What is psoriatic arthritis?:
Psoriatic arthritis (PsA) is a condition that combines the swollen, sore joints of arthritis with psoriasis . Psoriasis causes itchy, scaly red patches to appear on your skin and scalp.
Why You Should Care? Symptoms? Risk Factors? Complications? Treatment?
Why You Should Care:
About 7.5 million Americans have psoriasis and up to 30 percent of these people develop PsA.
Types of psoriatic arthritis:
Symmetric PsA: This type affects the same joints on both sides of your body. About 50 percent of people with PsA have this type.
Asymmetric PsA: This affects a joint or joints on one side of your body. It affects about 35 percent of people with PsA.
Distal interphalangeal predominant PsA: This type involves the joints closest to your nails. It occurs in about 10 percent of people with PsA.
Spondylitis PsA: This type of PsA involves your spine. Your entire spine from your neck to your lower back may be affected.
Psoriatic arthritis mutilans: About 5 percent of people with PsA have this type. Psoriatic arthritis mutilans usually affects your hands and feet.
Symptoms:
General symptoms of PsA include:
• swollen, tender joints on one or both sides of your body
• morning stiffness
• swollen fingers and toes
• painful muscles and tendons
• scaly skin patches, which may get worse when joint pain flares up
• flaky scalp
• fatigue
• separation of your nail from the nail bed
• eye redness(conjunctivitis)
• eye pain(uveitis)
Spondylitis PsA, in particular, can also cause the following symptoms:
• spinal pain and stiffness
• pain, swelling, and weakness in your hips, knees, ankles, feet, elbow, hands, wrists, and other joints
• swollen toes or fingers
Risk Factors:
You’re more likely to get PsA if you:
• have psoriasis
• have a parent, brother, or sister with PsA
• are between the ages of 30 and 50 (though children can get it, too)
• have had strep throat
• have HIV
PsA puts you at risk for complications that include:
• psoriatic arthritis mutilans
• eye problems, such as conjunctivitis or uveitis
• cardiovascular disease
Psoriatic Arthritis Triggers:
PsA flare-ups make the condition worse for a period of time. Certain things can set off PsA flares and these things are different for everybody.
Common PsA triggers include:• infections like strep throat and upper respiratory infection
• injuries such as a cut, scrape, or sunburn
• dry skin
• stress
• cold, dry weather
• smoking
• heavy drinking
• excess weight
• medicines such as lithium, beta-blockers, and antimalarial drugs
Although you can’t avoid all of these triggers, you can try to manage stress, stop smoking, and cut down on drinking.
Treatment:
The goal of PsA treatment is to improve symptoms like skin rash and joint inflammation. A typical treatment plan will include one or more of the following:
Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications help control joint pain and swelling. Over-the-counter (OTC) options include ibuprofen (Advil) and naproxen (Aleve).
Disease-modifying antirheumatic drugs (DMARDs): These medications decrease inflammation to prevent joint damage and slow the progression of PsA. The most commonly prescribed DMARDs include:
• methotrexate (Trexall)
• leflunomide (Arava)
• sulfasalazine (Azulfidine)
• Apremilast (Otezla)
Biologics: Commonly prescribed biologic drugs include:
• adalimumab (Humira)
• certolizumab (Cimzia)
• golimumab (Simponi)
• etanercept (Enbrel)
• infliximab (Remicade)
Steroids: These medications can bring down inflammation. For PsA, they’re usually injected into affected joints.
Immunosuppressants: Medications like azathioprine (Imuran) and cyclosporine (Gengraf) calm the overactive immune response in PsA.
Biologics: Commonly prescribed biologic drugs include:
Topical treatments: Creams, gels, lotions, and ointments can relieve the itchy PsA rash. Options include:
• anthralin
• calcitriol or calcipotriene, which are forms of vitamin D-3
• salicylic acid
• steroid creams
• tazarotene, which is a derivative of vitamin AA
Light therapy and other PsA medicines: Light therapy uses medicine, followed by exposure to bright light, to treat psoriasis skin rashes.
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