Psoriatic arthritis is a chronic (long-term), progressive, inflammatory arthritis (swelling and tenderness of the joints). People with psoriatic arthritis can have swollen, tender joints, as well as nail changes, and the scaly, raised, red skin changes of psoriasis.
Inflammation most commonly involves the joints of the hands, wrists, neck, back, knees, ankles, and feet. The pain and stiffness are usually worse in the morning, or after rest, and can improve with physical activity. The severity can vary from mild disease affecting only a few joints without any noticeable pain to severe disabling and painful arthritis with deformity and destruction of joints. In people with mild arthritis, the condition can remain undiagnosed and might have minimal impact on their quality of life. More severe forms of psoriatic arthritis can occur in people with multiple affected joints (more than four), and in younger, often female patients. Early diagnosis and treatment is important to prevent destruction and deformity of the joints.
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| Psoriasis And Arthritis |
In most people, the skin lesions of psoriasis usually occur before arthritis develops. Less commonly, arthritis can occur at the same time or before skin changes occur. In the past, it was believed that approximately 5 percent of patients with psoriasis had psoriatic arthritis. Recent research has determined that approximately 15-30 percent of patients with psoriasis develop psoriatic arthritis.
Psoriatic arthritis belongs to a group of conditions known as seronegative spondyloarthropathies. The term "seronegative" means that the blood (sero) is negative for a certain factor present in rheumatoid arthritis. The blood test is for the rheumatoid factor, which is a protein found in the blood of most patients with another type of arthritis called rheumatoid arthritis. The term "spondylo" means spine, and "arthropathy" means painful, swollen joints. Spondyloarthropathy refers to a group of conditions that share several features, including:
- a pattern of arthritis that affects the spine and extremities
- inflammation of ligaments and tendons
- inflammation of other organs such as the eye
- evidence of a family history of psoriatic arthritis
Understanding Arthritis
Arthritis: Inflammation (redness, swelling, and tenderness) of a joint
Monoarthritis: A single joint is affected
Oligoarthritis: Only a few joints are affected
Polyarthritis: Many joints are affected
- Psoriatic arthritis can be a difficult type of arthritis to diagnose, and doctors may misdiagnose psoriatic arthritis for another form of arthritis. There has been a lack of widely accepted criteria for diagnosing psoriatic arthritis.
- New criteria are currently being developed by rheumatologists to assist in diagnosing and assessing psoriatic arthritis.
What Causes Psoriatic Arthritis?
The exact cause of psoriatic arthritis is unknown. Yet, like psoriasis, genetic, environmental, and immunological factors are considered important in the development of psoriatic arthritis.
Genetic Factors
Psoriatic arthritis is more common in those with a family history (particularly in an affected parent or sibling) of the disease.
Environmental Factors
Although the initial event that causes psoriatic arthritis is unknown, trauma and infection are possible triggers for the development of psoriatic arthritis.
Immunological Factors
The immune system is of central importance in the cause of psoriatic arthritis. The activation of the T-cells in the immune system can cause the release of inflammatory messengers called cytokines, which are found in high levels in the joints of patients with psoriatic arthritis.
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| Psoriasis And Arthritis |
One such inflammatory messenger is tumor necrosis factor-alpha (TNF-alpha). It is found in increased concentration in the skin, blood, and joints of patients with psoriasis and psoriatic arthritis. TNF-alpha is normally present in the body at low levels. It plays a key role in mediating inflammation in the body and is an important messenger that helps cause many of the signs and symptoms of psoriasis and psoriatic arthritis. The continual release of TNF-alpha results in chronic inflammation with swelling and pain in the joints, and red, scaly, itchy lesions of psoriasis.
Blocking TNF-alpha can lead to significant improvement in the skin and joints of patients with psoriasis and psoriatic arthritis. To find out more, you can check out Psoriasis And Arthritis.