Psoriatic arthritis is an inflammatory arthritis associated with psoriasis. This may manifest as:
- Arthritis involving primarily the small joints of fingers or toes
- Asymmetrical arthritis, which involves joints of the extremities
- Symmetrical polyarthritis, which resembles rheumatoid arthritis
- Arthritis mutilans, which is rare but very deforming and destructive
- Arthritis of the sacroiliac joints and spine (psoriatic spondylitis)
Patterns may change with time in individual patients, and some patients may show overlapping features or more than one type. Sometimes arthritis is associated with inflammation of the eyes, or inflammation at the bony sites of attachment of ligaments and tendons. Psoriatic arthritis causes not only the joints to swell, but also the surrounding tissues (muscles, skin, tendons, ligaments). Over 80% of people with psoriatic arthritis also have involvement of the finger and toenails. If you have psoriatic arthritis your fingers or toes may become red and swell, and have a sausage-like appearance. Not all the fingers or toes may be involved. Your nails might also get small holes in them (pitting) or may detach from the skin.
The exact cause is unknown, but immune, genetic, and environmental factors are suspected. Up to 40% of patients with psoriatic arthritis may have a history of psoriasis or arthritis in family members. Both psoriasis and psoriatic arthritis flare up in the presence of immunodeficiency due to HIV infection.
Psoriatic arthritis affects at least 10% of the 3 million people with psoriasis in the United States. It affects men and women equally and usually begins between 30-50 years of age, but can begin in childhood. Psoriatic arthritis may precede the onset or the diagnosis of psoriasis in up to 15% of patients. Up to 30% of people with psoriasis also get psoriatic arthritis.
Establishing the correct diagnosis is very important because something can be done to manage most forms of arthritis, and most therapies work best when started early in the disease. Your doctor will probably be able to more easily diagnose you having psoriatic arthritis if you have psoriasis along with a single or several red, swollen fingers or toes. Usually, if your nails and skin are affected along with your joints, a firm diagnosis can be made.
However, since this form of arthritis is similar to other forms such as gout, Reiter’s syndrome and rheumatoid arthritis, your doctor may perform a physical examination and order various tests to assist in diagnosis. X-rays are often ordered to look for changes to the bone. Blood and joint fluid tests may be done to rule out other conditions such as rheumatoid arthritis, reactive arthritis or gout.
Once the diagnosis is confirmed, various treatments can help decrease your pain and stiffness and increase your movement. Treatment of psoriatic arthritis is for both the skin condition and the arthritis. For mild psoriatic arthritis the treatment plan usually is comprised of medication, physiotherapy and daily-living adjustments. Your active involvement in developing your prescribed treatment plan is essential.
Signs, symptoms & indicators of Psoriatic Arthritis
Joint pain/swelling/stiffness
Conditions that suggest Psoriatic Arthritis
Psoriasis
About one person in 10 suffering from psoriasis can get joint troubles, with a degree of arthritis affecting the back, or large or small joints of the body. This arthritis is rare, but worth looking into if you have psoriasis and an aching spine or joints. Patients who have inflammatory arthritis and psoriasis are diagnosed as having psoriatic arthritis.
Psoriatic Arthritis suggests the following may be present
Recommendations for Psoriatic Arthritis
NSAIDs
NSAIDs are often used to treat psoriatic arthritis. NSAIDs reduce pain when taken at a low dose, and relieve inflammation when taken at a higher dose. NSAIDs such as aspirin and ibuprofen (Motrin IB, Advil, etc.) can be purchased without a prescription. Examples of NSAIDs that require a prescription include Naprosyn, Relafen, Indocid, Voltaren, Feldene, and Clinoril. The various NSAIDs and Aspirin, if taken in full doses, usually have the same levels of anti-inflammatory effect. However, different individuals may experience greater relief from one medication than another. Taking more than one NSAID at a time increases the possibility of side effects, particularly stomach problems such as heartburn, ulcers and bleeding.
Boron
Patients of psoriatic arthritis feel relief from pain by topical application of 1.5% boric acid with 3% zinc oxide ointment.
Key
| Strong or generally accepted link |
| May do some good |
| Likely to help |
| Highly recommended |
Glossary
Arthritis
Inflammation of a joint, usually accompanied by pain, swelling, and stiffness, and resulting from infection, trauma, degenerative changes, metabolic disturbances, or other causes. It occurs in various forms, such as bacterial arthritis, osteoarthritis, or rheumatoid arthritis. Osteoarthritis, the most common form, is characterized by a gradual loss of cartilage and often an overgrowth of bone at the joints.
Psoriasis
An inherited skin disorder in which there are red patches with thick, dry silvery scales. It is caused by the body making too-many skin cells. Sores may be anywhere on the body but are more common on the arms, scalp, ears, and the pubic area. A swelling of small joints may go along with the skin disease.
Rheumatoid Arthritis
A long-term, destructive connective tissue disease that results from the body rejecting its own tissue cells (autoimmune reaction).
Spondylitis
Inflammation of one or more vertebrae.
HIV
Abbreviation for human immunodeficiency virus, a retrovirus associated with onset of advanced immunodeficiency syndrome (AIDS).
Gout
A disease characterized by an increased blood uric acid level and sudden onset of episodes of acute arthritis.