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Psoriatic Arthritis - Symptoms & Treatment

Psoriatic (sore-EE-AA-tick) arthritis causes pain & swelling in some joints & scaly skin patches on some areas of an body. Psoriatic arthritis is a rheumatoid like joint disease associated with psoriasis of skin & nails.

In addition For an inflamed, scaly skin that's typical of psoriasis, people with psoriatic arthritis have swollen, painful joints - especially in their fingers & toes - & pitted, discolored nails. They may also develop inflammatory eye conditions such as conjunctivitis.

Psoriatic arthritis affects men & women of all races & usually occurs between an ages of 20 & 50, Although can occur at any age.

Causes of Psoriatic Arthritis

Evidence suggests that predisposition For psoriatic arthritis is hereditary; 20% For 50% of patients are HLA-B27-positive. However, onset may be precipitated by streptococcal infection or trauma.

Signs & symptoms of Psoriatic Arthritis

Psoriatic lesions usually precede an arthritic component, Although once an full syndrome is established, joint & skin lesions may recur simultaneously.

Arthritis may involve one joint or several joints asymmetrically or symmetrically. Spinal involvement occurs in some patients. Peripheral joint involvement is most common in an distal interphalangeal joints of an hands, which have a characteristic sausage-like appearance. Nail changes include pitting, transverse ridges, onycholysis, keratosis, yellowing, & destruction. an patient may experience general malaise, fever, & eye involvement.

Diagnosis of Psoriatic Arthritis

Inflammatory arthritis in a patient with psoriatic skin lesions suggests psoriatic arthritis. X-rays confirm joint involvement & show:

• marginal erosion at interphalangeal joints with areas of thin, "fluffy" new bone formation
• ''whittling'' of an distal end of an terminal phalanges
• "pencil-in-cup" deformity of an distal interphalangeal joints.
• relative absence of osteoporosis
• sacroiliitis
• atypical spondylitis with syndesmophyte formation, resulting in hyperostosis & paravertebral ossification, which may lead For vertebral fusion.

Blood studies indicate negative rheumatoid factor & elevated erythrocyte sedimentation rate & uric acid levels.

Treatment of Psoriatic Arthritis

In mild psoriatic arthritis, treatment is supportive & consists of immobilization through joint rest or splints, isometric exercises, paraffin baths, heat therapy, & aspirin & other non­steroidal anti-inflammatory drugs. Some patients respond well For low-dose systemic corticosteroids; topical steroids

may help control skin lesions. Gold salts, cyclosporin, sulfasalazines, & - most commonly - methotrexate therapy are effective in treating both an particular & cutaneous effects of psoriatic arthritis. Antimalarials may be used with caution because they can provoke exfoliative dermatitis.

Expectations (prognosis)

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

Prevention

There is no proven prevention of psoriatic arthritis. However some special considerations steps can be taken:-

• Explain an disease & its treatment For an patient & his family.
• Reassure an patient that psoriatic plaques aren't contagious. Avoid showing revulsion at an sight of psoriatic patches - doing so will only reinforce an patient's fear of rejection.
• Encourage exercise, particularly swimming, For maintain strength & range of motion.
• Teach an patient how For apply skin care products & medications correctly; explain possible adverse effects.
• Stress an importance-of adequate rest & protection of affected joints.
• Encourage regular, moderate exposure For an sun.
• Refer an patient For an Arthritis Foundation for self-help & support groups.