Are you suffering from Psoriasis? It could be Psoriatic Arthritis. Good news: your Rheumy may be able to not only help you feel better but help clear your Psoriasis, too!
First let’s define Psoriatic Arthritis: it’s is a Rheum condition that belongs to a group of conditions known as a Seronegative Spondyloarthropathies (Spon – de – low – arth – rop – a – these). These are a group of conditions that like Rheumatoid Arthritis that are caused by inflammation being produced by our immune system. This constant inflammation in our bodies produces unwanted signs and symptoms such as joint pain, joint swelling, and joint stiffness.
Psoriatic arthritis is one of these conditions and is classified among Rheumatologists as a Spondyloarthropathy.
There are 5 Spondyloarthropathies:
- Psoriatic Arthritis (PSA)
- Enteropathic Arthritis (arthritis associated with Crohn’s)
- Ankylosing Spondylitis
- Reactive Arthritis
- Non-radiographic Spondyloarthropathy
In this post, I’ll focus on PSORIATIC ARTHRITIS.
First a few facts about Psoriatic Arthritis:
- PSA affects women and men in equal numbers
- It typically begins between 30 and 50 years of age
- A psoriatic rash appears before arthritis about 65% of the time
- Arthritis hits before or at the same time of the rash about 35% of the time
- 5% of the time PSA only affects THE SPINE ONLY
- 95% of the time PSA affects the SPINE and other joints
- PSA usually affects large joints
Most common joints affected by Psoriatic Arthritis:
- Joints can become red, warm and swollen
- DIP (finger joints closest to fingernail)
- Wrists
- Low back
- Sacroiliac joints (lower back where our hip meets our tailbone)
- Hips
- Knees
- Ankles
Can other organs be affected?
Typically, Psoriatic Arthritis and the other Spondyloarthropathies do not affect organs as frequently as conditions such as RA or Lupus—however, it is possible.
The most common organs include:
1. Fingernails / Toenails—this occurs in 80% of those with PSA and occurs in 30% of people with Psoriasis alone. So, if nail changes are present, that increases suspicion that the inflammatory arthritis (Psoriatic Arthritis) exists and not just Psoriasis (skin rash only). Common nail changes include: splinting, ridges, thickening of the nail, pitting, splinter hemorrhages
2. Tendons / Ligament—“enthesitis.” Inflammation of tendons / ligaments occurs where they connect to bone. Common sites: bottom of feet, heel.
3. Soft tissue—”dactylitis.” The entire finger or toe becomes swollen like a sausage.
4. Eye—33% of the time (Episcleritis, Iritis, Uveitis, Conjunctivitis).
5. Small and Large Intestine—33% of the time. Inflammatory bowel disease (Crohns / Ulcerative Colitis). 33% with bowel involvement have symptoms.
6. Heart—28% of the time. This includes heart valve, conduction problems, and hardening of blood vessels (arteries).
7. Bladder—25% of the time.
8. Skin—8% of the time. This includes oral ulcers, erythema nodosum, and pyoderma gangrenosum.
9. Lung—1% of the time.
10. Kidney—0.5% of the time.
11. Increased risk of Osteoporosis (thin bones).
Thus, Psoriatic Arthritis is MORE than just some joint pain and an unwanted rash. It is yet another autoimmune process that can affect us in many ways.
The next post of this series will include:
1. A brief discussion of Psoriasis (without arthritis)
2. Current Treatment options
. . . and remember, live your value one choice at a time!
