Psoriasis Monthly Newsletter
February, 2008
With featured articles on Psoriasis and skin-care, information on treating Psoriasis, reviews of recommended products, and interviews with practitioners.
Psoriatic Arthritis
by Edward F. Group III, DC, ND, DACBN
Psoriasis is a common skin disorder that affects millions of people throughout the United States. It is characterized by swollen and reddened patches of skin that are covered with silvery scales. Psoriasis can strike anywhere on the body, but it most often affects the elbows, scalp, lower back, navel, legs, and the backs of the knees. Approximately 10% of patients who suffer from psoriasis also develop an associated inflammation of their joints. Patients who have the skin disease, psoriasis, and an inflammatory arthritis of the joints are diagnosed as having psoriatic arthritis.
What Is Psoriatic Arthritis?
Psoriatic arthritis is a chronic disease that belongs to the same group of arthritis conditions that cause inflammation of the spine (spondyloarthropathies.) This disease is characterized by inflammation of the skin and joints. Patients with psoriatic arthritis can develop inflammation of tendons, cartilage, eyes, lung lining, and even the aorta. The onset of psoriatic arthritis generally occurs in those between forty and fifty years of age.
The skin disease (psoriasis) and the joint disease (arthritis) often appear separately. In fact, the skin disease precedes the arthritis in nearly 80% of patients, and the first appearance of psoriasis can be separated from the onset of arthritis by several years. Psoriatic arthritis causes pain, stiffness and swelling in and around the joints. Early diagnosis and treatment of this condition can help relieve pain and inflammation and it may even help reduce progressive joint damage. Without proper treatment, psoriatic arthritis can be debilitating.
What Causes Psoriatic Arthritis?
Doctors and health experts have not yet been able to identify the cause of psoriatic arthritis, although it is suspected that there are several factors involved. Genetic influences, immune responses, and environmental factors all likely play a role in the development of this condition. Some patients, who have psoriatic arthritis, also have a gene marker named HLA-B27; however, this is not always the case.
The presence of this gene can be confirmed with a simple blood test at your health care provider's office. There are also several other genes that have been associated with psoriatic arthritis, and researchers are currently investigating their connection to the disease. Certain immune system responses may also play a role in the development of psoriatic arthritis. Exposure to environmental factors such as chemicals and infectious agents may also be a cause of psoriatic arthritis.
What Are the Symptoms of Psoriatic Arthritis?
Psoriatic arthritis is characterized by inflammation in patches of the skin as well as the joints. In most patients, the skin disease precedes the joint disease by several months or even years. Patients with psoriatic arthritis develop skin lesions that are swollen, painful, and fiery red. They also experience painful arthritis that causes swelling, heat, stiffness, and redness in the joints. Psoriatic arthritis usually involves the knees, ankles, and the joints in the feet. Psoriatic arthritis can also cause a condition called spondylitis, or inflammation of the spine and the sacrum, which causes pain and stiffness in the lower back, buttocks, neck and upper back.
Psoriatic arthritis can also cause inflammation in the organs, such as the eyes, lungs, and aorta. When this condition occurs in the eyes, it can cause a painful condition called iritis in which the iris, or colored portion of the eye becomes inflamed. Iritis is aggravated by bright light as the iris opens and closes the opening of the pupil. Arthritic inflammation can also affect the lungs causing a condition called pleuritis. This condition is characterized by chest pain, pain when breathing, and shortness of breath. Inflammation of the aorta, called aortitis, can cause leakage in and around the aortic valve. Aortitis can lead to difficulty breathing and even heart failure.
How is Psoriatic Arthritis Diagnosed?
There is no specific medical procedure or test that can be used to diagnose psoriatic arthritis. The condition is usually diagnosed based on the presence of psoriasis in combination with the symptoms of arthritis. A blood test can be used to test for the presence of inflammation in the joints and in other organs of the body. If a large joint, such as the knee, is affected a test called arthrocentesis can be performed.
Arthrocentesis uses a sterile needle is used to withdraw fluid from the affected joints. The fluid is then analyzed for infection and other inflammatory conditions. Arthrocentesis is an in-patient procedure that can be performed in a physician's office. Your health care provider may also order a series of X-rays to evaluate changes in the cartilage or bone injuries that may indicate arthritis.