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Arthritis Explained

Psoriasis & Psoriatic Arthritis



What are Psoriasis & Psoriatic Arthritis?

Psoriasis is a skin condition that affects around 1 in every 50 people in the UK. Around 10% of all people with Psoriasis will develop Psoriatic Arthritis, although a National Psoriasis Foundation survey in 2002 reported that persistent joint pain or stiffness was found in 31% of patients with Psoriasis, which means that many people with Psoriatic Arthritis may not realise they have the condition. In fact, Psoriatic Arthritis may develop before Psoriasis in some people.

Unlike Rheumatoid Arthritis, men and women are affected equally and it tends to affect the joints in different manners. Typically one or two joints are affected. Some people with Psoriatic Arthritis will have back or neck pain due to spinal inflammation. Common signs and symptoms include joint pain and swelling, as well as general tiredness and morning stiffness. Other characteristic signs include eye soreness, changes to fingernails, mouth ulcers and pain when passing urine.

How does Psoriatic Arthritis cause Pain?

Psoriatic Arthritis appears to be triggered by an abnormal immune response, although the development of this condition has a lot to do with a person's genes. High levels of specific antigens (cells that produce antibodies which fight infection) are associated with Psoriatic Arthritis and the disease process may be triggered secondary to an infection.

Psoriatic Arthritis is characterised by inflammation of the Synovial Membrane that surrounds joints. Inflammation of this Synovial membrane causes a marked increase in blood vessels to this tissue, a thickening of the membrane and an increase in inflammatory fluid within the joint. The inflammatory cells within the joint cause tissue damage and erosion of bone. This produces more pain and deformity of the affected joints.

Patients with Psoriatic Arthritis can also suffer from Enthesitis and Spondylitis. Enthesitis is inflammation of muscle and tendon insertions (typically the Achilles Tendon). Spondylitis is inflammation of the joints of the spine.

What should you do if you suffer from Psoriatic Arthritis?

Psoariatic Arthritis is a lifelong condition. Long term continuous management under a Consultant Rheumatologist has been shown to be the best form of therapy. Where symptoms are mild and infrequent then the Rheumatologist may manage the symptoms with anti-inflammatory medication.

In more severe cases early prescription of Disease Modifying Anti Rheumatic Drugs (DMARDs) are thought to help by minimising the early joint damage then the more disabling joint symptoms of Psoriatic Arthritis can be minimised.

Treatment of joint problems is often complicated by skin symptoms. Phototherapy using UVa and UVb lamps can help settle skin symptoms, together with medication prescribed by a Dermatologist (skin specialist).

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