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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Psoriatic arthritis

Arthritis - psoriatic

Last reviewed: April 18, 2014.

Psoriatic arthritis is a joint problem (arthritis) that often occurs with a skin condition called psoriasis.

Causes

Psoriasis is a common skin problem that causes red patches on the body. It is an ongoing (chronic) inflammatory condition. About 1 in 20 people with psoriasis will develop arthritis with the skin condition. In most cases, psoriasis comes before the arthritis.

The cause of psoriatic arthritis is not known. Genes, immune system, and environmental factors may play a role. It is likely that the skin and joint diseases have similar causes. However, they may not occur together.

Symptoms

The arthritis may be mild and involve only a few joints. The joints at the end of the fingers or toes may be more affected.

In some people the disease may be severe and affect many joints, including the spine. Symptoms in the spine include stiffness, burning, and pain. They most often occur in the lower spine and sacrum.

Most of the time, people with psoriatic arthritis have the skin and nail changes of psoriasis. Often, the skin gets worse at the same time as the arthritis.

Exams and Tests

During a physical exam, the health care provider will look for:

  • Joint swelling
  • Skin patches (psoriasis) and pitting in the nails
  • Tenderness

Joint x-rays may be done.

There are no specific blood tests for psoriatic arthritis or for psoriasis, but the doctor may test for a gene called HLA-B27.

Treatment

Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDS) to reduce pain and swelling of the joints.

Worse arthritis will need to be treated with more powerful drugs called disease-modifying antirheumatic drugs (DMARDs). These include:

New medicines that block an inflammatory protein called tumor necrosis factor (TNF) are being widely used for progressive psoriatic arthritis. These drugs include:

Very painful joints may be injected with steroid medicines.

In rare cases, surgery may be needed to repair or replace damaged joints.

Your doctor may suggest a mix of rest and exercise. Physical therapy may help increase joint movement. You may also use heat and cold therapy.

Outlook (Prognosis)

The disease is often mild and affects only a few joints. In some people, very bad psoriatic arthritis may cause deformities in the hands, feet, and spine.

Early treatment can ease pain and prevent joint damage even in very bad cases.

When to Contact a Medical Professional

Call your health care provider if arthritis symptoms develop along with psoriasis.

References

  1. Fitzgerald O. In: Psoriatic arthritis. Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 77.
  2. Husni ME. Psoriatic arthritis. In: Carey WD, ed. Cleveland Clinic: Current Clinical Medicine. 2nd ed. Philadelphia, PA: Saunders Elsevier; 2010.

Review Date: 4/18/2014.

Reviewed by: Gordon A. Starkebaum, MD, Professor of Medicine, Division of Rheumatology, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Medicines for Psoriatic Arthritis: A Review of the Research for AdultsMedicines for Psoriatic Arthritis: A Review of the Research for Adults
    This summary will tell you about DMARDs, a type of medicine for people with PsA. It will also discuss the possible side effects of these medicines. It will tell you what research has found about how well DMARDs work to treat PsA. This summary can help you talk with your doctor about whether one of these medicines might be right for you. This summary does not discuss treatments for the skin condition of psoriasis.
See all (11) ...

Figures

  • Psoriasis, guttate on the arms and chest.
    Psoriasis, guttate on the cheek.

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