Psoriatic arthritis is a chronic autoimmune inflammatory arthritis that is seen in association with skin psoriasis. It affects men and women in equal proportion and can affect all age groups including children.
There are some genetic tendencies for development of this disease. There are theories that an infection could also trigger this condition in a person with the right genetic makeup.
About 15-30 percent of patients with psoriasis will develop the arthritis.
Usually the psoriasis occurs before the joint inflammation but not always.
Patients can present in a variety of ways. The spectrum includes inflammation of one or two small joints to widespread inflammation in multiple small and large joints including the sacroiliac joints.
A rheumatologist usually diagnoses this condition from history, physical exam and X-rays. Blood tests will be done to rule out other types of arthritis but usually psoriatic arthritis is blood test negative.
Treatment involves medications that reduce inflammation.
These include non-steroidals which help mild arthritis pain, stiffness and swelling.
Other medications can treat both the skin and joints. These include methotrexate, sulfasalazine and leflunomide.
Newer agents called biologic drugs have been developed to block molecules and their receptors decreasing inflammation.
These medications can suppress the immune system. They include Enbrel, Humira, Remicade, Cimzia, and Simponi.
Early treatment is important to diminish the risk of joint damage and improve overall outcomes.
- Destructive inflammatory joint disease.
- Various presentations.
- Most commonly seenin people with psoriasis but affecting only a small percentage of patients with psoriasis.
- Disabling disease that requires skilled treatment with immunosuppressive medications.