Psoriatic arthritis is a form of joint inflammation that develops among individuals who have psoriasis of the nails or skin. The commonly affected joints include the knees, hips and those that are close to the tips of the toes and fingers.
It is important to note that psoriatic arthritis strikingly resembles rheumatoid arthritis but does not trigger the antibodies distinctive of rheumatoid arthritis. The condition occurs in some individuals who have psoriasis. Those who have a certain gene and those who have a family history face a higher risk and the exact cause is unknown.
Indications of psoriatic arthritis
The inflammation often affects the joints that are close to the tips of the toes and fingers, although other joints including the knees, hips and spine are also affected as well. Oftentimes, the joints in the upper extremities are affected. In some cases, back pain is also present.
The affected joints can become swollen and appear deformed if there is chronic inflammation. Psoriatic arthritis affects the joints asymmetrically. The rash can manifest before or after arthritis develops. Oftentimes, the rash is not evident since it is hidden in the scalp, navel or skin creases such as between the back of the buttocks and the thigh. The joint and skin symptoms can manifest and disappear together.
How is it diagnosed
A diagnosis of psoriatic arthritis is done by identifying the distinctive joint inflammation in an individual who has psoriasis and arthritis. The doctor will also ask if the individual has a family history of psoriasis.
Even today, there are no tests to confirm a diagnosis but the blood tests for rheumatoid factor are carried out to exclude rheumatoid arthritis and x-rays are performed to reveal the extent of joint damage.
Management
The treatment for psoriatic arthritis is aimed on managing the rash and alleviating the joint inflammation. A number of medications are effective in treatment rheumatoid arthritis that are also used to treat psoriatic arthritis especially non-steroidal anti-inflammatory drugs (NSAIDs), cyclosporine, methotrexate and tumor necrosis factor (TNF) inhibitors. Take note that the TNF inhibitors are highly effective for psoriatic arthritis.
Some individuals are given psoralen orally with phototherapy. This combination can relieve the skin symptoms and most of the joint inflammation but might not help with the spinal inflammation.