What Is Psoriatic Arthritis?

Psoriatic arthritis is a type of arthritis linked to a second medical disorder – psoriasis, a dermatological condition in which crusty red patches with silver flecks form on the skin. Only a small amount of individuals with psoriasis develops psoriatic arthritis. It’s also possible to develop this condition without first having psoriasis. Like other forms of the disease, psoriatic arthritis is marked by joint swelling, pain, and immobility. The severity of a psoriatic disorder varies considerably and different joints can be affected by the disease at different times.

Left untreated, psoriatic arthritis can result in joint damage and permanent disability. There is no cure, but Baptist Health medical providers can help if you or a family member is dealing with this condition.

What Are the Symptoms of Psoriatic Arthritis?

The following symptoms are common to psoriatic arthritis:

• Physical weakness or fatigue, especially in the morning
• Joint swelling, pain, and stiffness
• Painful tendons
• Swollen toes and fingers
• Loss of limb motion
• Flaky scalp
• Red, scaly patches of skin
• Pitting or separation of the finger or toenails

Some individuals with psoriatic arthritis also develop an ocular condition, called uveitis. Symptoms are eye pain and redness. 

There are several forms of psoriatic arthritis. What they have in common is an overactive immune system attacking the joints and skin. Symmetric affects the same joints on both sides of the body, while asymmetric is concentrated on one side only. The distal interphalangeal form develops in the toes and fingers. Another version, spondylitis, targets the spinal column. Psoriatic arthritis mutilans is the most serious type, leading in some cases to deformed limbs. It occurs in about five percent of all persons with psoriatic arthritis. 

What Causes Psoriatic Arthritis? What Are the Risk Factors?

The cause or causes of psoriatic arthritis are unclear. There is some evidence that the condition is, in part, hereditary, with about four out of ten sufferers having a family member or close relative with either psoriasis or arthritis. Environmental factors likely play a role as well. An initial outbreak is sometimes preceded by a streptococcal infection (“strep throat”). Psoriatic arthritis is not contagious.

In addition to psoriasis and family medical history, a third risk factor is age. Most persons with psoriatic arthritis see it develop between the ages of 30 and 50. Adult men and women are about equally at risk.

How Is Psoriatic Arthritis Diagnosed?

There are several forms of arthritis and diagnosing them can be an involved process. Your physician will likely take one or more of the following steps to identify psoriatic arthritis as the source of your health concerns:

• Physical exam: In addition to recording your symptoms and family medical history, your physician will check your joints for stiffness and swelling and your nails for evidence of cracking or pitting. He or she may also press the bottoms of your feet, which are often tender in persons developing psoriatic arthritis. Reporting eye pain may also indicate uveitis. 
• Imaging tests: Different forms of arthritis alter the joints in different ways. Imaging tests are used to determine the exact nature of these changes, which can help pinpoint the type of arthritis behind your pain and reduced mobility. Either X-rays or magnetic resonance imaging (MRI) scans may be utilized. 
• Laboratory tests: Two laboratory tests are sometimes used to rule out the possibility of psoriatic arthritis, even when symptoms suggest it. One of these is a test for the presence of uric-acid crystals in joint fluid. Uric acid is linked to gout rather than psoriatic arthritis. A second is a blood test for RF, or rheumatoid factor, an antibody associated with rheumatoid arthritis. If test results are negative, a diagnosis of psoriatic arthritis is more likely. 

Your physician may run other tests, looking for evidence of inflammation or anemia, both of which are common in persons with psoriatic arthritis. 

How Is Psoriatic Arthritis Treated?

Because there is currently no cure for psoriatic arthritis, treatment focuses on reducing inflammation and pain, while maintaining limb motion and mobility. Primary treatments include:

Medications

• Nonsteroidal anti-inflammatory drugs (NSAIDS): NSAIDs control pain by decreasing inflammation. Many are available over-the-counter, including Advil, Aleve, and Motrin IB. Stronger NSAIDs are be obtained by prescription. 
• Topical ointments: Ointments are available for controlling psoriatic rashes. 
• Immunosuppressants: Immunosuppressant drugs are designed to reduce immune-system activity, which is one of the drivers of psoriatic arthritis. 
• Disease-modifying antirheumatic drugs (DMARDs): DMARDs protect limb mobility by slowing the impact of arthritis on the joints. 
• Biologics: Biologics block the body’s inflammatory response to infection. 

Some of these drugs have serious side effects, including nausea, organ damage, bone marrow suppression, and a lowered ability to fight infection. 

Other Procedures

• Steroids: Steroids injected directly into the joints can provide quick relief of inflammation. 
• Light therapy: When combined with medication, light therapy has shown promise in the treatment of psoriasis. 
• Joint-replacement surgery: The replacement of badly damaged joints by artificial protheses is one option for treating particularly difficult cases of psoriatic arthritis. 

The outlook for persons with psoriatic arthritis varies, depending on the severity of symptoms and the duration and intensity of treatment. That said, it is possible to maintain quality of life, if psoriatic arthritis is properly diagnosed and actively treated.

Baptist Health Can Help

Psoriatic arthritis is a serious and potentially debilitating condition that can lead to joint damage and immobility. It can’t be cured but it can be controlled. If you or a loved one is exhibiting the symptoms of this disease, don’t delay in seeking medical care.