What is Psoriatic Arthritis and How Can It Be Treated? Psoriatic Arthritis: Symptoms, Causes and Treatment
Some people with psoriatic arthritis, a form of inflammatory arthritis, may develop psoriatic arthritis. This is a condition where the skin cells are rapidly accumulated.
It is also known as an autoimmune disease, which means that your immune system misunderstands healthy tissue.
Psoriatic arthritis can cause skin and joint problems. The case may have different symptoms.
Most often, the skin problems develop first and arthritis follows later. Sometimes, joint problems may not be symptomatic of psoriasis.
Although there is no cure for psoriatic, there are many treatments that can be used to reduce the pain and minimize joint damage.
Psoriatic Arthritis: Signs and Symptoms
There are many symptoms that can be caused by psoriatic arthritis. Different people experience different symptoms.
Some symptoms may include:
- Stiff, painful joints
- Redness, heat or swelling of the tissues around the joints
- Silvery-white, scaly spots on red skin
- The skin may become itchy or blistered.
- Nails that break, crack, become pitted or lift from their nail beds.
- Toes and fingers “sausage-like”.
- Hand deformities
- Pain in the feet, neck or spine
- Trouble with bending and reduced range
- Inflammation can cause irritation to the eyes and vision problems.
- Fatigue
Psoriatic Arthritis: Causes and Risk Factors
Although doctors aren’t sure exactly what causes psoriatic, they know that it occurs when the immune system attacks healthy tissue. This causes inflammation and an increase in skin cell production.
Experts believe the immune system may be affected by both environmental and genetic factors.
Several factors can increase your risk, including:
- Psoriasis: Being diagnosed with psoriasis can increase your risk of developing psoriaticarthritis.
- Family History Approximately 40% of those with psoriatic arthritis have a relative with the condition.
- An Infection: Some people may develop psoriatic arthritis from a viral or bacteria-related infection.
- Psoriatic arthritis can occur at any age, but is more common among those aged 30 to 50.
- Obesity is a condition that causes more damage to the tendons than being overweight. This can cause inflammation and trigger psoriatic arthritis.
Different types of psoriatic arthritis
These are the five types of psoriaticarthritis:
- Symmetric Psoriatic arthritis As the name suggests, this type affects both your joints and muscles on both sides. The symmetric type is found in about half of those with psoriatic arthritis.
- Asymmetric Psoriatic arthritis This disease affects about 35% of patients and can cause milder symptoms.
- Spondylitis is a form of psoriatic and causes stiffness and pain in the spine and neck.
- Arthritis Mutilans: People suffering from arthritis mutilans have deformities in their small joints between the fingers and the toes. This is the most severe type of psoriatic, but only 5 percent of sufferers are affected.
- Distal Psoriatic Arthritis Causes inflammation and stiffness at the ends of fingers and toes. It also affects the nails.
How is Psoriatic Arthritis diagnosed?
Your doctor will likely first conduct a physical exam to check for swelling, skin or nail changes, eye problems, and joint tenderness in order to diagnose psoriatic.
Your doctor may ask you to have an X-ray or MRI taken of your joints.
A blood test may be required to rule out any other conditions such as gout, rheumatoid, or osteoarthritis. A test may be performed by some doctors to determine the amount of fluid in your joints.
Sometimes, a skin biopsy may be required in order to confirm a diagnosis of psoriasis.
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Psoriatic Arthritis: Duration
Psoriatic arthritis can be considered a chronic condition.
While symptoms will usually worsen over time you may experience periods of improvement or even remission. These improvements can be interrupted by flares, which are episodes of intense symptoms.
Flares can come and go. Flares can be frequent for some people, but not others.
You can avoid triggers by identifying what causes your flares. Stress, lack of sleep, and certain medications are all common triggers.
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Psoriatic arthritis treatment and medication options
The severity of your condition and your overall health will determine the treatment plan.
Medicines
There are several treatments for psoriatic inflammation.
- Nonsteroidal Anti-Inflammatory Devices (NSAIDs). NSAIDs such as ibuprofen (Advil Motrin, Motrin), naproxen (Aleve) can reduce pain and inflammation. These medicines can be purchased over-the-counter (OTC) but your doctor may be able write you a prescription to a stronger version.
- DMARDs are recommended for patients whose condition is not improving with NSAIDS. They can slow down the disease’s progression and prevent joint damage. DMARDs include Methotrexate (Trexall), sulfasalazine, and leflunomide.
- Janus Kinase (JAK), Inhibitors Tofacitinib, (Xeljanz), was the first drug in this class to be approved for PsA.
These drugs suppress the immune system and may increase your risk of infections, heart complications, or some types of cancer. - TNF-Alpha inhibitors These drugs block the production of an inflammatory substance called tumor necrosis factors (TNF). These drugs can reduce pain and swelling, as well as improve the appearance of joints. TNF-alpha inhibitors that are commonly used include Enbrel, Enalimumab(Humira), infliximab/Remicade, certolizumab/Cimzia, and golimumab/Simponi.
- Immunosuppressants are drugs that suppress the immune system. Some examples include azathioprine, Azasan, and Neoral, Sandimmune (Gengraf, Neoral)
- Steroids Steroids are a quick way to reduce inflammation. They can be administered orally, or injected directly into the problem joint.
- Selective co-stimulation modulators: Abatacept, also known as Orencia, is an immunomodulator. It blocks the activity of T cells, which is a type immune cell.
- Phosphodiesterase inhibitors The drug apremilast, also known as Otezla, works in inflammatory cells to decrease the activity of an enzyme called PDE4 (phosphodiesterase4) within your body. It reduces swelling and pain.
