Arthritic Psoriasis

Dry, flaky, irritated skin.

This is what usually comes into the mind of most people when the word Psoriasis is mentioned. Arthritis is generally not thought of in relation to psoriasis. But, perhaps it should be.

Up to 20% of people suffering from psoriasis will also develop an arthritis in association with their skin condition.

It is called Psoriatic Arthritis and it is usually seen in the 30 – 50 age group. It affects both men and women equally.

The symptoms of psoriatic arthritis are similar to those of rheumatoid arthritis, although they are often not as severe. They include pain, stiffness and swelling in and around a joint, decreased movement, morning stiffness and tiredness. Redness and pain of the eye may also occur in association with this condition.

Pitting and lifting of the nail is commonly associated with psoriasis. The likelihood of nail involvement increases if psoriatic arthritis develops. 80% of people with psoriatic arthritis will report pitting or lifting of the nail, while only 20% of people suffering from psoriasis without the arthritic involvement develop nail pitting.

Difficult to diagnose

Psoriatic arthritis commonly runs in families, so this is one aspect looked at when seeking a diagnosis. Diagnosis is based on a medical history, physical examination, blood tests, and xrays. It is the absence of the rheumatoid factor in a blood test that distinguishes psoriatic arthritis from rheumatoid arthritis.

The relationship between the psoriasis and the arthritis is often difficult to determine, as there is no set pattern to be followed. Symptoms of the two may not always occur at the same time. In fact it is not unusual for the psoriatic arthritis to appear some 10 years after the first signs of psoriasis appear on the skin. It is also possible for the arthritis symptoms to appear before the skin symptoms develop.

The severity varies

Similarly the severity of the psoriasis rash does not mirror the severity of the associated arthritis and a flare up in one does not indicate a flare up in the other.

The upper joints of the fingers and toes are most commonly affected in psoriatic arthritis. However there may also be some spinal involvement. Early diagnosis is important to prevent long term damage to the joints and tissues. This is not always straight forward, as diagnosis, especially in the early stages is quite difficult.

Many people have a degree of bone degeneration by the time the disease is diagnosed.

As there is no cure for the condition treatment is aimed at relieving the symptoms. Many doctors prescribe anti-inflammatory drugs as their preferred treatment. The use of steroids is not recommended as it may have a detrimental effect on the psoriatic rash causing a flare up on the skin.

The aim is to control inflammation and pain

There are also many self-help techniques available to help control the inflammation and pain. The application of heat and cold are effective in reducing both pain and inflammation. Regular gentle exercise will also help to reduce joint stiffness and immobility developing.

Glucosamine is a natural chemical derived from sugars and is an essential component of cartilage. Supplementing glycosomine may lessen the severity of arthritic psoriasis.

Mel Sinclair, RN