Psoriatic Arthritis: Overview

Psoriasis is an autoimmune disease that causes the body's immune system to attack the skin's cells, resulting in scaly red and white areas. Psoriatic arthritis is an inflammatory disorder in which the immune system begins to create inflammation in the joints, resulting in painful, stiff, and swollen joints in a small percentage of people with psoriasis. Psoriatic arthritis symptoms, like psoriasis, vary in intensity from person to person. Spondylitis or psoriatic arthritis of the spine, causes stiffness in the back or neck and difficulties bending. It commonly manifests itself in adults between the ages of 30 and 50, but it can begin as early as childhood. Both men and women are equally in danger. Children with psoriatic arthritis are at risk of getting uveitis (inflammation of the middle layer of the eye). Psoriatic arthritis affects around 15% of people who have psoriasis. Arthritis might sometimes emerge before the skin problem.


Types of Psoriatic Arthritis

There are five types of Psoriatic Arthritis:

Other symptoms may include:

  • Symmetric PsA
  • Asymmetric PsA
  • Distal interphalangeal predominant PsA
  • Spondylitis PsA
  • Psoriatic arthritis mutilans

Symptoms of Psoriatic Arthritis

PsA can develop gradually with modest symptoms or rapidly and aggressively. Typical symptoms include:

  • Fatigue
  • Tenderness, discomfort, and swelling around the tendons
  • Swollen fingers and toes
  • Stiffness, pain, throbbing, swelling and tenderness in one or more joints
  • Reduced range of motion
  • Tiredness and stiffness in the morning
  • Changes in the nail, such as pitting or detachment from the nail bed
  • Eye redness and discomfort (uveitis)

When To See a Doctor?

If a person suspects of experiencing early signs of psoriatic arthritis, he or she should consult a doctor. Following are the signs that need immediate attention:

  • Skin patches or scales that are not explained
  • Psoriasis symptoms that be new or worsening
  • Arthritis symptoms that be new or worsening
  • Psoriatic arthritis that is no longer responsive to therapy

Psoriatic arthritis causes joint destruction, increasing the severity of subsequent flares. Arthritis-related joint damage cannot be reversed once it has occurred. Although medication cannot cure psoriatic arthritis, it can help to avoid joint degeneration. This indicates that prompt, intensive therapy may have long-term advantages.

Get the best treatment for Psoriatic Arthritis from our Rhemutologists at Medicover Hospitals.


Causes

The immune system targets the joints and skin in PsA. Doctors are unsure what triggers these attacks. They believe it is caused by a combination of genes and environmental factors.

PsA is inherited. Approximately 40% of patients with PsA have one or more relatives who have the disease. For people who are predisposed to developing PsA, something in the environment generally starts the condition. This might be due to a virus, constant stress, or an accident.


Risk Factors

Many factors might increase your chances of developing psoriatic arthritis, including

  • Psoriasis Psoriasis : Psoriatic arthritis affects up to 30% of patients with psoriasis. It has an equal impact on males and women.
  • Age PsA can develop at any age, however, it most commonly affects adults between the ages of 30 and 50.
  • Family history A family history of skin or joint illness may be present in up to 40% of patients with psoriatic arthritis.

Complications

The condition may cause enough joint damage to limit the activity level. Lack of exercise can cause tight joints and muscular weakness, which can lead to the development of


Diagnosis

To diagnose PsA, the doctor will use imaging and blood tests to rule out other types of arthritis, such as Rheumatoid and gout.

Below imaging techniques are suggested to look for joint and tissue damage.

  • X-rays- These examine the bones and joints for inflammation and injury. This damage differs from that seen in other kinds of arthritis.
  • MRIs-Images of the interior of your body is created using radio waves and powerful magnets. These photos can assist the doctor in diagnosing joint, tendon, or ligament injury.
  • CT scans and ultrasounds-These can assist doctors in determining how far PsA has progressed and how adversely joints are impacted.

