Psoriatic Arthritis

Psoriatic arthritis is an inflammatory arthritis associated with a chronic skin disease called psoriasis.

Psoriasis causes small sized to large sized patches of red, scaly, itchy skin.

Patches of psoriasis frequently  are present over bony prominences such as the elbows and the knees. Psoriasis may also involve your scalp or your bellybutton. Psoriasis affects 1-2% of the population. Of these patients with psoriasis approximately 10%  will go on to develop a type of inflammatory arthritis. Besides skin involvement, nail lesions called pitting are frequently present especially in those patients who have arthritis of the DIP joints, those joints closest to your fingernails.

Most of the time the arthritis begins after the patient has had skin disease for a number of years.  However sometimes the arthritis may be the initial presenting feature and occasionally the arthritis and skin lesions present together. Psoriatic arthritis may have several different types of presentations. The most common is involvement of just a few joints (less than 5) in an asymmetric pattern. Some patients with psoriatic arthritis may resemble a patient with rheumatoid arthritis with multiple joints in a symmetrical pattern.  Some patients may have a predominance of involvement of the spine (spondylitis) and some patients may have digits that look like sausages (dactylitis). Other patients may have lots of inflammation where tendons attach to bone (enthesitis).

The diagnosis of psoriatic arthritis can best be made by a rheumatologist who is aware of the many subtleties of this disease.  There is no one special blood test that helps make this diagnosis. X-rays can sometimes assist in the diagnosis. A careful history, and a detailed physical examination with special attention to the joints, skin, and nails are most important. Once the diagnosis of psoriatic arthritis is made your rheumatologist will devise a treatment strategy for you.

Milder types of psoriatic arthritis may respond to nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen, diclofenac, or indomethacin. Patients failing to respond to NSAIDs are now treated with biologics. These are newer therapies developed over the past 15 years that target specific chemicals involved in the inflammatory process. Biologics have the best chance of improving symptoms of joint pain and swelling and also limiting long-term damage from the arthritis. They also frequently bring about a marked improvement in the skin disease.

Rheumatologists are experts in the diagnosis and treatment of psoriatic arthritis. With the advent of newer therapies the majority of patients can live healthy productive lives.

Jan 15, 2019

10 Ways to Build your Quality of Life with Arthritis

ntNco7TTS7W1TWEgbcuR_full_ways-to-build-quality-of-life-with-arthritis

People living with arthritis are often discouraged by how much the disease can take from their life. If you have arthritis, physical limitations caused by chronic pain and fatigue can diminish your quality of life. When you suffer from arthritis, so much energy is consumed just trying to accomplish ordinary tasks and usual daily activities […]

Read More »

Jan 8, 2019

Nine Strategies for Managing Depression Caused by Arthritis

ogsmj6MQ5evd89pIQcsg_full_managing-depression-caused-by-arthritis-healthy-living-tips

Anyone who suffers from arthritis knows that the blues can become a part of life. According to The Arthritis Foundation, “People with arthritis have high rates of depression and anxiety. Many of those affected don’t receive mental health treatment – which could potentially help with their physical arthritis symptoms.” The good news is that it […]

Read More »

Dec 12, 2018

Tips for Cold Weather Exercise with Arthritis

FjZa0bySOFEB3MsYTRws_full_7-Tips-for-Staying-Active-in-Cold-Weather

Winter has hit North Carolina! And while it may not be officially considered winter for a few weeks, these frigid days tell us otherwise. The temperatures are quickly dropping and that comfy couch and cozy blanket are much more appealing than a brisk walk outside. Unfortunately, inactivity will make pain and depression worse for arthritis […]

Read More »