Table of ContentsView AllTable of ContentsFrequent SymptomsBy SubtypePsoriatic SpondylitisWhen to See a Healthcare ProviderFrequently Asked QuestionsNext in Psoriatic Arthritis GuideSigns It’s Time to Switch Psoriatic Arthritis Treatments
Table of ContentsView All
View All
Table of Contents
Frequent Symptoms
By Subtype
Psoriatic Spondylitis
When to See a Healthcare Provider
Frequently Asked Questions
Next in Psoriatic Arthritis Guide
Psoriatic arthritis(PsA) symptoms such as pain and joint stiffness may seem distinct from those related to psoriasis, but they are actually a direct consequence of the disease.
Theinflammationthat results when the immune system suddenly attacks normal cells in the outer layer of skin can “spill over” and eventually impact other cells and tissues.
Over time, the same inflammation that gave way to skin changes can lead to the development of psoriatic arthritis. It is even possible to have psoriatic arthritis with no skin involvement at all.
1:29Click Play to Learn All About the Symptoms of Psoriatic Arthritis
1:29
Click Play to Learn All About the Symptoms of Psoriatic Arthritis
It is important to recognize the signs and symptoms of psoriatic arthritis so that a healthcare provider candiagnosethe disease and starttreatmentas soon as possible. Know, too, that psoriasis may look different depending on one’s skin tone.
According to a 2014 study in the journalDrugs, as many as 40% of people with psoriasis will develop psoriatic arthritis to varying degrees. On the flip side, 85% of people with psoriatic arthritis will also have psoriasis.
Psoriatic arthritis symptoms vary from person to person. They tend to develop in episodes, known asflares, in which symptoms suddenly appear and just as suddenly resolve.
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Racial Differences
Symptoms and the impact of psoriatic arthritis may vary depending on your race, which is particularly important to remember as you evaluate what you’re experiencing.
On lighter skin, psoriasis looks like red scales. On darker skin, the discoloration is darker and thicker. The differences in appearance can make the condition difficult to diagnose.
Two particular studies looking into racial differences in psoriatic arthritis also noted the following:
Researchers called for the medical community to apply standards equally in order to eliminate racial disparities in treatment.
The changes in subtype also reflect the progressive nature of the disease. As certain joints sustain damage, often irreversible, the inflammatory response may simply broaden and affect other joints in the body.
Inflammation can also occur where a tendon or ligament is inserted into the bone. This is called enthesitis, and it’s more common in PsA than in most other forms of arthritis.
Moreover, it is possible to have multiple subtypes or to develop other forms of arthritis, bothautoimmune and non-autoimmune.
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Asymmetric Psoriatic Arthritis
Psoriatic arthritis is asymmetric when a joint is affected on only one side of the body.Asymmetric psoriatic arthritistends to be milder than other forms of the disease and is often the first type experienced.
According to a 2013 review in thePolish Journal of Radiology, asymmetric psoriatic arthritis accounts for roughly 70% of all cases.
By definition, asymmetric psoriatic arthritis affects no more than five joints and will usually impact larger joints rather than smaller ones.
Symmetric Psoriatic Arthritis
The symmetrical pattern is similar to that of rheumatoid arthritis, an autoimmune disease that directly targets joint tissue. Up to 10% of patients with PsA can have a positiverheumatoid factor (RF) blood test.Anti-CCPis a more specific test for RA.
Distal Interphalangeal Predominant (DIP) Psoriatic Arthritis
Distal interphalangeal predominant (DIP)psoriatic arthritis may sound complicated, but it simply means that the distal (near the nail) joints of the phalanges (fingers or toes) are affected.
Nail changes, including pitting, thickening, and lifting (onycholysis), are also common.
Arthritis Mutilans
The aggressive nature of the disease can cause the breakdown of bone tissue, cartilage loss, and joint deformity.
Severe cases may require surgery to either relieve joint compression (arthroscopic debridement) or fuse the joints to reduce pain (arthrodesis).
Spondylitisrefers to inflammation of the spinal column. Around 7% to 32% people with psoriatic arthritis will have spondylitis as one of their symptoms.
Another common denominator is the genetic marker human leukocyte antigen B27 (HLA-B27), which is present in over half of the people with psoriatic spondylitis.
Differentiating Psoriatic Arthritis From Other Joint Diseases
As a general rule, you should suspect psoriatic arthritis if you havesymptoms of psoriasisor a family history of autoimmune diseases. At the same time, it is not uncommon to havemultiple autoimmune disordersgiven that the diseases often share the samegenetic mutations.
Earlydiagnosisand treatment are key to bringing the disease under control. Doing so can help slow disease progression, prevent joint damage, and improve your overall quality of life.
If you develop symptoms of psoriatic arthritis, ask your healthcare provider for a referral to a joint specialist known as arheumatologist.
While many internists are capable of managingmild psoriasis, psoriatic arthritis is a far more complicated disease. It is not only more difficult to diagnose but often requires a combination of drugs, includingdisease-modifying antirheumatic drugs (DMARDs)like methotrexate and newer-generationbiologic drugslike Enbrel (etanercept) and Humira (adalimumab).
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Psoriatic arthritis can affect joints on one or both sides of the body, causing them to become painful, swollen, and warm to the touch. Psoriatic arthritis is suspected when arthritis affects the following body parts:Feet: Often resulting inAchilles tendinitisorplantar fasciitisToes and fingers: Causingdactylitis(sausage-like swelling) and joint deformityLower back: Causingspondylitis(affecting the spine) orsacroiliitis(affecting the pelvis)Nails: Causinghyperkeratosis(nail thickening), pitting, flaking, or detachment
Psoriatic arthritis can affect joints on one or both sides of the body, causing them to become painful, swollen, and warm to the touch. Psoriatic arthritis is suspected when arthritis affects the following body parts:
Psoriatic arthritis is an extension of the autoimmune diseasepsoriasis. The onset of symptoms generally occurs between the ages of 30 and 50 and will often start 10 years after symptoms of psoriasis first develop. With that said, psoriatic arthritis can sometimes develop first or be the sole condition.
As anautoimmune disease,rheumatoid arthritis (RA)has many of the same features as psoriatic arthritis (PsA). However, RA is most often symmetrical, while PsA is more often asymmetrical. RA tends to involve more joints and can cause fatigue, weight loss, morning stiffness, and low-grade fever. PsA is more likely to cause dactylitis andnail psoriasis.
The chronic inflammation associated with psoriatic arthritiscan affect other organ systemsover time, increasing the risk oftype 2 diabetesand heart disease (particularly in overweight people) as well asinflammatory bowel disease (IBD)and mood disorders.
25 Sources
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