PSORIATIC ARTHRITIS

General Information

DEFINITION--Joint inflammation that accompanies psoriasis lesions in nearby nails and skin.

BODY PARTS INVOLVED

• Joints in any part of the body, but most likely in finger joints and low-back and neck joints in the spine.
• Skin or nails that have psoriasis lesions and are close to the affected joint. Sometimes additional skin sites include the scalp, navel, underarm and groin.

SEX OR AGE MOST AFFECTED--Usually begins between ages 30 and 35 and continues intermittently throughout life.

SIGNS & SYMPTOMS

• Pain, swelling, restricted movement, tenderness and warmth in the affected joint.
• Scaling skin.
• Pitted, ridged, yellow nails.
• Tiredness and fever (sometimes).

CAUSES

• Predisposition to psoriatic arthritis may be hereditary.
• Immunological response to a streptococcal infection.
• Unknown (usually).
• Physical or emotional trauma (rare).

RISK INCREASES WITH

• Strep infections (rare).
• Family history of rheumatoid arthritis or psoriasis.

HOW TO PREVENT--No specific preventive measures. Always obtain prompt antibiotic treatment for strep infections.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies to detect a rheumatic factor and measure antinuclear antibodies (ANA).
• X-ray.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment. Treatment is directed at control of skin lesions and joint inflammation.

POSSIBLE COMPLICATIONS--Progression to chronic arthritis and severe crippling may occur (rare).

PROBABLE OUTCOME--This condition is currently considered incurable. It is characterized by acute flare-ups and remissions. However, symptoms can be relieved or controlled, and medical literature cites a few instances of unexplained recovery. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES--

• Immobilize inflamed joints with splints.
• Use heat to relieve joint pain. Hot soaks, whirlpool treatments, heat lamps, ultrasound or diathermy are all effective.
• Schedule periods for regular, moderate exposure to sunlight. If heat does not help, try cold compresses.
• PUVA therapy, high intensity ultraviolet light along with psoralen medication, is effective for the skin lesions.
• See Resources for Additional Information.

MEDICATION--

• For minor discomfort, you may use non-prescription drugs such as aspirin.
• To reduce joint inflammation, your doctor may prescribe: Nonsteroidal anti-inflammatory drugs. Cortisone injections into inflamed joints (occasionally). Immunosuppressive drugs (sometimes) such as methotrexate.

ACTIVITY--Rest inflamed joints during flare-ups, then resume your normal activities gradually. Try to increase outdoor activity in sunshine.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of psoriatic arthritis.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.