Psoriatic Arthritis

Tai Chi For Psoriasis

Psoriatic arthritis is a chronic disease characterized by inflammation of the skin (psoriasis) and joints (arthritis). Psoriasis is a common skin condition affecting approximately 2% of the population. This skin condition is characterized by patchy, raised, red areas of skin inflammation with scaling. Psoriasis can affect any part of the body, but most often affects the tips of the elbows and knees, the scalp, the navel, and around the legs, hands, and nails. Approximately 5–7% of psoriasis patients also develop an associated inflammation of their joints, a condition we know as psoriatic arthritis. Patients who have inflammatory arthritis and psoriasis together are diagnosed as having psoriatic arthritis.

Article of interest: Psoriasis symptoms

This type of arthritis usually starts in a person’s forties or fifties, and it can affect both men and women in the same way. Both the psoriasis and the arthritis often appear separately. In fact, the skin disease precedes the arthritis in nearly 80% of patients. However, the arthritis may precede the psoriasis in up to 15% of patients. It can be very difficult to diagnose psoriatic arthritis, because both arthritis and psoriasis may occur in a patient but manifest many years apart.

Psoriatic arthritis is a particular form of arthritis sometimes associated with other auto-immune diseases, such as ankylosing spondylitis, reactive arthritis (Reiter’s syndrome), and arthritis associated with inflammatory bowel disease (IBD), such as Crohn’s disease and ulcerative colitis. All of these auto-immune conditions can cause inflammation in the spine and other joints, as well as the eyes, skin, mouth, and various organs.

Psoriatic arthritis belongs to a group of arthritis conditions that cause inflammation of the spine (spondyloarthropathies). You might like to read the article on the pharmaceutical approach to auto-immune disease and the most effective natural auto-immune disease treatment.

Psoriatic arthritis symptoms

Some people with psoriasis may experience psoriatic arthritis, a form of inflammatory arthritis. The first appearance of the skin disease (psoriasis) can be separated from the onset of joint disease (arthritis) by years.

Psoriatic arthritis symptoms can differ from person to person, but typical symptoms include:

Joint pain and swelling. The most obvious sign of psoriatic arthritis is frequently joint discomfort and swelling, which can affect any joint in the body. The joints could feel warm to the touch, swollen, and sensitive.Stiffness. Joint stiffness is a common symptom of psoriatic arthritis, especially after periods of inactivity, such as when a person first wakes up in the morning.Fatigue. Tiredness: People with psoriatic arthritis often feel tired, which can be very hard to deal with and make it hard to do day-to-day things.Nail changes. Changes in the nails: Some people with psoriatic arthritis have changes in their nails, like thickening, pulling away from the nail bed, or pitting (tiny holes in the nails).Skin changes. People with psoriatic arthritis may have psoriasis or may develop new patches of psoriasis.Eye changes. Eye problems: People with psoriatic arthritis who get eye inflammation may have redness, pain, and trouble seeing.Inflammation. Patients with psoriatic arthritis can develop inflammation of tendons, cartilage, eyes, lung lining, and, rarely, the aorta.

Psoriatic arthritis nails

People who have psoriatic arthritis may experience changes to their nails, such as thickness, separation from the nail bed, or pitting (tiny pits in the nails). This change in the nails is called “nail psoriasis” or “psoriatic nail disease,” and it may mean that the person has psoriatic arthritis.

One or more nails may become discoloured, brittle, and prone to breaking as a result of nail psoriasis. In severe cases, the skin around the nails may become red and swollen, and the nails themselves may swell and take on an abnormal shape. It can be uncomfortable and challenging to carry out daily tasks like typing or writing when you have nail psoriasis.

Psoriatic arthritis nails

The interesting point with auto-immune conditions is that there are “no known causes” as far as conventional medicine is concerned, and the cause of psoriatic arthritis is currently unknown. A combination of genetic, immune, and environmental factors are likely involved. There is a gene involved, and the HLA-B27 gene is found in more than half of those with spine arthritis, and a blood test for this marker has recently become available. With ankylosing spondylitis, HLA-B17 is also apparent.

Some experts believe that there are infectious agents responsible for auto-immune conditions such as psoriatic arthritis, because certain changes in the immune system may be important in the development of psoriatic arthritis. For example, a reduction in the number of immune cells called helper T cells in people with AIDS may play a role in the development and progression of psoriasis and psoriatic arthritis in these patients.

Psoriatic arthritis diagnosis

Psoriatic arthritis is a diagnosis made mainly on clinical grounds, based on a finding of psoriasis and the typical inflammatory arthritis of the spine and/or other joints. There is no laboratory test to diagnose psoriatic arthritis. Some blood tests, like the sedimentation rate, can show that inflammation is present in the joints and other organs of the body.

Other blood tests, such as rheumatoid factor, are obtained to exclude rheumatoid arthritis. When one or two large joints (such as the knees) are inflamed, arthrocentesis can be performed. Arthrocentesis is a procedure done in a doctor’s office where a sterile needle is used to remove fluid from inflamed joints. The fluid is then analysed for infection, gout crystals, and other inflammatory conditions.

Changes in cartilage or broken bones in the spine, sacroiliac joints, or joints of the hands can be seen on X-rays. Typical X-ray findings include bony erosions resulting from arthritis. The blood test for the genetic marker HLA-B27, mentioned above, is often performed. This marker can be found in over 50% of patients with psoriatic arthritis who have spine inflammation.

Psoriatic arthritis treatment

People often treat psoriatic arthritis with a mix of prescription drugs, physical therapy, and changes to their diet.

There are 3 main drugs used to treat psoriatic arthritis:

Nonsteroidal anti-inflammatory drugs (NSAIDs), which reduce pain and inflammationDisease-modifying anti-rheumatic drugs (DMARDs), which slow the progression of the diseaseBiologics, which are proteins produced in a laboratory that target particular immune system regions to lessen inflammation.

Physical therapy and exercise can help people with psoriatic arthritis get more flexible, stronger, and able to do more. People with psoriatic arthritis need to stay active and keep a healthy weight because being overweight can make the condition worse.In addition to making lifestyle changes, such as giving up smoking and controlling stress, psoriatic arthritis symptoms may also benefit from such management. The arthritis of psoriatic arthritis is treated independently of the psoriasis, with exercise, ice applications, medications, and surgery.Patients with psoriatic arthritis should work closely with their health-care professionals to come up with a treatment plan that fits their specific needs and goals.As better and safer medicines are made, psoriatic arthritis will be treated in different ways in the future. Recently, it has been shown that vitamin D might actually improve the symptoms of psoriatic arthritis. Other areas of research involve treatment with medications that can alter the immune systems of patients with psoriatic arthritis. As the immune system changes and the genetics of this illness are better understood, these treatments will work better.

For more information about psoriatic arthritis, please visit the following sites:

National Psoriasis Foundation/USA (


Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia: Lippincott Williams & Wilkins, 2003.Ruddy, Shaun, et al., eds. Kelley’s Textbook of Rheumatology, 6th ed. Philadelphia: Saunders, 2001.


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