Psoratic arthritis

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

The actual spelling is psoriatic arthritis. Psoriatic (or psoratic... if you prefer) arthritis is a specific type of arthritis that occurs in approximately 23 percent of people who have psoriasis, according to the Psoriasis Foundation’s 2001 Benchmark Survey.

It commonly affects the ends of the fingers and toes. It can also affect the spine. The disease can be difficult to diagnose, particularly in its milder forms and earlier stages. Early diagnosis, however, is important for preventing long-term damage to joints and tissue.

Most people with psoriatic arthritis also have psoriasis. Rarely, a person can have psoriatic arthritis without having psoriasis.

Symptoms include:

• Stiffness, pain, swelling and tenderness of the joints and surrounding soft tissue
• Reduced range of motion
• Morning stiffness and tiredness
• Nail changes, including pitting (small indentations in the nail) or lifting of the nail—found in 80 percent of people with psoriatic arthritis
• Redness and pain of the eye, similar to conjunctivitis

Psoriatic arthritis can develop at any time. It usually appears about 10 years after the first signs of psoriasis. For most people it appears between the ages of 30 and 50. It affects men and women equally. In about one of seven people with psoriatic arthritis, arthritis symptoms occur before any skin lesions.

Like rheumatoid arthritis, psoriatic arthritis is thought to be caused by a dysfunctional immune system. Psoriatic arthritis is usually milder than rheumatoid arthritis, but some patients with psoriatic arthritis have as severe a disease as patients with rheumatoid arthritis.

Psoriatic arthritis is not the same disease as rheumatoid arthritis. There are different immune abnormalities. Unlike rheumatoid disease, psoriatic arthritis attacks the entheses, the attachment of tendons into bones.

Psoriatic arthritis can start slowly with mild symptoms, or it can develop quickly. It is very important to have as early and accurate a diagnosis as possible. Left untreated, psoriatic arthritis can be a progressively disabling disease. In fact, half of those with psoriatic arthritis already have bone loss by the time the disease is diagnosed.

There is no definitive test for psoriatic arthritis; However, the onset of joint swelling and pain in patient with psoriasis should be a warning signal

Treatment for this condition involves anti-inflammatory medications (to help with symptoms),disease-modifying medicines (to slow down the progression of disease), and biologic drugs to put it into remission.

Other biologics may also be effective.

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