Patients experiencing both psoriasis and arthritis often wonder about correlation and causation. Many medical professionals have weighed-in on the subject, and they’ve worked to understand a disease called Psoriatic Arthritis, arthritis associated with psoriasis.
How is Psoriatic Arthritis Linked to Psoriasis?
If you’ve experienced considerable stiffness, aching or joint swelling, a discussion with a dermatologist or rheumatologist may be required. Psoriatic arthritis, called PsA within the medical field, occurs when the human body’s immune system attacks healthy joint tissue as well as the skin and even the blood vessels.
In psoriasis, inflammatory pathways are excessively promoted by the immune system and induce overly rapid replication of skin cells and the unsightly rash of psoriasis. This inflammation can also affect joints, reducing their movement while causing pain, and can induce inflammation in the blood vessels resulting in heart disease and stroke. So herein lies the achy link between psoriasis and psoriatic arthritis.
Many sources, such as WebMD, have outlined PsA symptoms for potential patients. While psoriatic arthritis symptoms vary from person to person, symptom onset may be incredibly subtle. Normally, PsA symptoms include the following, defined, symptoms:
- Reduced joint motion
- Stiffness, discomfort, throbbing and swelling
- Joint tenderness
- Gray “scaly” spots across elbows, knees, scalp and lower spine
- Lower back stiffness
- Nail depression “pitting”
- Toenail and fingernail detachment
Who’s at Risk?
TheMayo Clinic has outlined a risk list, of those likely to develop PsA. This list is defined by those with a family history of psoriatic arthritis. Similarly, those who’ve experienced psoriasis are at risk. While anyone can develop the disease, those between ages 30 and 50 are at highest risk.
Those who have psoriasis and experience stiffness, pain or swelling in the joints, should consider discussing the possibility of PsA with their dermatologist or rheumatologist. Many university medical centers will have a joint dermatology/rheumatology clinic that can offer two opinions at once and help to make a more accurate diagnosis. Psoriatic arthritis can affect upwards of 30 percent of regular psoriasis patients, and psoriasis is often a precursor to PsA.
Protection and Treatment
For most, early detection is the best defense. If you haven’t yet experienced joint pain, but you have experienced reduced mobility and have psoriasis, then contact a dermatologist or rheumatologist for help. Psoriatic arthritis and psoriasis are associated with many other health problems including diabetes, heart disease, stroke and obesity. These conditions should all be addressed with your primary care doctor and should be monitored regularly. When PsA is diagnosed and treated very early on, management is relatively easy and can prevent extreme joint deterioration and damage.
PsA symptoms may not appear until 10 years after the onset of psoriasis. This delayed onset benefits those with early preventive care. Immunosuppressants are often provided by the dermatologist or rheumatologist. These medications help to quell the overactive immune system that is responsible for the unsightly rash of psoriasis, and they may reduce potential PsA symptoms before they begin.
Recognition, Prevention and Care
The link between psoriasis and PsA is closely-knit. The body’s overactive inflammatory pathways can be incredibly dangerous—resulting in a variety of health problems as outlined above. Although no outright “cure” for psoriasis exists, there are many very effective medications available. PsA may be preemptively avoided if psoriasis is treated early and aggressively. I like to explain psoriasis as an inflammatory disease to my patients. Not only is there excessive inflammation in the skin, but it may be present in your entire body as well. This inflammation needs to be turned off in order to avert its effects throughout the body. When you think about psoriasis as a disease of inflammation, it is easier to understand the importance of seeking out early and aggressive treatment.
For many years, the connection between psoriasis and arthritis was not recognized. Fortunately, nowadays this correlation is well-understood and can help to get early and aggressive treatment into place.
+Dr.Lee is a board certified dermatologist who has dedicated her career to research and treatment of skin ailments. She writes regularly at cherylleemd.com