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Psoriatic Arthritis

Psoriatic arthritis is an inflammation of the joints and skin. During the development of the condition, psoriasis (skin inflammation) precedes the development of arthritis. Only in about 15% of patients does arthritis precede psoriasis. Psoriatic arthritis affects joints in the feet and hands and can cause pain and inflammation in the hips, spine, elbows and knees. In some cases, the condition affects tendons and causes tissue inflammation in the eyes, lungs, heart and kidneys.


The real cause of psoriatic arthritis is not known but it is believed that genes have something to do with it. The condition occurs in the 40s and 50s and affects men and women equally. Psoriatic arthritis can be mild or severe. In mild cases, it can be years before the condition fully develops. Arthritis in this case may only affect few joints, in particular toe and finger tips. In severe cases, most joints in the body will be affected, the spine included. Patients will experience a burning sensation, pain and stiffness in the spine and sacrum. Adverse change in nails and skin occur, one has reduced range of movement and feels general tiredness.


To diagnose psoriasis arthritis, doctors will check for tenderness of the skin, sores and joint swelling. X-ray tests on joints and blood tests may also be done. The doctor may also check for a family history of psoriasis arthritis.


Doctors will prescribe salicylates to reduce pain and inflammation. Severe cases of psoriasis arthritis require more powerful drugs. Disease-modifying antirheumatic drugs (DMARDs) are used for this. These include leflunomide, sulfasalazine and methotrexate. Newer drugs called tumor necrosis factor (TNF) are thought to be the most effective in treating psoriasis arthritis and are currently the preferred treatment for the condition. They include infliximab, adalimumab and etanercept.


Very painful joints may require steroid medications while badly damaged joints may require surgery. Taking up regular exercise will improve movement in some joints.


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