Psoriatic arthritis is a type of arthritis experienced by some sufferers of psoriasis.
As in the most common form of arthritis, osteoarthritis, the most typical symptoms of psoriatic arthritis are:
- Pain, stiffness and swelling of the joints
- Tender areas in and around joints
- Lower back pain, particularly in the sacrum
- A sausuage-esque appearance caused by swelling in fingers and toes known as dactylitis
- Tendinitis, especially around the feet areas
- Plantar Fasciitis
These last 3 symptoms are especially associated with psoriatic arthritis as opposed to other forms of arthritis.
This condition develops in up to 30% of psoriasis sufferers. The likelihood of developing psoriatic arthritis has a genetic component. Individuals with the tissue type HLA-B27 are more at risk. Different populations vary widely in the rate of occurrence of this antigen. However, it is important to note that other genetic and environmental factors mediate the disease process and possession of this tissue type is by no means a guarantee of eventual onset.
This condition has the potential to grow into a more serious joint condition. For this reason, an early diagnosis is beneficial as subsequent treatment helps to curb inflammation and mitigate damage to the joints. Psoriatic arthritis usually comes and goes in bouts, or flare-ups.
Diagnosing psoriatic arthritis is somewhat complicated as there is no specific test for the disease.
However, there are several possible indicators:
- Psoriasis in the patient
- Localization to the fingers and feet
- Ridged or pitted toenails and/or fingernails
- Negative test for rheumatoid factor (partially ruling out a diagnosis of rheumatoid arthritis)
How is psoriatic arthritis treated? Treatment is typically two-pronged. It is
Aimed curbing systemic (body-wide) inflammatory processes as well as local inflammations
Providing symptom control in the form of pain and swelling relief
For milder cases of psoriatic arthritis, NSAID (non-steroidal anti-inflammatory drugs) may be used. Ibuprofen, Naproxen and other over the counter NSAIDs are available for this purpose. There are also stronger NSAIDs available for particularly strong discomfort. However, these drugs do not come without their share of risks. Among them are possible damage to the intestinal lining and ulceration as well as potential cardiovascular and kidney problems.
Systemic treatments that have been gaining in popularity in recent years include the use of so called "Disease-modifying antirheumatic drugs" and "biological response modifiers".
Disease-modifying antirheumatic drugs act in a slow fashion and may take several weeks or more to take effect. These drugs are prescribed with the goal of reducing joint damage over time and curtailing psoriasis symptoms. They are, however, immunosuppressing compounds that can negatively impact liver and kidney health.
The other class of drugs en vogue right now are biological response modifiers. These drugs are designed with the use of recombinant DNA and act upon specific parts of the immune system as opposed to producing system-wide effects. These drugs, delivered by injection or IV, are used to mitigate inflammation.
Other available treatments include surgery for patients with markedly damaged joints, joint replacement and corticosteroid injections.
Perhaps the most valuable therapy for combating psoriatic arthritis and psoriasis is a healthful psoriasis diet, adequate sleep and exercise and a low-stress lifestyle.
John Ritenhouse is a psoriasis patient who shares information about various types of psoriasis and psoriatic arthritis and explores treatment options on his psoriasis blog.
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