Psoriatic arthritis

Psoriatic arthritis is a disease belonging to a group of chronic inflammatory conditions with a very different course. About one-third of psoriasis patients also suffer from SD. The course of the disease usually begins between the ages of 30 and 50, regardless of gender.

Symptoms

The symptoms and course of the disease depend on a varied clinical picture. In most patients, skin symptoms appear before joint symptoms. Arthritis can involve either one or multiple joints.

The main symptoms are pain and/or swelling of the joints, their stiffness upon awakening, tenderness, warmth and prominent changes visible on ultrasound and X-ray. Also characteristic is inflammatory pain in the spine beginning in the lumbosacral region, usually manifesting at night and at rest.

The characteristic skin lesions in patients with psoriasis are red papules with a keratinized surface. Psoriatic lesions, depending on their course, can cover small areas of skin as well as most of the body surface. The most common lesions are on the elbows, knees, head, navel and buttocks. Often the lesions also involve the nails causing visible depressions and scaling.

Often, weakness, elevated temperature and general malaise are present in patients with SD. Conjunctivitis, gout, atherosclerosis, heart disease, inflammatory bowel disease and metabolic syndrome may also be present.

Causes and risk factors

Psoriasis is an autoimmune disease in which the immune system produces antibodies that attack its own cells. The exact aetiology of SD, like many other autoimmune diseases, is unknown. Causes of SD that can initiate an abnormal immune response are:

• Genetic predisposition – about 50% of patients with SD have a family member with psoriasis or SD, and the presence of the HLA-B27 antigen is also important
• Viral/bacterial infections
• Mechanical injuries
• Increased levels of stress
• Medications and other chemical compounds
• Treatment and complications
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Currently, there is no treatment available that will cure Psoriasis. Current treatment focuses on alleviating symptoms and increasing the patient’s quality of life.

The main therapies used to treat Psoriasis are:

• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Glucocorticosteroids (ICS)
• Immune-modifying drugs (methotrexate, sulfasalazine, cyclosporine, azathioprine and leflunomide)
• Biological drugs (etanercept, infliximab, adalimumab, golimumab)

Supportive therapies for the treatment of Psoriasis include:

• Local treatment methods – these are treatments that address the specific joint involved. These treatments may include joint puncture, removal of synovial membrane from the joint, corrective and reconstructive procedures for the joint, or replacement of the joint with an artificial prosthesis
• Mental support – patients who have SD are at greater risk of decreased well-being, stress and depression, so controlling mental health is extremely important
• Exercise and physical therapy – regularity in exercise and appropriate physiotherapy methods prevents or slows the development of joint real estate
• Maintaining an appropriate body weight and an adequate supply of calcium and vitamin D

 Although there’s currently no method that will lead to a complete cure for psoriatic arthritis, it’s possible to control the symptoms of psoriatic arthritis and slow the progression of the disease, resulting in long periods of remission. Current clinical trials may help patients achieve a longer and more effective symptom-free period, which is a huge opportunity for patients with severe psoriatic arthritis.