Psoriatic Arthritis

Psoriatic arthritis is an arthritis that is associated with psoriasis of the skin.

Causes, incidence, and risk factors   

Psoriasis is a common, chronic skin condition that causes red patches on the body. About 1 in 20 individuals with psoriasis will develop arthritis along with the skin condition. In the majority of cases, psoriasis comes before the arthritis.

The disorder can be exhibited in a variety of ways. The arthritis is generally mild and involves only a few joints. In a few people, the disease is severe and usually affects the fingers and the spine. When the spine is affected, the symptoms are very much like those of ankylosing spondylitis.

The cause of psoriatic arthritis is not known, but genetic factors may play a role. In general, people who have psoriasis have a higher prevalence of arthritis than the general population.

Symptoms    

    * Nail abnormalities, or skin lesions of psoriasis
    * Joint swelling and joint pain (arthritis)
          o Usually of the fingers and toes, but other joints can be affected
          o Wrist pain, knee pain, hip pain, elbow pain, ankle pain
    * Pain and swelling at the site of attachment of tendons to bone
          o The Achilles tendon is often involved

Signs and tests   

During a physical examination, the doctor will identify skin lesions, tenderness, and swelling of joints. Joint x-rays may be performed.

Treatment   

Treatment of psoriatic arthritis involves medication, patient education, and physical and occupational therapy.

Nonsteroidal anti-inflammatory medications (NSAIDS) or salicylates are used to reduce the pain and inflammation of the joints. More severe arthritis requires treatment with more powerful drugs called disease modifying antirheumatic drugs (DMARDS). Occasionally, particularly painful joints may be injected with steroid medications. Psoriasis treatment is usually continued or started.

Rarely, surgery to repair or replace damaged joints will be performed.

Get rest and exercise. To increase mobility, physical therapy provides exercise programs for specific joints. Heat and cold applications, or hydrotherapy may also be used.

Expectations (prognosis)   

The course of the disease is often mild and affects only a few joints. In those with severe arthritis, treatment is usually very successful in alleviating the pain.

Complications   

Repeated episodes may occur.

Calling your health care provider   

Call for an appointment with your health care provider if arthritis symptoms develop along with psoriasis.

Prevention   

There is no proven prevention of psoriatic arthritis.