Psoriasis has many faces, one of which is psoriatic arthritis. This type of psoriasis is one of the chronic inflammatory joint diseases and is also known as arthritis psoriatica or psoriasis arthropatica. The disease often developed over the course of life in about a third of people affected by psoriasis. Psoriatic arthritis affects, among other things, the joints, especially the small joints on the fingers and toes, but also the larger joints and the spine.
Symptoms & course
The course of psoriatic arthritis is very individual and manifests itself differently. There are these symptoms:
- Redness and swelling of the joints
- Nail change
- Joint pain and stiffness
- Deformation of joints and destruction of articular cartilage and bones
Individual joints on the fingers and toes as well as all joints on a finger or toe can be affected. The swelling occurs at irregular intervals and may or may not go away over time. Psoriatic arthritis can also cause ossification around the affected joints, limiting their mobility.
Appear
Psoriatic arthritis usually occurs between the ages of 35 and 55, but it can occur at any age. Children with psoriasis can also be affected, although this is rarely the case (1%). It often happens that they only develop psoriasis on the skin after the joint pain, which makes the correct diagnosis of psoriatic arthritis very difficult.
- Previous illness with psoriasis
Although many studies have been conducted on the risk factors associated with the development and progression of psoriatic arthritis, there is comparatively little on the clinical features of psoriasis that are associated with the onset of psoriatic arthritis. Nevertheless, it is known that psoriatic arthritis can develop over the course of their lives, especially in people who already suffer from psoriasis. According to studies, it is possible that this risk is increased in those with severe psoriasis. The reason for this is that larger psoriasis plaques offer more surface area for microorganisms to settle and these then serve as a kind of entry point for microorganisms. The persistent infestation of microorganisms on psoriasis areas triggers an immune reaction. Since this reaction is often not enough to combat the infestation, it leads to chronic inflammation. This chronic inflammation can be considered a mechanism for the development of psoriatic arthritis.
In addition, those affected with psoriasis on the scalp have a four times higher risk of developing psoriatic arthritis than those without psoriasis on the scalp ( National Library of Medicine ).
- Nail dystrophy
Nail dystrophy (= the change in nail structure and/or nail color on the fingers or toes), is present in almost all patients with psoriatic arthritis ( National Library of Medicine ). Furthermore, psoriasis patients with nail dystrophy have a threefold higher risk of later developing psoriatic arthritis than psoriasis patients without nail dystrophy ( National Library of Medicine ).
- Genetic predisposition
Approximately 15% of the relatives of a so-called index patient (a person in whom a disease occurs for the first time) who suffers from psoriatic arthritis will also be affected by this disease. Additionally, it is likely that (an additional) between 30-45% will struggle with psoriasis.
Treatment
Early diagnosis is important to appropriately treat psoriatic arthritis. The diagnosis, as well as the therapy, should be carried out by a dermatologist and a rheumatologist. Together we can create an individually tailored treatment plan.
