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News Letter

Psoriatic Arthritis: Symptoms, Causes and Treatments Print E-mail

Psoriatic arthritis is related to the skin condition psoriasis. It causes pain and swelling in some joints and scaly skin patches on a number of places on the body. About 10 to 30 percent of people who have psoriasis will develop this type of arthritis. Psoriatic arthritis can occur at any age in men and women, but it is more common in people between the ages of 20 and 50.

Psoriasis is a rough, scaly patch type of rash that affects about 30 million Americans. The rash commonly appears on the scalp, elbows and knees. People may also experience problems with their toes, fingernails and/or eyes. In about 15 percent of psoriatic arthritis cases, the arthritis part of the disease appears first. Psoriasis is not contagious and its cause is unknown. Some experts believe that having a weakened immune system will put people at risk of developing psoriasis. Cuts and scrapes and insect bites are known triggers for causing a flare-up.

Causes of Psoriatic Arthritis

The causes of psoriasis and psoriatic arthritis are unknown. Some doctors believe it may be partly inherited and environment might play a role. In order to find out if you are suffering from psoriatic arthritis, your doctor may order X-rays, blood tests and joint fluid tests. He or she will ask you for your medical history and will examine your body.

Symptoms of Psoriatic Arthritis

The symptoms usually come on slowly and the majority of people with psoriatic arthritis have a mild case. More than 80 percent of people with psoriatic arthritis will have problems with their fingernails and/or toenails. Joints that are usually affected include the wrist, knee, ankle, lower back and neck.

Symptoms of psoriatic arthritis include:

  • Silver or grey scaly spots on the scalp, elbows, knees and/or lower end of the spine
  • Lifting or pitting of fingernails/toenails
  • Redness and pain in the eye
  • Pain, stiffness and swelling in one or more joints and the soft tissue surrounding them
  • Swelling of fingers and/or toes
  • Limited range of motion


Five Types of Psoriatic Arthritis

There are five types of psoriatic arthritis. A person may have one or more types. Each type has its own progression and course of treatment.

  • Asymmetric arthritis: Asymmetric arthritis does not occur in the same joints on both sides of the body and usually affects only one to three joints. Typically the knee, hip, ankle or wrist will be affected. You may notice that your hands and feet are swollen and the joints may be warm, tender or red. This form is generally mild and is the most common.


  • Symmetric arthritis: This type is similar to rheumatoid arthritis but is typically milder and with less cases of deformity. It can be severe and multiple joints on both sides of the body may be affected. For instance, if one knee is affected, the other will be too. The accompanying psoriasis may be particularly bad in this type of psoriatic arthritis.  


  • Distal Interphalangeal Predominant: Sometimes mistaken for osteoarthritis, this type usually affects the last joint of the fingers and toes (distal interphalangeal joint).


  • Spondylitis or Psoriatic Spondyloarthritis: A rare but serious condition, spondylitis can cause deformity and changes in posture. Inflammation of the spine is the most common symptom. Movement may be painful as the neck and lower back may also be stiff and inflamed.


  • Arthritis Mutilans: Less than five percent of people with psoriatic arthritis have this serious type of arthritis. Usually the small joints in the hands and feet are affected. This type is unusually severe because it may actually destroy the bones and cartilage. Pain may be associated to skin flare-ups and remissions.

Treatment of Psoriatic Arthritis

At this time, there is no cure for psoriatic arthritis.  Every patient is different, and your treatment program will be tailored to fit your own particular needs. Your doctor may advise you to see a dermatologist, a doctor who specializes in skin diseases, for treatment of your psoriasis. Depending on your case, a rheumatologist may be called in for specialized treatment.

Treatment plans are designed to reduce inflammation in the joints, reduce pain and prevent further damage.  Non-steroidal anti-inflammatory drugs (NSAIDs) are used to control the pain and swelling of the arthritis. Your doctor may inject steroids directly into affected joints. Other drugs, such as methotrexate and an antimalarial drug known as hydroxychloroquine, may also be used. Other more aggressive treatments include corticosteroid injections into the joints or injections of gold salts for patients with more destructive joint damage. Surgery may be necessary in cases of very severe joint damage.

Soaking in warm water or using heat or cold applications may provide some pain relief. Make sure you get enough rest and proper nutrition. Your doctor may also suggest an exercise program to improve the health of your joints. Your doctor can work with you to find the best treatment for your type of psoriatic arthritis.


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