What is Psoriatic Arthritis ?
Psoriasis is a kind of skin disease that results in itchy, scaly rashes, and crumbling nails. While Psoriasis affects the skin mainly, in many cases the people infected also develop a type of inflammatory arthritis and the two diseases combined form a disease called Psoriatic Arthritis. There is a link between Psoriasis and Arthritis, they are both autoimmune diseases; they are a result of the immune system attacking healthy tissue (skin and joints). As a result of arthritis occurring due to psoriasis, the people infected suffer from inflammation that causes joints pain and this inflammation can spread through the entire body and cause permanent damage to the skin and joints if it doesn’t get treated early. The people who develop psoriatic arthritis are mostly in their fourth or fifth decades of life and there is no difference when it comes to gender; both men and women can suffer from this chronic disease.
Psoriatic Arthritis is a systemic rheumatic disease that may cause inflammation in the body tissue not only targeting the skin and joints, it can also target and harm other organs such as the heart, lungs, eyes, and kidneys. The main causes of the disease are still unknown until today, however we may assume that genetic, environmental, and immunity factors play a major role in influencing such diseases. It has also been noticed that people who have a family member who suffers from psoriasis have a high risk of developing psoriatic arthritis. Doctors and researchers discussed the influence of stress and psychological factors in the development of such diseases and the effect on the immune system. However, the link between psychological states and diseases hasn’t been fully established.
The Types of Psoriatic Arthritis
There are five types of Psoriatic Arthritis and the treatment process, of course, starts with figuring out which type the patient is infected with. The five types of Psoriatic Arthritis are:
- Symmetric Psoriatic Arthritis: this type of Psoriatic Arthritis is the most common type of the disease; it affects the same joints mostly in matching pairs in both right and left sides of the body. Symmetric Psoriatic Arthritis is very harmful and there is always a high chance for it to cause disability and loss of function.
- Asymmetric Psoriatic Arthritis: This type is called Asymmetric arthritis because it may affect a joint on one side of the body while the mirror-image joint on the other side remains healthy. This type affects mostly 1 to 4 joints in the whole body (large or small).
- Distal Interphalangeal Predominant (DIP): Distal interphalangeal predominant psoriatic arthritis affects the small joints at the ends of fingers and toes. These joints are very close to nails and this is why in many cases of Psoriatic Arthritis changes in nails is one of the most common symptoms.
- Spondylitis: Spondylitis affects the spinal column and in many cases inflammation reaches the spine causing stiffness, difficulty of moving, and pain in the neck, lower back, and sacroiliac joints. Spondylitis may also affect the joints of the arms, legs, hands, and feet…
- Arthritis Mutilans: While Arthritis Mutilans is the rarest type of Psoriatic Arthritis, it is also the most destructive and deforming. It targets the small joints at the end of fingers and toes. It almost always results in the destruction of the joints it targets.
- Link between Psoriasis and Psoriatic Arthritis
Many people ask “Does psoriasis cause arthritis?” and the answer is Psoriatic arthritis is a combination of the two diseases; the first one is called psoriasis and it affects the skin while the second is called arthritis and it affects the joints. In almost all cases they occur separately; psoriasis appears first in over 80% of cases while arthritis precedes the skin diseases in around 20% of the cases. Meaning that psoriasis doesn’t cause arthritis and while in many cases the two diseases follow one another, in many other cases patients developed one of the diseases without any appearance of the other. So people who have psoriasis will not necessarily develop Psoriatic Arthritis despite the fact that the two diseases are usually related. Inflammation is another link between psoriasis and psoriatic arthritis; the two diseases cause inflammation in the skin and joints.
Symptoms of Psoriatic Arthritis
In the majority of cases psoriasis affects patients before months or years of any appearance of arthritis. The first most common symptom is the changes and tiny pitting in the finger nails and toenails. The symptoms and signs of the disease depend on which kind of psoriatic arthritis the patient has been developing and the kind of psoriatic arthritis developed is determined by the distribution of the joints affected (please check the Types of Psoriatic Arthritis section). The most common areas where Psoriatic Arthritis appears are the knees, ankles, and joints at the end of fingers and nails.
Joints that suffer from Psoriatic Arthritis inflammation become painful, stiff, swollen, hot, and red. People infected with the disease may develop inflammation in various other parts of the body such as tendons; this will result in pain when walking or climbing the stairs. It is very important to acknowledge that inflammation caused by Psoriatic Arthritis can spread through the entire body and cause permanent damage to other organs such as the heart, lungs, eyes, and kidneys if it doesn’t get treated early.
Treatment of Psoriatic Arthritis
Psoriatic arthritis treatment starts with anti-inflammatory medications and some effort by the patient in exercise. The use of medications will depend on the response of the body as doctors may use anti-inflammatory medications of different intensities in order to reach the treatment that will result in skin recovery. Exercise is also an important part in the process of recovering from Psoriatic Arthritis; exercise can be done at home or with the assistance of a physical therapist. The exercises will depend on the ability of the patient and the main purpose behind them is to strengthen and improve the joints range of motion. In exercising there are many other techniques that may contribute to the relaxation of the joints; taking a hot shower before exercise can help in relaxing muscles and joints before exercise while ice application after the exercise can decrease after-exercise soreness and inflammation.