Early diagnosis and treatment key to fighting psoriatic arthritis – ET HealthWorld


Early diagnosis and treatment key to fighting psoriatic arthritis

By Dr Anu Daber

Psoriasis is an autoimmune disorder that causes systemic inflammation which primarily manifests as a skin condition. This inflammation can also spread to other tissues and affect other organs. One such complication which can arise is psoriatic arthritis, which affects three in ten psoriasis patients . Psoriatic arthritis, or PsA can affect the joints and cause damage to the ligaments and tendons. The condition impacts men and women equally . While it is seen commonly in ages 30-45, it can also strike at a younger age.

Common symptoms associated with the condition include joint pain, stiffness, and swelling. For some people, the condition can be mild and cause less-frequent flare-ups. While for others, psoriatic arthritis can be more severe and impact more than one joint at a time. A mild case of psoriatic arthritis affects four or fewer joints, while severe PsA tends to affect more than five joints in the body. For example, it can cause inflammation in the fingers and toes, which is medically referred to as ‘dactylitis’. It can also cause tenderness and pain in the back of the heel and around the elbows and feet, which is referred to as ‘enthesitis’. When psoriatic arthritis impacts the spine, it can also lead to ‘psoriatic spondylitis’ and ‘ankylosing spondylitis’ (AS). This affects the axial joints and makes it difficult to move. If left untreated, psoriatic arthritis can not just worsen the pain, but also cause irreversible damage .

Typically, psoriasis symptoms appear first on the skin, sometimes even years before signs of psoriatic arthritis emerge. When they do appear, they are often confused with symptoms of other conditions such as osteoarthritis, rheumatoid arthritis, and gout. Often, they are dismissed as just signs of natural ageing. It is, therefore, important that patients with diagnosed psoriasis and under treatment for it recognize the following signs as perhaps being related to psoriatic arthritis:

-Redness and warmth in the joints
-Pain, swelling, and tenderness in more than one joint
-Indentations in the nails (pitting)
-Ache and stiffness in the lower back, feet, or ankles

Once the doctor recognizes the signs, different tests including X-rays, ultrasounds, blood tests, skin biopsies or CT scans can confirm the diagnosis of psoriatic arthritis and investigate inflammatory markers.

A bout of psoriatic arthritis can also be accompanied by symptoms such as fatigue, anemia, and mood changes. People who have psoriasis, and psoriatic arthritis are also more likely to develop chronic conditions like diabetes, obesity, Inflammatory Bowel Disease (IBS) as well as acute risks such as eye inflammation (Uveitis), conjunctivitis, and post-inflammatory hypopigmentation or hyperpigmentation. Proper treatment of the condition can thus minimize these risks.

Today, there are effective therapies available to manage psoriatic arthritis. If a patient has a mild form of arthritis, they may only need treatment when they have painful joints. In some cases, when treatment is not as effective, disease-modifying anti-rheumatic drugs and corticosteroid injections may be prescribed. Hydroxychloroquine, a popular anti-malarial drug can also help. Newer available anti-necrosis factor agents and anti-cytokine therapies such as IL-17 inhibitors can also help patients manage skin psoriasis with their arthritis symptoms. Surgery can be considered for patients who have badly damaged joints. In addition to the treatment and medication, it is important that patients follow a suitable, healthy diet and lifestyle modifications to lead a healthy life with the condition. Maintaining a healthy weight, BMI , and keeping blood pressure and cholesterol levels under check also help.

Dr Anu Daber, Senior Consultant, Rheumatology,Paras Hospitals, Gurgaon

(DISCLAIMER: The views expressed are sole of the author and ETHealthworld does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person/organisation directly or indirectly.)





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