Arthritis Arthritis Basics

What is Psoriatic Arthritis?

Psoriasis is commonly misunderstood to be a disease exclusively of the skin due to its easily recognizable presentations. The abnormalities that characterize it do indeed point to a skin disorder; it is marked by scaly, raised, red patches on the genitalia, scalp, knees and elbows. However, psoriasis is the result of the immune system overworking and producing the excessive growth of silvery-white dead skin cells commonly referred to as scale. This buildup of cell patches forms unsightly, itchy and uncomfortable lesions. Further, the malfunctioning immune system associated with psoriasis can affect other organs as well.

Psoriatic arthritis (PsA) is a potentially debilitating condition that can result in the painful swelling of the joints, hands and feet. It can also lead to inflammation in body tissues, such as tendons and cartilage, eyes, heart, lungs and kidneys. The symptoms of psoriatic arthritis can vary in intensity and may change over time. Swelling of fingers is common, and fingernails and toenails may become pitted, thickened and discolored. Inflammation may attack the spine as well, making it hard for a patient to bend. Sometimes spondylitis, a condition associated with pain in the back or neck, can develop as a result of psoriatic arthritis. People with psoriatic arthritis may also experience tender spots in the back of the heel or the sole of the foot.

According to the National Institutes of Health, between 5.8 and 7.5 million people in the United States have psoriasis. Although they can develop at any age, initial symptoms often appear in people between ages 15 and 35. Approximately 10 to 15 percent of people will notice the signs of psoriasis before age 10, but the disease is rarely seen in infants.

Having psoriasis does not guarantee a diagnosis of psoriatic arthritis, but it greatly increases the odds. Approximately 10 to 30 percent of people with psoriasis eventually develop psoriatic arthritis, and this likelihood increases with the severity of psoriasis. The National Psoriasis Foundation states that half of those with severe psoriasis will develop psoriatic arthritis. A survey conducted by the Psoriasis Foundation found that one million Americans have this form of arthritis.

The common disease course of psoriatic arthritis begins with the formation of characteristic skin lesions. The joint symptoms of psoriatic arthritis can follow sometimes as many as 10 years later. Like psoriasis, the condition can flare and subside. In up to 20 percent of patients, the signs and symptoms of psoriatic arthritis, including painful swelling of the joints, hands, feet and connective tissue, will appear first. About one-third of people with psoriatic arthritis will develop a destructive form of the disease, which includes progressive joint damage that eventually can make movement painfully difficult.

Like psoriasis, psoriatic arthritis can begin at any time; it usually strikes adults between ages of 30 and 50. Children can develop a form of the disease called juvenile psoriatic arthritis. Men and women are generally affected equally, though the disease may be slightly more common in women. It is found in all ethnic groups, but some studies suggest a higher prevalence among Caucasians.

Despite the prevalence of both psoriasis and psoriatic arthritis, the potential severity of both conditions is often overlooked, and both diseases are commonly misunderstood even by the people who experience them. According to a survey conducted by the National Psoriasis Foundation, one-third of the people who suffer from psoriasis said they also experience persistent joint stiffness or stiffness for at least 3 months, but they were not diagnosed with psoriatic arthritis. This fact leads researchers to believe that the condition is going untreated or unrecognized.

Learning to identify the signs and symptoms of psoriatic arthritis is important, because when left untreated, the disease can diminish quality of life and lead to painful, irreversible joint damage. Fortunately, efforts are underway to increase patient and physician awareness about the chronic condition. While there is no cure for psoriasis or psoriatic arthritis, there are safe and effective treatments that, when used at the first sign of disease, can help people manage these potentially disabling diseases. Researchers are spending more time looking into more effective and safer treatment methods that will isolate and control the bodily mechanisms believed to trigger these conditions.