Psoriatic arthritis (PsA) is a possible complication due to psoriasis. In psoriasis, the immune system recognizes your own body as foreign and starts attacking itself, including the skin. Similarly, psoriatic arthritis occurs when the immune system targets the joints to cause inflammation and damage. Like psoriasis, psoriatic arthritis can look very different between people.
PsA has a slow gradual progression and can affect multiple joints. Up to 30% of people with psoriasis can get PsA, and it usually affects both men and women between the ages of 30 and 50. There are five general patterns of PsA:
- It can develop in an asymmetrical pattern and affect fewer than 5 different joints.
- It can develop symmetrically and affect multiple joints.
- It can develop in a distal pattern, where joints close to the nails on your hands and feet are most affected.
- It can affect the joints of the spine.
- It can in rare cases develop in a destructive pattern and cause joint deformations.
Before developing psoriatic arthritis, 85% of people will experience the skin effects of psoriasis. However, not everyone who has psoriasis will develop psoriatic arthritis.
Psoriatic arthritis often has numerous symptoms that are very similar to those of regular arthritis. Local inflammatory symptoms such as tenderness, pain, and swelling are common along with joint stiffness and reduced range of motion. There are also generalized symptoms that affect the entire body, such as chronic fatigue and tiredness.
Although PsA is not actually curable, early treatment can help control the disease and avoid severe damage to the joints. This means that early detection is very important. There are symptoms that serve as warning signs of PsA. This type of arthritis normally feels more painful and stiff early in the morning, and then feels better after the joint “loosens up.” Some people also notice that they feel more tired or gain a little weight before PsA starts, due to a lack of physical activity. If you keep an eye out for warning signs, you may be able to start treating PsA early enough to prevent joint damage. [5-6]
Treatment of PsA also varies between people due to the highly individualized nature of the condition. Treatment options for psoriatic arthritis include disease-modifying anti-rheumatic drugs (DMARDs), non-steroidal anti-inflammatory drugs (NSAIDs), steroids, and biologics. DMARDs slow down the cell processes that cause inflammation and help to prevent or slow joint damage. NSAIDs reduce inflammatory symptoms and decrease pain. Steroids also help reduce inflammation through a different method. Biologics also suppress inflammation and like DMARDs help to prevent or slow joint damage.
Picking a treatment option that gives best results with minimum side effects is a highly personalized process. It will involve working together with your health care providers closely and continuously.
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