Psoriatic arthritis is a painful disease characterized by both joint erosion and skin lesions. It causes inflammation in and around the joints and affects an estimated one million adults. People with psoriatic arthritis experience progressive joint pain and swelling, which is often coupled with scaly, red skin lesions.
Psoriatic arthritis has a physical impact and can make simple daily activities more difficult and frustrating. It also has an emotional impact on people’s feelings, behaviors and experiences. Because of the skins lesions associated with psoriatic arthritis, patients may feel sadness, despair, guilt, anger and low self-esteem. A person’s sense of self-worth can be affected and, in some cases, the emotional turmoil of psoriatic arthritis can lead to depression.
Causes and symptoms
The exact cause of psoriatic arthritis is unknown, but it is believed to be an autoimmune disease with genetic components. Environment may also be a factor in the development of the disease. Psoriatic arthritis can manifest differently in various patients. About 95 percent of people with psoriatic arthritis have swelling in joints outside the spine, and more than 80 percent of people with psoriatic arthritis experience changes in their nails such as indentations or lifting of the nail. Other symptoms may include:
- Stiffness, pain, swelling and tenderness of the joints and the soft tissue around them.
- Reduced range of motion.
- Morning stiffness, tiredness and fatigue.
- Silvery layers of skin that flakes off leaving red, inflamed skin underneath.
- Redness and pain of the eye, similar to conjunctivitis.
Diagnosis of psoriatic arthritis
Psoriatic arthritis can develop at any time. On average, it appears about 10 years after the first appearance of the skin lesions associated with psoriatic arthritis. However, about one of seven people develops arthritic symptoms before any skin lesions appear. The disease can be difficult to diagnose, particularly in its milder forms and earlier stages. Typically, diagnosis of psoriatic arthritis is based on the patient’s medical history or a physical exam.
Psoriatic arthritis is a chronic inflammatory arthritis that occurs in 5 to 40% of patients with psoriasis of the skin or nails. The arthritis is often asymmetric; some forms involve the distal interphalangeal joints.
Disease risk is increased in patients with human leukocyte antigen HLA-B27 or some other specific alleles and in family members. Etiology and pathophysiology of psoriatic arthritis are unknown.
Psoriatic arthritis is diagnosed clinically and by excluding other disorders that can cause such similar manifestations. Plain X-rays can help pinpoint changes in the joints that occur in psoriatic arthritis but not in other arthritic conditions. As rheumatoid factor, cyclic citrullinated peptide antibodies (anti-CCP) and mutated citrullinated vimentin antibodies (anti-MCV) are often present in the blood of people suffering from rheumatoid arthritis, but not usually in the blood of people with psoriatic arthritis, these tests may be useful to distinguish between the two conditions.
- World Psoriasis Day: http://www.worldpsoriasisday.com/
- International Federation of Psoriasis Associations: http://www.ifpa-pso.org/t1.aspx
- World Psoriasis Day in Germany [German]: http://www.weltpsoriasistag.de