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Psoriatic arthritis develops in people with psoriasis that is either present before the arthritis develops or it occurs shortly afterward. Around 30% of people with psoriasis develop arthritis.
What is psoriasis?
Psoriasis is a dry, flaky skin condition caused by an over production of skin cells. The skin normally re-generates itself regularly by forming new skin cells but sometimes this process is accelerated so that too much skin is formed. Scaly patches then appear on the affected areas. It is normally auto-immune and can sometimes be hereditary (passed down from family members). Environmental issues may play a role in some cases.
What are the Symptoms of Psoriatic Arthritis?
Signs that you may have developed psoriatic arthritis include:
• Swelling and pain of joints and tendons
• Stiffness and difficulty moving the affected joints
• Swollen toes and fingers
• Tiredness
• Changes in your toenails that look very similar to a fungal nail infection
• Some sufferers develop sticky eyes.
Types of Arthritis
There are different types of psoriatic arthritis which may vary the symptoms. These are:
Asymmetric: This is the most common type and occurs in joints down one side of the body.
Symmetric: This occurs in joints on both sides of the body.
Distal interphalangeal joint predomination: this involves only the joints in the fingers and toes.
Spondylitis: This affects the spinal column discs and sometimes the hips and hands and feet. You will also get back pain and possibly neck ache in addition to the other listed symptoms.
Arthritis mutilans: This form of arthritis is very severe, affecting the hands, feet and spine. It deforms the joints, hence the word ‘mutilans’ which originates from the word mutilate. Thankfully, only 5% of psoriatic arthritis sufferers have this disabling variety.
Diagnosis
If you have psoriasis and you start to have aches and pains, it’s important to tell your doctor, because if the condition is left untreated it can develop into a permanent disability. Even if the psoriasis is only in your family members, in around 15% of cases the psoriasis starts after the arthritis.
Based on your condition and family history, you may be diagnosed with psoriatic arthritis if you have any of the tell tell symptoms such as infected looking toe nails.
Tests may be done to rule out other types of arthritis. For instance, your doctor may do a joint aspiration to see if there are any calcium or urate crystals present. If there aren’t, then this rules out gout and pseudogout.
Blood tests can be done to check for the presence of an antibody called rheumatoid factor (RF). This only occurs in people with rheumatoid arthritis and not in people with psoriatic arthritis.
If these tests are negative and you have the recognized symptoms, you will be diagnosed with psoriatic arthritis.
Treatment
Treatment options from your doctor include:
• Anti-inflammatory medication to reduce pain and swelling
• Steroid injections into the affected joints
• For severe cases, immune-suppressant drugs will be offered (since sufferers have a hyper-responsive immune system, dampening it down can relieve the condition). This is only used as a last resort as it has notable side-effects and can make the person more susceptible to illness.
• Disease-modifying antirheumatic drugs (DMARDs) can slow down joint and tissue damage to prevent disability.
Source: National Psoriasis Foundation, USA.
Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting, in addition to running a charity for people damaged by vaccines or medical mistakes.
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