Psoriatic arthritis is a chronic disease and a type of inflammatory arthritis characterized by inflammation of the skin known as psoriasis and inflammation of the joints known as arthritis. It affects 10-30% of the Caucasian population in the United States. Psoriasis features patchy, raised, redness of skin inflammation with scaling, thickness, and dryness and nail abnormalities.
Symptoms include discomfort, stiffness, pain, throbbing, swelling or tenderness in one or more joints; joints decreased range of motion; morning stiffness and fatigue; silver or gray scaly spots on the scalp, knees, elbows, or the lower spine; inflammation or stiffness in the lower back, knees or ankles, wrists, or swelling in the small joints in the fingers and toes closest to the nail known as dactylitis; small depressions or pitting of the nails; detachment of fingernails or toenails; enthesitis; and inflammation of the eye.
Symmetric psoriatic arthritis, asymmetric psoriatic arthritis, distal interphalangeal predominant (DIP), spondylitis and arthritis mutilans are among the five types of psoriatic arthritis. Symmetric arthritis affects the same joints and in matching pairs on both sides of the body, while Asymmetric arthritis involves one to three parts of the body like the knee, hip, or one or more fingers. Distal interphalangeal predominant psoriatic arthritis is sometimes confused with osteoarthritis because it mainly affects small joints in toes and fingers that are nearer to the nail. Affecting the spinal column is spondylitis which causes neck, spinal vertebrae, lower back and pelvic area stiffness and inflammation. It also attacks connective tissue ligaments or may also be the cause of arthritic diseases affecting joints in the arms, legs, hips or feet. Last type of psoriatic arthritis is the arthritis mutilans which happens to be a destructive, deforming and severe form of psoriatic arthritis. This type of psoriatic arthritis is uncommon.
Psoriatic arthritis affects men and women equally and can progress at any age affecting mostly in people between their 30s and 50s. Genetic, immune system, infection and physical trauma are some of the factors causing psoriatic arthritis.
The diagnosis of the disease depends on the appearance of symptoms, complete evaluation of medical history, blood studies, physical examination and X-rays of the joints.
Medications for symptoms relief would include any combination of non-steroidal anti-inflammatory drugs (NSAIDs) along with misoprostol (Cytotec). Corticosteroids or steroids like prednisone can be taken orally or by injection to reduce pain and inflammation. Disease modifying anti-rheumatic drugs or DMARDs such as methotrexate and sulfasalazine are given to modify or suppress the immune system which makes the disease process slow. Regular, tailored program of range-of-motion and strengthening exercises like hydrotherapy, recreational exercise, hot and cold therapy is also helpful to alleviate joint stiffness and pain. Synovectomy, a surgical procedure to restore joint function may be necessary when all other medications and treatments fail. Joint fusions can also be performed for pain relief that can no longer be controlled with treatment thus allowing the person to perform again his daily normal activities.
Three techniques which include pacing, conservative joint use and assistive devices such as canes and grab bars can contribute workloads distribution and stress throughout the body. Splinting may also be needed to minimize destruction of the joints.
Cure for psoriatic arthritis has not yet been discovered, however, understanding the disorder, personal observation and learning from it, exercise and assertive treatment has been proven to impede disability which lessens discomfort, stress and fatigue.