- Topicals Applying directly to the skin can reduce itchy, scaly rashes that are caused by psoriasis. These treatments come in creams and lotions as well as shampoos, gels or sprays.
Light Therapy
Phototherapy or light therapy exposes the skin to ultraviolet light. This can reduce the symptoms of psoriasis.
Surgery
Sometimes, surgery may be necessary to fix or replace severely damaged joints due to psoriatic arthritis.
Joint replacement surgery is the procedure of removing a diseased joint and replacing it by an artificial prosthesis.
Lifestyle Approaches
These lifestyle habits can help reduce pain and make you feel better.
- Exercise. Regular exercise can improve your flexibility. Walking, biking, and swimming are all options.
- Keep your weight under control. Being overweight can cause more pain and strain to your joints. This stress can be relieved by losing a few pounds to increase your energy and reduce your overall weight.
- Don’t overdo it. Extreme fatigue can be caused by psoriatic arthritis and the medications you take to treat it. It’s important to be active, but it’s equally important to take a break when you feel tired.
Clinical trials
Researchers are constantly looking for new treatments to treat conditions such as psoriatic. To find out if you are eligible to participate in a clinical study, visit ClinicalTrials.gov.
Learn more about Psoriatic Arthritis Treatments
Psoriatic Arthritis Prevention
There is currently no way to stop psoriatic. Research suggests that patients with psoriatic arthritis who seek treatment within six month may experience less damage and have fewer long-term issues.
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Psoriatic Arthritis: What are the complications?
Psoriatic arthritis, if left untreated can lead to joint damage and disability.
Sometimes complications can result from the condition, such as:
- High blood pressure
- High levels of cholesterol
- Obesity
- Diabetes
- Heart disease
- Deformities in the spine, hands, and feet
- Eye problems, such as conjunctivitis or uveitis, can be caused by a variety of conditions.
- Osteopenia or osteoporosis
- Gastrointestinal problems
- Lung disease
- Liver disease
- Gout
- Depression
Research and Statistics: Who has Psoriatic Arthritis
About 1.5 million Americans suffer from psoriatic arthritis.
The Arthritis Foundation estimates that about 30% of people with psoriasis will develop psoriatic arthritis.
This condition is most common in those aged 30 to 50. However, it can also affect anyone at any age, including children. Psoriatic arthritis can affect both men and women equally.
Psoriasis is a condition that affects most people. Most people are diagnosed with psoriaticarthritis around 10 to 20 years later.
Psoriatic Arthritis: Causes and Conditions
Psoriatic arthritis can be associated with more than just psoriasis.
Psoriatic arthritis symptoms are similar to gout, rheumatoid, and reactive arthritis (triggered due to a bacterial infection).
The inflammatory bowel diseases, particularly Crohn’s disease, are also closely associated with psoriatic arthritis.
Research has actually shown that Crohn’s and psoriatic arthritis sufferers share many of the same genetic mutations.
BIPOC, Psoriatic Arthritis
Psoriatic arthritis is a significant burden for people of color (BIPOC), who are Black, Indigenous, or People of Color.
Clinical Rheumatology published a study that found that African Americans were more likely to develop psoriatic arthritis than Caucasians. However, the condition had a greater impact on their lives and caused them more psychological distress. Researchers found that Black participants in the study were less likely to be prescribed biologic medication than their white counterparts.
Patients of color might not have psoriatic arthritis symptoms if their doctors aren’t trained. This can lead to missed diagnosis and treatment opportunities. According to the American Academy of Dermatology, psoriasis can appear in white patients as pink or red with a silvery-white-scale scale. However, it can also be found in Hispanic patients as salmon-colored with a silvery-white-scale scale. In Black patients, it could be violet with gray scale or dark brown.
According to a study published in the Journal of the American Academy of Dermatology, Blacks, Asian Americans and Native Americans are 40% less likely than non-Hispanic whites to visit a dermatologist to treat their psoriasis. This is regardless of whether they have health insurance or their socioeconomic status.
We love these resources
Information about Essential Psoriatic Arthritis Information
Arthritis Foundation
The Arthritis Foundation offers reliable information and resources to those suffering from psoriatic. There are many opportunities to advocate and reach out to the community through their site. We love that you can receive personalized advice on exercise based upon your fitness level and condition.
National Psoriasis Foundation
The site contains a lot of information on psoriasis, psoriatic arthritis and other topics. Request a free electronic psoriatic joint kit. This includes a flare tracker and triggers to help you manage your condition. Patients, caregivers, and their families can also get personalized and free assistance from the Navigation Center.
American College of Rheumatology
This professional membership organization has been around for a long time and provides the latest news on psoriatic arthritis, as well as other rheumatic diseases. The American College of Rheumatology has more than 8,400 members, including scientists and health professionals. The Find a Rheumatologist page allows you to find a doctor that specializes in your condition.
Spondylitis Association America
The Spondylitis Society of America provides resources for people with spondyloarthritis or related diseases like psoriatica. This organization offers support groups and message boards.
American Academy of Dermatology
The American Academy of Dermatology has more than 20500 members and is the most important dermatology organization in America. It advocates for skin conditions such as psoriasis, psoriatic arthritis, and other conditions.
CreakyJoints
CreakyJoints provides a community for patients with arthritis and their caregivers. They provide education, advocacy, support, and patient-centered resources for all types of arthritis.
The Skin of Color Society
The nonprofit works to raise awareness about dermatological issues that impact the BIPOC community. It also educates physicians and the public. People with skin color, such as African Americans, Asians, Hispanics, Latinos, Native Americans, and Pacific Islanders, can find the right doctor by using the “Find A Doctor” database.
