Psoriatic Arthritis
In psoriatic arthritis, the small joints of the hands and feet may become swollen and deformed. Nail changes are common if the arthritis affects the hands and feet. Statistics says that about 7-10% of patients with psoriasis have joint associated complaints, and these are most often occurring in patients with fingernail involvement. Back pain may indicate arthritis of the spine and/or sacroiliac joints. If you have joint pain or swelling, you should consult your physician about having psoriasis as well.
Shoulders is another area that is frequently affected by rheumatoid arthritis but goes unnoticed because suffers may tend to think of it as having other origins. Initial symptoms of an affected shoulder may include painful arc syndrome and pain in the upper arms at night. As the joints become damaged further stiffness will occur. At a later stage of the disease, you will find rotator cuff tears becoming common which interferes with dressing, feeding and using the toilet.
Causes For Psoriatic Arthritis
Hereditary:
40% of patients with psoriatic arthritis have a family history of either psoriasis or psoriatic arthritis in a first-degree relative.
Genes on chromosome 6p have been associated with both psoriasis and psoriatic arthritis.
Other genes have been identified in genome wide scans.
Symptoms and Diagnosis
Inflammation usually affects joints of the fingers and toes, although other joints, including the hips and spine, are often affected as well. The joints may become swollen and deformed when inflammation is chronic. Arthritis often involves joints less symmetrically than in rheumatoid arthritis and involves fewer joints. The joints at the end of the fingers adjacent to the diseased nails may be involved. The skin and joint symptoms sometimes appear and disappear together.
Treatments of Psoriatic Arthritis
If septic arthritis is a possibility, broad-spectrum antibiotic treatment should be started immediately, Fractures and most internal derangements require orthopedics involvement, Appropriate referral and treatment for malignancy.
More severe arthritis requires treatment with more powerful drugs called disease-modifying antirheumatic drugs (DMARDS) such as:
Leflunomide
Methotrexate
Sulfasalazine
Newer disease-modifying drugs:
A new class of drugs which have recently been developed are drugs that modify the effect of TNF-alpha. The chemical TNF-alpha plays an important role in causing inflammation in joints and skin. Blocking the effect of TNF-alpha has been shown to reduce damage to joints, and reduce symptoms. Drugs which modify or block the effect of TNF-alpha include: etanercept, infliximab, adalimumab, and anakinra. They show promise but their long-term benefits are still being evaluated. One problem with these drugs is that they need to be given by injection. They are also expensive
Advanced Therapy for Psoriatic Arthritis
The goal of therapy for people with psoriatic arthritis is to effectively manage both joint and skin symptoms over the long term in order to help stop further joint damage and help maintain quality of life. The benefits of advanced therapy include relief from joint pain and skin symptoms such as itching, scaling, and inflammation. Such symptoms can interfere with your daily routine and quality of life.
