Is psoriatic arthritis linked to psoriasis?
Psoriasis is a chronic skin problem that causes skin cells to grow too quickly, resulting in thick, white, silvery, or red patches of skin. This commonly affects skin of the scalp and over the knees and elbows, but can occur anywhere on the body.
About 10% to 30% of people with psoriasis develop psoriatic arthritis. Psoriatic arthritis may develop at any age, but usually affects people between the ages of 30 and 50. While the cause is not known, genetic factors, along with the immune system, likely play a role in determining who will develop the disorder.
What are the symptoms of psoriatic arthritis?
Psoriatic arthritis frequently involves inflammation of the knees, ankles, and joints in the feet and hands. Usually, only a few joints are inflamed at a time. The inflamed joints become painful, swollen, hot, and red. Sometimes, joint inflammation in the fingers or toes can cause swelling of the entire digit, giving them the appearance of a sausage.
Joint stiffness is common and is typically worse early in the morning. Less commonly, psoriatic arthritis may involve many joints of the body in a symmetrical fashion, mimicking the pattern seen in rheumatoid arthritis.
Psoriatic arthritis can also cause inflammation of the spine (spondylitis) and the sacrum, causing pain and stiffness in the low back, buttocks, neck, and upper back. In about 50% of those with spondylitis, the genetic marker HLA-B27 can be found. In rare instances, psoriatic arthritis involves the small joints at the ends of the fingers. A very destructive form of arthritis, called "mutilans," can cause rapid damage to the joints of the hands and feet and loss of their function. Fortunately, this form of arthritis is rare in patients with psoriatic arthritis.
Patients with psoriatic arthritis can also develop inflammation of the tendons (tendinitis) and around cartilage. This inflammation may lead to an enthesopathy, which is inflammation of a tendon at the site where it inserts into the bone. Inflammation of the tendon behind the heel causes Achilles tendinitis, leading to pain with walking and climbing stairs. Inflammation of the chest wall and of the cartilage that links the ribs to the breastbone (sternum) can cause chest pain, as seen in costochondritis.
Does psoriatic arthritis cause inflammation of organs?
Yes. Psoriatic arthritis can cause inflammation in other organs, such as the eyes, lungs, and aorta. Inflammation in the colored portion of the eye (iris) causes iritis, a painful condition that can be aggravated by bright light.
Corticosteroids injected directly into the eyes of patients with iritis are sometimes necessary to decrease inflammation and prevent blindness. Inflammation in and around the lungs (pleuritis) causes chest pain, especially with deep breathing, as well as shortness of breath. Inflammation of the aorta (aortitis) can cause leakage of the aortic valves, leading to heart failure and shortness of breath.
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