Rheumatology

Psoriatic arthritis

What is Psoriatic Arthritis?

Psoriasis is a disease in which scaly red and white patches develop on the skin. Psoriasis is caused by the body’s immune system going into overdrive to attack the skin. Some people with psoriasis can also develop psoriatic arthritis, manifested by painful, stiff and swollen joints. Like psoriasis, psoriatic arthritis symptoms flare and subside, vary from person to person, and even change locations in the same person over time.
 

Who is impacted?

What causes psoriatic arthritis is not known exactly. Of those with psoriatic arthritis, 40% have a family member with psoriasis or arthritis, suggesting heredity may play a role. Psoriatic arthritis can also result from an infection that activates the immune system. While psoriasis itself is not infectious, it might be triggered by a streptococcal throat infection, commonly known as strep throat.
 

How is Psoriatic Arthritis diagnosed?

To diagnose psoriatic arthritis, rheumatologists look for swollen and painful joints, certain patterns of arthritis, and skin and nail changes typical of psoriasis. X-rays often are taken to look for joint damage. MRI, ultrasound or CT scans can be used to look at the joints in more detail.
 

How is Psoriatic Arthritis treated?

Treating psoriatic arthritis varies depending on the level of pain, swelling and stiffness. Those with very mild arthritis may require treatment only when their joints are painful. Patients may stop therapy when they feel better. Non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin or Advil) or naproxen (Aleve) are used as initial treatment.

There are several biologic type medications available to treat psoriatic arthritis via infusion or injection.
The TNF Inhibitors such as adalimumab (Humira), etanercept (Enbrel), golimumab (Simponi), certolizumab (Cimzia) and infliximab (Remicade) are also available and can help the arthritis as well as the skin psoriasis.

Secukinumab (Cosentyx), a new type of biologic injection, was recently approved to treat psoriatic arthritis and can additionally be helpful in treating psoriasis.
Ustekinumab (Stelara) is a biologic injection given in your doctor’s office that is effective in treating psoriatic arthritis and psoriasis.
Abatacept is given to patients who have not responded to one or more DMARDs or other biologic drugs. Abatacept may be used alone or in combination with DMARDs.
For swollen joints, corticosteroid injections can be useful. Surgery can be helpful to repair or replace badly damaged joints.
 

Living with Psoriatic Arthritis

Many people with arthritis develop stiff joints and muscle weakness due to lack of use. Proper exercise is very important to improve overall health and keep joints flexible. This can be quite simple. Walking is an excellent way to get exercise. A walking aid or shoe inserts will help to avoid undue stress on feet, ankles, or knees affected by arthritis. An exercise bike provides another good option, as well as yoga and stretching exercises to help with relaxation.