Definition Psoriatic arthritis is a chronic inflammation of the joints that occurs in some people with a chronic skin condition known as psoriasis. Psoriasis causes flare-ups of red patches on the body. This condition usually occurs between the ages of 30 and 35.
What is going on in the body? People with psoriatic arthritis may develop arthritis that causes destruction of various joints. In some people this may look like rheumatoid arthritis, which is an autoimmune disorder involving swelling, pain, and often joint destruction. With an autoimmune disorder, it is thought that the body acts against itself.
What are the signs and symptoms of the disease? Signs and symptoms of this condition may include:
This type of arthritis usually affects joints of the fingers and toes. Other joints including the hips and spine may also be affected.
What are the causes and risks of the disease? Psoriatic arthritis occurs in people with underlying psoriasis. Approximately 5- 8% of people with psoriasis will develop this form of arthritis. It affects both men and women equally.
What can be done to prevent the disease? There is no known way to prevent the development of psoriatic arthritis in someone who is prone to it.
How is the disease diagnosed? The diagnosis is made by identifying the typical symptoms of arthritis in a person with psoriasis. Blood tests may be done to rule out other diseases such as rheumatoid arthritis. X-rays may show severe erosion of joints. In some people the degree of skin psoriasis may be minimal. Careful examination is required to detect even small areas of psoriasis.
What are the long-term effects of the disease? A person may have progressive destruction of the affected joints. This can lead to disfigurement and disability.
What are the risks to others? Psoriatic arthritis is not contagious and does not place others at risk.
What are the treatments for the disease? Treatment for psoriatic arthritis includes medication, education, physiotherapy, and Occupational therapy. Most people are treated with anti-inflammatory medications including the non-steroidal anti-inflammatory drugs (NSAIDs). This helps to reduce the pain and inflammation of the joints.
Others may require more potent antirheumatic medications, such as methotrexate. In certain people, aggressive immune suppressant therapy will be needed. In this case, medications that decrease the body's destruction of its own cells are given. Creams and ointments may be used for the skin lesions.
Physiotherapy provides exercise for specific joints. Exercise helps to maintain strength and range of motion. occupational therapy can teach the person how to cope with this condition.
What are the side effects of the treatments? NSAIDs can cause stomach upset and allergic reactions. Potent immune-suppressing medications can greatly decrease a person's resistance to infections. Some medications such as methotrexate can be damaging to the lungs or liver.
What happens after treatment for the disease? The person is monitored periodically to determine the level of control of the psoriatic arthritis. Flare-ups of the arthritis are common.
How is the disease monitored? Psoriatic arthritis is monitored with repeated physical examinations, blood tests, and x-rays. Mediations are adjusted to help decrease or delay the destructive process.
Author: Bill Harrison, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
