About 10 percent to 30 percent of people with psoriasis also develop psoriatic [pronounced sore-ee-AA-tic] arthritis, which causes pain, stiffness and swelling in and around the joints.
Early recognition, diagnosis and treatment of psoriatic arthritis can relieve pain and inflammation and possibly help prevent progressive joint involvement and damage. Without treatment, psoriatic arthritis can potentially be disabling and crippling.
Psoriatic arthritis is a less common form of arthritis. It affects both men and women in equal numbers, and usually between the ages of 20 and 50. Up to 30% of people with psoriasis will also get psoriatic arthritis. Although psoriasis may start at any age (commonly in the late teens), the arthritis component usually makes its appearance later – in the 20s, 30s and 40s. Commonly, psoriasis shows first, but in a small percentage of people (approximately 15%), arthritis may show first.
Psoriatic Arthritis Causes
A particular combination of genes makes some people more likely to get psoriasis and psoriatic arthritis. Current research suggests that something (perhaps an infection) acts as a trigger in people who are susceptible to this type of arthritis because of their genetic make-up. No specific infection has been found and it may be that a variety of infections (including bacteria that live in patches of psoriasis) can trigger the disease.
Psoriatic Arthritis Symptoms
Symptoms associated with psoriatic arthritis vary in how they occur (i.e. symmetrical or asymmetrical) and what joints are affected. Any joint in the body can be affected. When psoriasis causes pitting and thickened or discolored fingernails, the joints nearest the fingertips are likely to become arthritic.
In most patients, the psoriasis precedes the arthritis by months to years. The arthritis frequently involve the knees, ankles, and joints in the feet. Usually, only a few joints are inflamed at a time. The inflamed joints become painful, swollen, hot, and red. Sometimes, joint inflammation in the fingers or toes can cause swelling of the entire digit, giving them the appearance of a “sausage.” Joint stiffness is common and is typically worse early in the morning.
Other Symptoms include:
· Silver or grey scaly spots on the scalp, elbows, knees and/or lower end of the spine.
· Pitting of fingernails/toenails
Psoriatic Arthritis Diagnosis
Skin and nail changes characteristic of psoriasis with accompanying arthritic symptoms are the hallmarks of psoriatic arthritis. A blood test for rheumatoid factor, antibodies that suggest the presence of rheumatoid arthritis, is negative in nearly all patients with psoriatic arthritis. X rays may show characteristic damage to the larger joints on either side of the body as well as fusion of the joints at the ends of the fingers and toes.
Psoriatic Arthritis Treatment
Treatment plans are designed to reduce inflammation in the joints, reduce pain and prevent further damage. Non-steroidal anti-inflammatory drugs (NSAIDs) are used to control the pain and swelling of the arthritis. Your doctor may inject steroids directly into affected joints. Other drugs, such as methotrexate and an antimalarial drug known as hydroxychloroquine, may also be used. Other more aggressive treatments include corticosteroid injections into the joints or injections of gold salts for patients with more destructive joint damage. Surgery may be necessary in cases of very severe