The Warning Signs of Psoriatic Arthritis [Video]

  • When psoriasis affects the joints, the condition is called psoriatic arthritis (PsA).  
  • The common symptoms of PsA include swollen, inflamed joints, reduced mobility, fatigue, nail changes, and other skin issues.
  • PsA can interfere with daily life, but the condition can be treated

Psoriatic arthritis (PsA) refers to the condition where psoriasis has affected the joints. Issues in the immune system cause psoriasis and psoriatic arthritis. 

Common symptoms of PsA

The severity of PsA symptoms varies in people. It may affect one or two joints or several joints throughout the body. 

Swollen and painful joints

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PsA can cause pain, swelling, or redness and a warm feeling in any joint in the body, including:

  • hands
  • fingers, close to the nail
  • feet
  • toes
  • knees
  • ankles
  • spine
  • neck
  • wrists
  • lower back

When there is excessive fluid surrounding the joint, or the lining of the joint increases in volume and causes more blood to enter the joint area, this increases pressure and results in redness and swelling associated with arthritis.

Stiffness and reduced mobility

Many people experience painful or painless stiffness, particularly after rest, which limits movement.

Fatigue

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According to a National Psoriasis Foundation article, around 29% of PsA patients experience severe fatigue, while 50% experience moderate to severe fatigue. PsA may also cause fatigue-inducing conditions like anemia, obesity, diabetes, sleep problems, and mental issues. 

Nail changes

PsA can cause pits or small depressions in nails, and even detachment of nails from nail beds, which may cause onycholysis, a fungal-like infection.  

Swollen fingers and toes

One unique symptom of PsA is dactylitis, which causes fingers and toes to swell. 

Statistics

According to the National Psoriasis Foundation, PsA develops around ten years after the skin symptoms appear during childhood or young adulthood. The foundation also notes that 10–30% of psoriasis patients will develop PsA.

A 2016 study notes that 85% of PsA cases start before the age of 40 and that 70% of PsA patients experience skin changes before PsA symptoms appear. Fifteen percent of people develop skin changes after having PsA symptoms for around two years, while other people may develop both simultaneously. 

Forty percent of people describe PsA as a significant problem in their lives. 

Types

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There are five types of PsA, according to the Genetics Home Reference: the asymmetric oligoarticular and symmetric polyarthritis, which are the most common types, the distal interphalangeal predominant, the spondylitis, and the arthritis mutilans. The latter only affects 5% of people with PsA. 

Complications

PsA may increase a person’s risk of cardiovascular disease, diabetes, obesity, NAFLD, and depression. Regular screening is recommended for people with psoriasis.  

When to see a doctor

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People with PsA must see a doctor if they have any new or worsening psoriasis or PsA symptoms or a family history of psoriatic disease. Diagnosing psoriasis may include a physical examination, blood tests, and imaging tests. 

Treatment

A 2018 guideline recommends TNFi as a first-line treatment for people newly diagnosed with PsA. TNFi has been shown to reduce the risk of flares and severity of PsA symptoms and slow the condition’s progress. However, these drugs may not be suitable for everyone. 

Other options for treatments are topical applications, steroid injections, and oral medications and injections. Following a healthy diet, avoiding smoking, and low-impact exercise may also help manage the symptoms.

Differentiating PsA from rheumatoid arthritis

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A rheumatologist can help you identify which type of arthritis you have. In time, symptoms will show which kind of PsA you have. PsA involves psoriasis plaques on the body, while RA may affect both hands instead of just one.

Source: Medical News Today



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