Psoriatic arthritis

Psoriasis, guttate on the arms and chest

Psoriasis, guttate on the cheek

Psoriatic arthritis

Definition:

Psoriatic arthritis is an arthritis that is associated with psoriasis of the skin.

Alternative Names:

Arthritis - psoriatic

Causes, incidence, and risk factors:

Psoriasis is a common chronic skin condition that causes red patches on the body. About 1 in 20 individuals with psoriasis will develop arthritis along with the skin condition. In about 75% of cases, psoriasis precedes the arthritis.

The disorder can be exhibited in a variety of ways. The arthritis is generally mild and involves only a few joints. In a few people, the disease is severe and usually affects the fingers and the spine. When the spine is affected, the symptoms are very much like those of ankylosing spondylitis.

The cause of psoriatic arthritis is not known, but genetic factors may play a role. In general, people who have psoriasis have a higher prevalence of arthritis than the general population.

Symptoms:

Nail abnormalities, or skin lesions of psoriasis
Joint swelling and joint pain (arthritis)
- Usually of the fingers and toes, but other joints can be affected
- Wrist pain, knee pain, hip pain, elbow pain, ankle pain
Pain and swelling at the site of attachment of tendons to bone
- The Achilles tendon is often involved

Signs and tests:

Physical examination reveals skin lesions and tenderness and swelling of joints. Joint X-rays may be performed.

Treatment:

OVERVIEW:
Treatment of psoriatic arthritis involves medication, patient education, and physical and occupational therapy.

MEDICATIONS:
Nonsteroidal anti-inflammatory medications (NSAIDS) or salicylates are used to reduce the pain and inflammation of the joints. More severe arthritis requires treatment with more powerful drugs called disease modifying antirheumatic drugs (DMARDS). Occasionally, particularly painful joints may be injected with steroid medications. Psoriasis treatment is usually continued or started.

SURGERY:
Rarely, surgery to repair or replace damaged joints will be performed.

LIFESTYLE CHANGES:
Rest and exercise. To increase mobility, physical therapy provides exercise programs for specific joints. Heat and cold applications, or hydrotherapy may also be used.

Expectations (prognosis):

The course of the disease is often mild and affects only a few joints. In those with severe arthritis, treatment is usually very successful in alleviating the pain.

Complications:

Repeated episodes may occur.

Calling your health care provider:

Call for an appointment with your health care provider if arthritis symptoms develop along with psoriasis.

Prevention:

There is no proven prevention of psoriatic arthritis.

Review Date: 10/6/2001
Reviewed By: Birgit Kovacs, M.D., Division of Rheumatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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