Psoriatic Arthritis

Psoriatic arthritis (PsA) is a chronic inflammatory condition that affects the joints of people with psoriasis, a skin condition characterized by red, scaly patches on the skin. It is estimated to affect up to 30% of people with psoriasis.

What is Psoriatic Arthritis?

PsA is an autoimmune disease, meaning that it occurs when the body's immune system mistakenly attacks healthy tissues, leading to inflammation and damage in the joints. The exact cause of PsA is not fully understood, but it is believed to involve a combination of genetic, environmental, and immune system factors.

Symptoms of Psoriatic Arthritis

The symptoms of PsA can vary from person to person, but common symptoms include:

• Joint pain and stiffness: Pain and stiffness in the joints, particularly in the hands, feet, knees, elbows, and spine.
• Swollen joints: Swelling and redness in the affected joints.
• Skin symptoms: Red, scaly patches on the skin (psoriasis), which may appear before or after joint symptoms develop.
• Nail changes: Changes to the nails, such as thickening, pitting, or separation from the nail bed.
• Eye problems: Inflammation in the eyes (uveitis), which can cause eye pain and sensitivity to light.
• Fatigue: Feeling tired or exhausted due to chronic inflammation and joint pain.
• Morning stiffness: Stiffness in the joints that lasts for hours after waking up.

Types of Psoriatic Arthritis

There are five types of PsA, each with distinct symptoms:

• Asymmetric oligoarthritis: Asymmetric joint pain and stiffness, affecting fewer than five joints.
• Symmetric polyarthritis: Symmetric joint pain and stiffness, affecting five or more joints.
• Distal interphalangeal predominant: Joint pain and stiffness in the distal interphalangeal joints (joints closest to the fingertips).
• Spondylitis: Inflammation of the spine, which can cause back pain and stiffness.
• Arthritis mutilans: A rare and severe form of PsA that causes deformity and disability in the joints.

Treatments for Psoriatic Arthritis

The goal of treatment is to reduce inflammation, relieve symptoms, and prevent joint damage. Treatment options may include:

• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), biologics, and corticosteroids to reduce inflammation and slow disease progression.
• Physical therapy: Exercises and stretches to maintain joint mobility and strength.
• Occupational therapy: Strategies to adapt daily activities and conserve energy.
• Surgery: Joint replacement or other surgical procedures may be necessary in severe cases of PsA.
• Lifestyle modifications: Maintaining a healthy weight, exercising regularly, and managing stress can help reduce symptoms and improve overall health.

Management and Prognosis

With proper treatment and management, many people with PsA can lead active and fulfilling lives. Regular monitoring of disease activity and adjustments to treatment as needed can help prevent joint damage and reduce the risk of complications. Early diagnosis and treatment are essential for optimal outcomes.