It’s not the most common skin disorder, acne gets that honour, but psoriasis is the one that can lead to psoriatic arthritis (PsA) which is often painful joint inflammation. The National Psoriasis Foundation estimates more than eight million Americans — two to three percent of the total population — have psoriasis.
As high as thirty percent of those folks will develop psoriatic arthritis often between their thirtieth and fiftieth birthdays or roughly ten years after the first signs of psoriasis. It’s unusual, but one can develop psoriatic arthritis without having psoriasis.
For those of you who need a refresher, psoriasis is a skin disorder that causes skin cells to multiply up to ten times faster than usual. The result is that the skin builds up into bumpy red patches covered in white scales that can grow anywhere but mostly on the scalp, elbows, knees, and lower back. This condition is not in any way, shape, or form contagious.
“Though there is no cure, there is a growing range of treatments available to help stop the disease progression, lessen pain, protect joints and preserve the range of motion,” NPF says. “Early recognition, diagnosis, and treatment of psoriatic arthritis are critical to relieve pain and inflammation and help prevent joint damage.”
Let’s emphasize early recognition. NPF says that permanent joint damage can occur without seeking treatment in as little as six months, confirming this is not one of those conditions that you should take a wait and see the type of attitude.
PsA doesn’t follow a set pattern. Symptoms can develop quickly with severe pain, or slowly with mild discomfort. Some people may develop PsA after an injury that, at first thought, appears to be a cartilage tear.
Common symptoms include fatigue, tenderness, pain and swelling over tendons; swollen fingers and toes that make those appendages look like sausages; stiffness, pain, throbbing, swelling and tenderness in one or more joints; a reduced range of motion; morning stiffness and tiredness; nail changes (I’ll explain more in a bit), and redness and pain in the eye(s).
“There is little connection between psoriasis severity and PsA severity. Having a severe case of psoriasis does not necessarily mean you will have a severe case of psoriatic arthritis,” NPF explains. “You could have a few skin lesions, but many joints affected by arthritis.”
The National Institutes of Health says that psoriatic arthritis may be “difficult to distinguish from other forms of arthritis, mainly when skin changes are minimal or absent. Nail changes and dactylitis (digit swelling) are two features that are characteristic psoriatic arthritis, although they do not occur in all cases.
Nail changes include tiny dents described as pitting and ridges in the fingernail. And, WebMD explains that “sometimes the entire nail pulls away from the nail bed. The separated part might be opaque with a white, yellow, or green tint. Your doctor might call this condition onycholysis.”
Having PsA can put you at risk of developing other conditions. The most common are cancer (lymphoma and non-melanoma skin cancer), cardiovascular disease, Crohn’s disease, depression, eye inflammation, and vision problems, gout, and joint damage.
“Researchers have found a link between psoriasis, psoriatic arthritis, and metabolic syndrome, a cluster of conditions that include heart disease, obesity, and high blood pressure. Women with psoriasis and anyone with severe psoriatic arthritis may be almost twice as likely to get it as others,” WebMD explains.
There isn’t a definitive test for psoriatic arthritis. Your healthcare provider will make the diagnosis utilizing observation and the process of elimination. Blood tests, MRIs, and X-rays of the joints will help to rule out other diseases and to determine the cause of symptoms. Your and your family’s medical history will aid the diagnosis as frequently, people with psoriatic arthritis have a parent or sibling with the disease.
“The symptoms of psoriatic arthritis are similar to those of three other arthritic diseases: rheumatoid arthritis, gout, and reactive arthritis,” NPF says. It’s important to know what type of arthritis you’re suffering from because they are all treated differently.
Although there is no cure, symptoms to control inflammation are often successfully managed by medications. Sometimes steroid injections are used to reduce inflammation quickly. When PsA severely damages joints and will require surgery.
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com
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