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Psoriatic Arthritis

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Some people who suffer from psoriasis may develop a kind of arthritis known as psoriatic arthritis. Psoriasis is a serious skin condition that can cause the overproduction of skin cells. It can cause skin to become thick, red, irritated and/or scaly. Most people develop the skin condition first and then symptoms of arthritis, although for some this order is reversed. Joint pain, stiffness and swelling are the most common signs of psoriatic arthritis. It can also lead to swollen fingers and toes, and foot back and neck pain. These symptoms can range from mild to severe. This can affect any part of the body, including the fingers and spine. The condition can worsen over time. Psoriasis and its related form of arthritis can have periods of inactivity, when symptoms disappear. When they come back, this is usually referred to as a “flare.” For many people with the condition, problems of the skin and joints develop and disappear simultaneously.
Psoriasis and arthritis are both autoimmune disorders. These are thought to occur when the body’s immune system begins attacking healthy tissues and cells. Doctors aren’t exactly sure what causes the immune system to go haywire but genetics and environment are thought to play a role. Many people who suffer from psoriatic arthritis have a close relative with the disorder. Physical trauma and certain viral or bacterial infections can trigger psoriatic arthritis. There is also another variable – a substance called tumor necrosis factor (TNF) which causes inflammation in people with rheumatoid arthritis. People with psoriatic arthritis have high levels of this substance in their skin and joints.
Treatment and regular exercise are strongly encouraged to prevent the condition from becoming disabling. There is no cure for psoriatic arthritis so treatment is centered on controlling symptoms and pain. General symptoms include pain and inflammation in the affected joints, and joints that are warm to the touch. Doctors believe there are five different types of psoriatic arthritis. Sufferers can develop several of these over time. These different types of arthritis can cause pain in joints on one side of the body, pain in joints on both sides, pain in the joints of the fingers and spinal pain. A small number of people with psoriatic arthritis can develop destructive arthritis or “arthritis mutilans.” This is a severe condition that is painful and disabling. Over time it can destroy the small bones of the hands and fingers, leading to deformity and disability.
There is no single test that identifies this condition but X-Rays, blood tests and joint fluid tests can help in the diagnosis. Medications that may be helpful include nonsteroidal anti-inflammatory drugs, corticosteroids, disease modifying anti-rheumatic drugs and immune suppressing drugs. Though rarely done, surgery may help ease symptoms and restore mobility.

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