Psoriatic arthritis

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

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 the majority of cases, psoriasis comes before the arthritis.

The arthritis may be generally mild and involve only a few joints. In a few people, the disease is severe and usually affects the fingers, toes, the spine, and other joints. When the spine is affected, the symptoms are very much like those of ankylosing spondylitis.

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

• Nail abnormalities
• Skin lesions
• Joint swelling and joint pain (arthritis)
• Pain and swelling at the site of attachment of tendons to bone

During a physical examination, the doctor will identify skin lesions, tenderness, and swelling of joints. Joint x-rays may be performed.

Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDS) or salicylates to reduce pain and inflammation of the joints.

More severe arthritis requires treatment with more powerful drugs called disease-modifying antirheumatic drugs (DMARDS).

New medications that block an inflammatory protein called tumor necrosis factor (TNF) are fast becoming the treatment of choice. These include etanercept (Enbrel), infliximab (Remicade), and adalimumab (Humira).

Occasionally, particularly painful joints may be injected with steroid medications.

In rare cases, surgery to repair or replace damaged joints is needed.

Your doctor may tell you to get rest and exercise. Physical therapy may be recommended to help increase movement for specific joints. Heat and cold therapy may also be used.

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.

Repeated episodes may occur.

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

There is no known prevention.