Psoriatic arthritis is a type of arthritis that sometimes affects patients who suffer from psoriasis. In most cases, patients will first develop psoriasis, a serious skin disorder, and then will be diagnosed with psoriatic arthritis at a later time. However, in less common cases, a patient may develop arthritis before they develop psoriatic skin lesions. Psoriatic arthritis symptoms vary from patient to patient, but most people with this condition will experience stiffness, pain, and swelling of their joints.
Symptoms of Psoriatic Arthritis
Psoriatic arthritis is a chronic disease so psoriatic arthritis symptoms may improve for a certain period of time and then become worse for a certain period of time. The most common symptoms include pain, swelling, and warmth of the affected joints. The joint pain a patient experiences has five different patterns.
Patients may only have the joints on one side of their body affected with pain. This is referred to as asymmetric psoriatic arthritis and is the mildest form. Patients may have joints on both sides of their body affected with pain. This is referred to as symmetric arthritis and the psoriasis tends to be quite severe.
Some patients will only experience this condition with their hands. This is rare and referred to as distal interphalangeal joint predominant psoriatic arthritis. This type tends to affect men most often and symptoms are experienced mostly in the finger and toe joints closest to the nail. The patient’s nails are often pitted, thick, and discolored.
Some patients will only experience this condition in their spine. This is referred to as spondylitis and as the condition advances, movement often becomes difficult and painful. Patients will experience spinal stiffness and inflammation in their lower back, neck, and sacroiliac joints.
A small number of patients will experience arthritis mutilans. This is referred to as destructive arthritis and is a very painful, severe, and disabling form of this condition. This type ultimately results in permanent disability and deformity due to destruction of the small bones in the fingers and hands.
There is no cure for this condition, but it can be managed for most patients. The goal of treatment is to prevent joint disability and joint pain by controlling the inflammation. Medications are commonly prescribed to control the inflammation. Non-steroidal anti-inflammatory drugs are beneficial in alleviating the swelling, pain, and morning stiffness. Disease-modifying antirheumatic drugs will help to limit how much the joints are damaged in addition to helping to alleviate inflammation and pain. Corticosteroids are prescribed to help control flares of joint pain that are infrequent in mild forms of this condition. TNF-alpha inhibitors are prescribed to patients who have a severe form of this disease to help alleviate the inflammation, which will help to lessen the severity of their symptoms. Immunosuppressant medications will help to prevent the immune system from attacking the body to lessen the progression of this condition.
Though it is rarely performed, surgery can be used to treat this condition. This is only used when all other possible treatments fail to alleviate the patient’s symptoms. The goal of surgery is to restore the patient’s mobility.
Mayo Clinic. (2008). Psoriatic Arthritis. Retrieved on February 15, 2010 from the Mayo Clinic: https://www.mayoclinic.com/health/psoriatic-arthritis/DS00476
MedlinePlus. (2010). Psoriatic Arthritis. Retrieved on February 15, 2010 from MedlinePlus: https://www.nlm.nih.gov/medlineplus/ency/article/000413.htm
Psoriatic Arthritis of the Spine: Fiona McQueen, Mikkel Ostergaard, and Marissa Lassere – Wikimedia Commons