What is psoriatic arthritis?
- PsA is a type of inflammatory arthritis and an autoimmune disease.
- PsA is a chronic disease characterized by inflammation of the skin and joints.
- The onset of psoriatic arthritis generally occurs in the fourth and fifth decades of life.
- Males and females are affected equally.
- No one knows what causes PsA but genetics plays a role.
What causes psoriatic arthritis?
- If someone in your family has psoriasis or psoriatic arthritis there is a greater chance that you will develop it.
- In patients with PsA who have arthritis of the spine, a gene marker named HLA-B27 is found in about 50% of cases.
- Joint pain and stiffness is worse in the morning; typically lasting more than 30 minutes.
What are symptoms and signs of psoriatic arthritis?
- The arthritis frequently involves the knees, ankles, and joints in the feet.
- Usually, only a few joints are inflamed at a time.
- The inflamed joints become painful, swollen, hot, and red.
- Sometimes, joint inflammation in the fingers or toes can cause swelling of the entire digit, giving them the appearance of a “sausage like appearance”.
- Inflammation in the colored portion of the eye (iris) causes iritis, a painful condition that can be aggravated by bright light as the iris opens and closes the opening of the pupil.
- Inflammation in and around the lungs causes chest pain, especially with deep breathing, as well as shortness of breath.
What is the treatment for psoriatic arthritis?
- Generally, the treatment of arthritis in psoriatic arthritis involves a combination of anti-inflammatory medications or/and Disease-Modifying Anti-Rheumatic Drugs (DMARDs).
- Exercise programs at home or with a physical therapist can help patients with PsA.
- Ice application after the routine can help minimize post-exercise soreness and inflammation.
- The best-tolerated and most commonly prescribed DMARD for psoriatic arthritis is methotrexate. Other DMARDs includes Leflunomide, Cyclosporine, and Sulfasalazine.
- Non-steroidal anti-inflammatory drugs are a group of medications that are helpful in reducing joint inflammation, pain, and stiffness.
- Corticosteroids are potent anti-inflammatory agents. Corticosteroids can be given by mouth or injected directly into the joints to reduce inflammation.
- Patients who experience progressive joint destruction in spite of NSAIDs are candidates for more aggressive DMARD medications.
- Biologics agents like DMARDs are used tosuppress inflammation and help prevent damage tothe joint. In psoriatic arthritis, the biologics may alsoimprove the psoriasis as well as the arthritis. Depending on the biologic prescribed; they are either given by injection at home or by an intravenous infusion at a clinic. Examples of biologic agents are Etanercept, Adalimumab, Infliximab and Golimumab.
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