Psoriatic arthritis is a type of arthritis that develops in about fifteen percent of people with psoriasis.
Psoriatic arthritis is a form of arthritis that can affect people diagnosed with the skin disorder psoriasis. People with psoriasis experience flare-ups of red, patchy skin or skin lesions. According to the American College of Rheumatology, between 15 and 30 percent of people with psoriasis develop arthritis. In some cases, arthritis is diagnosed before the skin disorder.
Psoriatic arthritis is a chronic condition. Anyone can get it, but it is most often diagnosed in middle age. There is no cure, so treatment is targeted toward symptom management and preventing permanent joint damage.
Psoriatic arthritis affects many parts of the body. Symptoms range from mild to disabling, and may come and go.
Psoriatic arthritis causes inflammation in the joints. It can affect a single joint or many joints throughout the body. Stiffness, swelling, and joint pain are classic symptoms of psoriatic arthritis. Inflammation in the knees or shoulders can limit range of motion, making it hard to move freely. It can cause severe neck and back pain, and make it difficult for the spine to bend (spondylitis).
Imaging tests, like MRI and X-rays can identify the classic signs of arthritis in the joints, and are useful in diagnosing the condition.
Fingers and toes may swell (dactylitis), causing a sausage-like appearance. One of the more common symptoms of psoriatic arthritis is soreness where the tendons and ligaments connect to the bones (enthestitis). This causes pain in the heel (Achilles tendinitis), sole of the foot (plantar fasciitis), and around the elbows.
Low-impact exercise, especially water exercise, can help keep joints flexible. For some people, physical and occupational therapy can strengthen muscles and improve flexibility. Walking is one of the best exercises, and shoe inserts can help lessen impact on joints.
About 5 percent of people with psoriatic arthritis can develop arthritis mutilans, according to the Arthritis Foundation of America. This is a less common, but more severe form of arthritis that can destroy the joints of the hands and feet and cause permanent disfigurement and disability. Medications, like biologics, can prevent this damage.
Integumentary system (skin, hair, and nails)
Psoriasis is a chronic skin disorder that causes rough, red patches to form on the skin. It sometimes looks like silvery scales. Symptoms include tenderness and itching. The patches can form anywhere, but tend to show up around the elbows, knees, hands, and feet. The skin around the joints can appear cracked. In some cases, skin lesions or blisters may form. A skin biopsy can be used to confirm the diagnosis of psoriasis and topical medications may offer relief.
Patches on the scalp can range from what resembles a mild case of dandruff, to quite severe shedding. Scratching may cause flakes in your hair and on your shoulders. Fingernails and toenails may become thick, ridged, or discolored. They can grow abnormally, develop pits, or even separate from the nail bed (oncycholysis).
Psoriasis can be mild or it can be severe enough to impact quality of life. Symptoms may flare up periodically and then go into remission.
Eyes and vision
Studies have found that psoriasis can also lead to vision problems. Inflammatory lesions such as conjunctivitis are the most likely side effect. In very rare cases, psoriasis might cause a loss of vision. Uveitis, a condition in which the middle layer of the eye (uvea) swells, can occur in those with psoriatic arthritis.
The musculoskeletal system
Chronic inflammation can damage the cartilage that covers the ends of bones. As the disease progresses, damaged cartilage causes the bones to rub against each other. Besides weakening the bones, this process weakens surrounding ligaments, tendons, and muscles, which leads to inadequate joint support. Furthermore, inactivity can compound the problem.
It’s important that people with arthritis continue to engage in regular, moderate exercise to keep muscles strong. Ask your doctor to recommend an exercise program or physical therapist who can teach you how to exercise without stressing your joints.
The immune system
Psoriatic arthritis is an autoimmune condition. Your immune system is designed to protect you from foreign invaders like viruses and bacteria. Sometimes, the body mistakenly attacks healthy tissue. In the case of psoriatic arthritis, the attack includes the joints, tendons, and ligaments. Psoriatic arthritis is a lifelong condition, but you may experience periodic attacks followed by remission.
Physical pain and discomfort, along with the chronic nature of the disease, can have an impact on your emotional health. Some people with psoriatic arthritis may be prone to moodiness. According to the National Psoriasis Foundation, psoriasis is associated with feelings of embarrassment, low self-esteem, and depression, especially among those who have not found a way to manage the disease effectively.
People with arthritis often report generalized fatigue. Psoriasis patients have a slightly raised risk of developing high blood pressure, high cholesterol, or diabetes. It’s important that people with chronic illness make healthy lifestyle choices that will promote overall good health and well-being. A healthy diet, regular moderate exercise, and a good night’s sleep go a long way towards helping you reach that goal.