Our bodies are like ecosystems, with every individual part affecting another. A disease or condition that affects one part of your body might also lead to problems elsewhere. While skin ailments certainly fall into their own category of medical conditions, sometimes the underlying problem or symptoms go deeper than the skin. This is the case with psoriatic arthritis, which shares the names and symptoms of both a skin disease (psoriasis) and a joint disease (arthritis).
Here we’ll define psoriatic arthritis and explore how this disease can affect not only the skin but also the joints.
Arthritis comes in many forms, with psoriatic arthritis falling into the “inflammatory arthritis” classification. This category includes types of arthritis that cause swelling, stiffness, and pain. Psoriasis holds the first name because this disease most often (though not exclusively) affects those who already have psoriasis. Indeed, between 10 and 30% of those with psoriasis eventually suffer from psoriatic arthritis. As such, psoriatic arthritis symptoms are often the same as those offered by psoriasis, such as red, itchy, scaly skin (usually around skin folds), alongside arthritic symptoms such as joint pain and swelling.
While the root cause of psoriasis and psoriatic arthritis remain a mystery to this day, most researchers and dermatologists attribute these conditions mostly to genetics, with environmental factors playing into the severity and frequency of flare-ups.
Psoriasis and psoriatic arthritis aren’t just linked by their namesake or symptom profile. The main connection between these conditions involves immune system malfunction. White blood cells are like the foot soldiers of our immune systems. When our bodies are functioning as they should, these cells constantly keep out harmful pathogens that might do us harm. However, our white blood cells may also go rogue and start attacking healthy tissue for no apparent reason, resulting in inflammation and an overproduction of skin cells.
This scenario describes the potential beginnings of psoriasis and/or psoriatic arthritis. As for why our immune systems would fail us, the answer falls back on genetics, as psoriasis and psoriatic arthritis tend to run in families.
While psoriatic arthritis is often accompanied by psoriasis symptoms, the disease is mainly characterized by its impact on one’s joints. There are a number of ways in which psoriatic arthritis can affect the joints, some more severe than others. These varying levels of severity can be classified as two different types of psoriatic arthritis, oligoarticular (milder, in which four or fewer joints are affected) and polyarticular (more severe, in which more than four joints are affected).
Beyond these two distinctions, psoriatic arthritis can also be labeled based on which joints or areas of the body are most affected. Enthesitis, for instance, refers to the inflammation of those areas where tendons and ligaments enter the bone (entheses). Spondylitis deals with the spinal column and connected areas. And dactylitis, common in those with psoriatic arthritis, is the inflammation of the joints of fingers or toes, often asymmetrically. All joints can be affected by psoriatic arthritis, causing various levels of pain, stiffness, discomfort, and fatigue.
While there is no cure for either disease, treatments are available for both psoriasis and psoriatic arthritis. The main goal of these treatments is to reduce inflammation and pain. Some treatments are designed to suppress one’s immune system to prevent or slow down future flare-ups. Examples of psoriatic arthritis treatment include anti-inflammatory medication, anti-rheumatic drugs, immunosuppressants, topical or oral steroids, enzyme inhibitors, and biologics, which target specific proteins that cause inflammation.
While having psoriasis doesn’t ensure that you will also get psoriatic arthritis, it does put you at higher risk. Taking care of your psoriasis with proper treatment and attention can help you avoid further complications and major episodes. At Premier Dermatology Partners, we seek to educate our patients and provide them with the best possible treatments for their skin conditions. To learn more about our team and all the services we provide, contact us.