Many people think psoriasis is just a skin condition and often do not associate their 'aches and pains' with their underlying psoriasis.However, in reality, it is estimated that up to 30 percent of people with psoriasis develop Psoriatic arthritis (PsA) at some point in their life-time.
It is even less known to people that people with Psoriatic arthritis are at greater risk of developing other chronic and serious health conditions known as 'comorbidities'.
As a rheumatologist, I am passionate about treating many rheumatological conditions however Psoriatic arthritis has been at the top lately.
PsA Symptoms:
Pain, swelling and stiffness of affected joints
It can also affect spine in some patient causing lower back pain and stiffness
It can also cause enthesitis (inflammation of the point where tendon and ligament attaches to the bone - e.g achilles tendon).
Sometimes it can cause dactilitis (inflammation of the whole finger or toe often called 'sausage digit')
Tenosynovitis can also occur when the sheaths surrounding certain tendons, especially those in the hands and arms, become swollen and inflamed.
80-90% of people can have nail changes
In some cases, people with PsA can experience eye problems. Inflammation of the structures of eye can cause eye pain and redness and is referred to as 'Uveitis' or 'Iritis'.
PsA diagnosis:
Rheumatologists diagnose PsA by obtaining the medical history and performing a physical examination. X-rays of the joints may be done to look for inflammation and joint damage. Blood tests or joint fluid tests may be done to rule out other types of arthritis.
PsA is mainly a clinical diagnosis and there are no blood markers to diagnose like we have in Rheumatoid arthritis. Rheumatologists are trained to look for signs and symptoms of PsA and know the right questions to ask. I also have great dermatologist colleagues in my community who often identify concerning symptoms for PsA and send patients with Psoriasis to me for further evaluation.
Treatment:
While psoriasis is mainly treated by dermatologists, PsA is usually treated and managed by rheumatologists. Usually prolonged therapy is required as no treatment can cure the disease. PsA treatment can not only help manage the symptoms, it can also stop the progression of disease. Many different types of treatments are available for PsA. Please talk to your rheumatologist about your options.
Lifestyle changes:
Weight loss can help! Several studies have found that weight loss can improve response to medical treatment for both psoriasis and PsA. Exercise and physical therapy may also help to relieve the pain and stiffness associated with psoriatic arthritis.
The following organizations also provide reliable health information and support.
Arthritis Foundation (www.arthritis.org)
National Psoriasis Foundation (www.psoriasis.org)