Psoriatic arthritis percentage
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.
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Psoriatic arthritis is a type of arthritis that has been diagnosed in approximately 23 percent of people who have psoriasis.
Information from the Arthritis Foundation and the National Institutes of Health
Psoriasis is an inflammatory skin disorder characterized by frequent episodes of redness and itching, thick, dry, silvery scales on the skin and nail abnormalities.
Psoriatic arthritis can develop at any time. On average, it 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 due to a dysfunctional immune system. Psoriatic arthritis is usually milder than rheumatoid arthritis, but some patients with psoriatic arthritis have as severe a disease issue as patients with rheumatoid arthritis.
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.
While the cause is not known, genetic factors, along with the immune system, infection and physical trauma, play a role in determining who will develop the disorder.
As many as 40 percent of people with psoriatic arthritis have a family history of skin or joint disease. Children of parents with psoriasis are three times more likely to have psoriasis and are at greater risk for developing psoriatic arthritis than children born of parents without psoriasis.
There are five types of psoriatic arthritis. It is important to know what type of psoriatic arthritis you have and understand its characteristics so that it may be treated properly.
Symmetric arthritis affects the same joints – usually in multiple matching pairs – on both sides of the body. Symmetric arthritis can be disabling, causing 50 percent of people with this type of arthritis to develop variable degrees of progressive, destructive disease. While symmetric arthritis resembles rheumatoid arthritis because it typically affects the peripheral joints (joints in the fingers and toes), it is less severe.
Asymmetric arthritis typically involves one to three joints in the body – large or small – such as the knee or hip, one finger or several fingers. Asymmetric arthritis does not affect matching pairs of joints on both sides of the body.
Distal Interphalangeal Predominant (DIP)
Distal interphalangeal predominant psoriatic arthritis involves primarily the distal joints (small peripheral joints in the fingers and toes closest to the nail). DIP is sometimes confused with osteoarthritis, a chronic, non-inflammatory disease that causes the deterioration of joint cartilage and tissues, and the formation of bone spurs at the joints.
Spondylitis affects the spinal column and may cause inflammation and stiffness in the neck, lower back, spinal vertebrae or sacroiliac region (pelvic area), making motion difficult. Spondylitis also may attack connective tissue, such as ligaments, or cause arthritic disease in the joints of the arms, hips, legs or feet.
Arthritis mutilans is a severe, deforming and destructive arthritis that primarily affects the distal joints (small peripheral joints in the fingers and toes closest to the nail) of the hands and feet, but also may be frequently associated with lower back and neck pain.
The onset of psoriatic arthritis symptoms may vary. For some, the onset of symptoms may be gradual and subtle, and for others it may be sudden and dramatic. Generally, the signs and symptoms of psoriatic arthritis include some or all of the following:
• Discomfort, stiffness, pain, throbbing, swelling or tenderness in one or more joints
• Reduced range of motion in joints
• Morning stiffness and fatigue
• Silver or gray scaly spots on the scalp, elbow, knees and/or the lower spine
• Inflammation or stiffness in the lower back, wrists, knees or ankles, or swelling in the distal joints (small joints in the fingers and toes closest to the nail), giving these joints a sausage-like appearance
• Pitting of the nails (small depressions)
• Detachment of fingernails or toenails
• Tenderness, pain or swelling where tendons and ligaments attach to the bone
• Inflammation of the eye (such as conjunctivitis)
The diagnosis of psoriatic arthritis is based upon:
• The appearance of symptoms
• A complete evaluation of your medical history
• Blood studies
• X-rays or MRI of the joints
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