If You Have Psoriasis You Have a Higher Risk for This Disease
If you have patches of red, dry, and cracked skin it could be more than just a temporary reaction – it could be psoriasis. Psoriasis is a surprisingly common skin condition that speeds up the life cycle of cells, causing them to build up on the skin’s surface in scales and red patches.
As difficult as psoriasis can be to live with at times, the bad news doesn’t end there – having psoriasis puts you at risk for another condition, psoriatic arthritis. Psoriatic arthritis is characterized by psoriasis symptoms paired with joint inflammation, though in most cases the skin-related symptoms develop first. Keep reading to learn more about psoriatic arthritis and how to manage it.
What is Psoriasis?
Psoriasis is a skin condition that cannot be cured, and it affects different people in different ways. The most common signs of psoriasis include red patches of skin covered in thick scales, patches of dry and cracked skin, itching, or a burning sensation. There are several different types of psoriasis, though plaque psoriasis is the most common – it causes red skin lesions called plaques to develop on the surface of the skin which then dry out and scale over. These plaques can occur anywhere on the body and flare-ups can be triggered by stress, infection, smoking, alcohol consumption, some foods, and certain medications.
Understanding the Basics of Psoriatic Arthritis
If you have plaque psoriasis or one of the other less common forms, you may be at risk for a disease called psoriatic arthritis. An inflammatory form of arthritis, psoriatic arthritis affects about 15% of the 6.7 million people in the United States who have psoriasis. In 85% of cases, symptoms of psoriasis develop first and are later followed by arthritis symptoms which may include joint pain and tenderness, stiffness, difficulty moving, and reduced range of motion. Other signs of psoriatic arthritis may include fatigue, swollen fingers, tendonitis, lower back pain, and conjunctivitis.
In the same way that there are different forms of psoriasis, there are also several types of psoriatic arthritis – five, to be exact:
- Symmetric psoriatic arthritis
- Asymmetric psoriatic arthritis
- Distal interphalangeal predominant psoriatic arthritis
- Spondylitis type psoriatic arthritis
- Arthritis mutilans type psoriatic arthritis
Symmetric psoriatic arthritis is named for the fact that it affects joints on both sides of the body – it also usually affects multiple joints which is known as polyarthritis. Similar to rheumatoid arthritis in its symptoms, symmetric arthritis is a milder form of arthritis and causes less deformity. This type of psoriatic arthritis affects about 25% of people with the disease, whereas asymmetric psoriatic arthritis affects 80% of patients. This form of psoriatic arthritis can affect any joint, but usually only on one side of the body. It also causes warm, swollen, and painful joints.
According to the National Psoriasis Foundation, distal interphalangeal predominant (DIP) psoriatic arthritis is the classic type of the disease. This condition occurs only in 5% to 10% of patients, and it affects the distal joints of the fingers and toes. Spondylitis type psoriatic arthritis is characterized by inflammation of the spine, and it affects 5% to 20% of people with the disease. Arthritis mutilans type psoriatic arthritis is often severe and disabling, but it is also very rare, affecting only 5% of people with the disease. This condition usually causes joint deformity, particularly in the small joints of the hands and feet. It also frequently causes low back and neck pain.
What Are Your Treatment Options?
Because many patients who have psoriatic arthritis do not develop symptoms right away, it can sometimes be tricky to diagnose this condition. Unfortunately, there is no single test that can be used to make a diagnosis either – your doctor will need to perform a physical examination and take x-rays and possibly an MRI. Blood tests may be used to rule out other forms of arthritis as well.
Once your doctor has diagnosed you with psoriatic arthritis, you need to start thinking about your treatment options. Treatment for psoriatic arthritis is two-pronged because you have to manage both the skin symptoms and the joint problems. The first line of defense against psoriatic arthritis is usually some kind of nonsteroidal anti-inflammatory drug (NSAID), at least for people with a mild form of the disease. For people with severe symptoms and those who don’t respond well to NSAIDs, a different class of drugs known as disease-modifying antirheumatic drugs (DMARDs) may be recommended.
When it comes to managing both skin and joint symptoms medically, there are a few options. TNF blockers, for example, can control both skin and joint inflammation. Other options may include methotrexate, retinoic acid, photochemotherapy, and cyclosporine. In addition to managing symptoms of psoriatic arthritis, you should also take steps to avoid triggers. It will also be important for you to maintain a healthy body weight, exercise regularly, and manage any concurrent conditions.