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Psoriatic Arthritis

About 10-30% of people with psoriasis will develop psoriatic arthritis. Like psoriasis, the symptoms of psoriatic arthritis can range from mild to severe.

Symptoms of psoriatic arthritis include the following:

The joints most commonly affected are in the fingers and toes (usually the "distal" joints at the ends), the lower back, wrists, knees, and ankles.

Most people with psoriasis do not develop arthritis symptoms until they are 30-50 years old, and they usually experience psoriasis on their skin well before the onset of joint symptoms. However, about 15% of people may develop joint symptoms BEFORE developing the classic skin lesions of psoriasis.

EARLY DIAGNOSIS AND TREATMENT OF PSORIATRIC ARTHRITIS IS IMPORTANT TO MINIMIZE THE DAMAGE TO THE JOINTS.

Types of Psoriatic Arthritis

Psoriatic arthritis may be categorized by how many joints are affected, which also reflects its severity.

Psoriatic arthritis may also be categorized into five "types" that describe different ways the joints are affected.

Diagnosis of Psoriatic Arthritis

There is no single test that can prove whether someone has psoriatic arthritis or not. The diagnosis requires a physical exam, medical history, and a variety of medical tests that help to confirm psoriatic arthritis as the cause of the symptoms. Other medical conditions that can cause similar symptoms, such as rheumatoid arthritis or gout, must be ruled out.

Medical tests that may be performed include the following:

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X-rays may appear normal during early stages of psoriatic arthritis, but signs of inflammation develop over time, particularly in the distal joints of the fingers and toes.

An x-ray finding that is unique to psoriatic arthritis is the "pencil in the cup" appearance of the bone that narrows at the end, similar to a pencil.

There are a variety of treatments for psoriatic arthritis. Your doctor will recommend a treatment based on the severity of symptoms, results of past treatments, and your medical history.

Some medications that slow disease progression and miminize disabilty are described as DMARDs (Disease-modifying antirheumatic drugs).

Medications

Your doctor may prescribe medications to help manage your symptoms.  Medications include:

Biologics for Psoriatic Arthritis

Biologics (also called “immunomodulators” or “disease-modifying therapies”) are a relatively new treatment option for moderate to severe psoriasis and psoriatric arthritis. Biologics are especially effective at healing the progression of arthritis in patients with psoriasis.

Biologics are derived from human or animal proteins instead of chemicals. They work by targeting specific parts of the immune system such as T-cells or TNF, a chemical messenger used by immune cells. This focused approach reduces the likelihood of side effects that are seen following treatment with other medications that impact the entire immune system.

Biologics must be administered by injection, either into the skin (subcutaneously), into the muscle (intramuscular or IM), or by intravenous infusion (IV). Some biologics may require long-term use to keep psoriatic arthritis under control.

Biologics available for the treatment of psoriatic arthritis include:

Additional Measures

 

 


Reference: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)