Approximately 1 in 10 people who are suffering from psoriasis also suffer from inflammation of joints or what is called psoriatic arthritis. This essentially means that itchy skin can trigger arthritis. However, the first appearance of psoriasis is not at the same time as the beginning of psoriatic arthritis. In fact, it can be separated by a few years. Patients who are suffering from psoriatic arthritis can suffer from inflammation of eyes, tendons, cartilage, lung lining and in some cases the aorta.
Psoriatic arthritis is a chronic disease that involves the inflammation of the skin and joints. Psoriasis is a skin condition that affects approximately 2% of the United States Caucasian population. Psoriasis patients experiences patchy, red and raised areas of skin inflammation that often has scaling. It usually affects the scalp, ears, knees, elbows, genital area or anus. About 10% of patients with psoriasis also develop inflammation of their joints (psoriatic arthritis). As of now, there is still no clear explanation as to how itchy skin can trigger arthritis.
The onset of psoriatic arthritis usually occurs when a person reaches his/her 40’s or 50’s. There is no difference between males and females as they are equally affected. Often, the skin disease and joint disease appear separately. In 8 out of 10 patients, the skin disease precedes the arthritis.
The diagnosis of psoriatic arthritis is very difficult in many cases where the arthritis precedes psoriasis by a couple of years. In fact, in some cases the patients have been suffering from arthritis for more than 20 years before the onset of psoriasis. The opposite can also occur wherein patients have been suffering from psoriasis for more than 20 years before the onset of arthritis. This is the reason why the ultimate diagnosis of psoriatic arthritis usually takes a long time.
Cause and Types
The specific cause of psoriatic arthritis is still unknown. However, experts believe that it involves a combination of genetic, environmental and immune factors. Experts are still studying how itchy skin can trigger arthritis. There are five types of psoriatic arthritis depending on the distribution of affected joints namely: symmetrical, spondylitis, asymmetric and few joints, distal interphalangeal joints and arthritis mutilans.
Usually, the arthritis involves the joints in the hands, feet, knees and ankles. In most cases, only a few joints are inflamed at a given time. These joints not only become painful but also become swollen, red and hot.
The general treatment of arthritis from psoriatic arthritis is a combination of exercise and non-steroidal anti-inflammatory drugs (NSAIDs). These are used for reducing pain, joint inflammation and stiffness. Some examples of NSAIDs are indomethacin, aspirin, tolmetin sodium, diclofenac and sulindac. If the NSAIDs treatment doesn’t work and progressive joint destruction and inflammation continues, more potent medication like corticosteroids, methotrexate and antimalarial medication are used.
Exercise programs are customized according to each patient by a physical therapist. In most cases, the exercise program can be done at home but in more serious cases it has to be done under the supervision of a physical therapist. The exercises are generally for strengthening and either maintaining or improving joint range of motion.