages of 35 and 45; however, earlier cases have been reported. There are no statistics that indicate how many people with psoriasis have symptoms of arthritis.
What causes it?
The cause of psoriatic arthritis has not been determined. However, genetic factors are involved in psoriasis, so they would also appear to be involved in psoriatic arthritis. People with psoriatic arthritis are likely to have close relatives with psoriasis, but these family members may or may not also have arthritis. Psoriasis and other forms of arthritis are thought to be triggered by the body's immune system attacking the body's own tissues, called an autoimmune disorder. So, the immune system most likely plays a role in psoriatic arthritis
also.
What are the symptoms?
Psoriatic arthritis usually affects the joints of the fingers and toes, causing pain and swelling. Joint symptoms may follow a flare-up of psoriasis, and the two may come and go together. Some patients also experience joint pain in the hips and spine. Symptoms may affect joints on only one side of the body, or on both sides at the same time. The fingernails may also undergo changes, becoming thickened and pitted. Although it is unusual, a condition called psoriatic arthritis mutilans can destroy the joints and bones. In these patients, the hands and feet curl inward, giving them a club-like
appearance.
How is it diagnosed?
A diagnosis of psoriatic arthritis is usually made when psoriasis is accompanied by symptoms of arthritis. Your doctor will review your symptoms, carefully examine your skin and nails for indications of psoriasis, and ask about any personal or family history of this skin condition. He or she will also order a blood test to check for the antibodies that indicate rheumatoid arthritis. X-rays of the fingers and toes may show that these joints are fused, and may show damage to the larger joints on either side of the
body.
What is the treatment?
Treatment of psoriatic arthritis focuses on controlling the skin rash and relieving joint inflammation. To do this, doctors recommend standard arthritis treatments, including gold compounds, nonsteroidal anti-inflammatory drugs, and sulfasalazine. Psoriatic arthritis is also treated with etretinate, which is derived from vitamin A. Etretinate should not be taken by pregnant women or women who are planning to become pregnant within one year because it remains in the body for a long time and can cause birth defects. A combination of methotrexate , a drug that suppresses the immune system, and ultraviolet light (PUVA) treatment also reduces skin lesions and most joint inflammation. Some doctors believe that food allergies and intolerances play a role in autoimmune disorders. An allergist can help you determine if you have any food allergies that could be triggering your condition. Other alternative treatments include constitutional homeopathy, acupuncture, herbal medicine, and nutritional supplements. Your doctor can help you explore these types of treatments and determine if they are right for you.
Self-care tips
While psoriasis can be a nuisance, most people with psoriatic arthritis have much milder arthritis symptoms than those with other forms of arthritis. While there is no known way to prevent psoriatic arthritis, following your doctor's treatment recommendations can help reduce and relieve symptoms.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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