Treatment

Medical treatments for psoriatic arthritis include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) Ibuprofen and naproxen are examples of over-the-counter drugs.
  • Disease-modifying antirheumatic drugs (DMARDs) These can help to reduce or eliminate pain, oedema, and joint and tissue damage. If NSAIDs do not relieve your pain, your doctor may prescribe DMARDs. They may take longer to complete.
  • Immunosuppressants If you are unable to take a DMARD, you may be prescribed an immunosuppressant. These medications suppress your immune system, which is what causes an autoimmune illness like PsA. They can, however, render you more susceptible to illness.
  • UV light UVA light therapy can help people with severe psoriasis to relieve their skin symptoms. However, it may increase your risk of developing skin cancer.
  • Biologics If immune suppression fails, the doctor may recommend a biologic. These are a more recent form of DMARD. These drugs, instead of weakening the entire immune system, suppress a protein that promotes inflammation.
  • Enzyme inhibitor This works by inhibiting a specific enzyme, or protein, known as PDE-4. This helps to calm down other inflammatory processes.
  • Steroids These can help decrease inflammation, but they are rarely used to treat PsA since they might aggravate the skin rash. Doctors only give steroids when they are really necessary. Long-term use may result in major adverse effects such as brittle bones, weight gain, hypertension, and diabetes.
  • Surgery A severely damaged joint can be replaced with a new metal joint.

Lifestyle Changes and Selfcare

Some activities people can do on their own to help with psoriatic arthritis symptoms. These include:

  • Maintaining a healthy weight Carrying excess weight puts more strain on your joints. It may also have an impact on how effectively your meds perform.
  • Stopping smoking This is one of the most beneficial things you can do for your health.
  • Limiting alcohol It can also have an impact on how the treatments work.
  • Exercising Exercising : It's an excellent technique to preserve the joints while still maintaining your weight. Muscle strength can also help to support the joints. Low-impact workouts, such as swimming or strolling, are less taxing on them. Consult the doctor about an activity programme.
  • Try physical or occupational therapy The doctor may advise you to consult a specialist who can instruct you on how to manage the symptoms. This might include exercises, modifications to the body, and heat and cold treatment. A physical or occupational therapist can also aid you in selecting supportive equipment to support your joints, such as braces or splints.
  • Using acupuncture or massage therapy These are natural methods of relieving pain and stiffness.

Dos and Don’ts

Psoriasis and psoriatic arthritis are both difficult to treat. They are most likely caused by a mix of genetics, inflammation, skin and joint traumas, and particular psoriasis triggers. There is no cure for psoriatic arthritis, but quick and efficient therapy can help lessen the frequency and severity of the symptoms. So, by following these do's and don'ts, you can avoid the negative repercussions. The guidelines are as follows:

Do’s Don’ts
Eat healthy fats like omega-3 fatty acids Ignore the condition and mild symptoms
Avoid taking stress Forget your emotional health
Consult your doctor if you have symptoms Have saturated and trans fat in your diet
Try yoga Have frequent OTC Medicines without doctor’s advice
Quit Smoking Have negative attitude regarding the health.

Following these do’s and don’ts will help you increase the quality of your life and march towards better management of the condition.


Psoriatic Arthritis Care at Medicover

At Medicover, we have the best team of Rhemutologists, pain management therapists, physiotherapists and orthopedic surgeons who work together to deliver the most precise Psoriatic Arthritis treatment and therapies. To treat many forms of autoimmune illnesses and disorders, our highly qualified staff use cutting-edge medical equipment, diagnostic techniques, treatments and technologies that bring good results for our patients. For Psoriatic Arthritis, we use a multidisciplinary approach to give patients an all-around healing experience and address all of their medical requirements at once, resulting in a faster and more sustainable recovery.

Citations

https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis
https://ard.bmj.com/content/68/9/1387.short
https://www.psoriasis.org/about-psoriatic-arthritis/
https://www.nhs.uk/conditions/psoriatic-arthritis/
https://www.arthritis.org/diseases/psoriatic-arthritis

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