Monday, March 26, 2007
Common skin disease can develop into arthritis
About 10 percent to 30 percent of people with psoriasis also develop psoriatic arthritis, which causes pain, stiffness and swelling in and around the joints.
It can develop at any time, but for most people it appears between the ages of 30-50. In 85 percent of patients, skin disease precedes joint disease.
Therefore, it is important to tell your dermatologist if you have any aches and pains. Psoriatic arthritis seems to affect men at a slightly higher percentage than women.
Both genetic and environmental factors seem to be associated with the development of psoriatic arthritis.
Prompt diagnosis and treatment can relieve pain and inflammation and possibly help prevent progressive joint involvement and damage.
There are five types of psoriatic arthritis: symmetric, asymmetric, distal interphalangeal predominant (DIP), spondylitis and arthritis mutilans.
Symmetric arthritis is similar to rheumatoid arthritis, but generally milder with less deformity. It usually affects multiple symmetric pairs of joints.
Asymmetric arthritis can involve a few or many joints and does not occur in the same joints on both sides of the body. It can affect any joint, such as the knee, hip, ankle or wrist. The hands and feet may have enlarged "sausage" digits.
Distal interphalangeal predominant (DIP). Although considered the "classic" type, occurs in only about 5 percent of people with psoriatic arthritis. Primarily, it involves the distal joints of the fingers and toes (the joint closest to the nail). Nail changes are usually prominent. 4. Spondylitis is inflammation of the spinal column. In about 5 percent of individuals with psoriatic arthritis, spondylitis is the predominant symptom.
Arthritis mutilans is a severe, deforming and destructive arthritis that affects fewer than 5 percent of people with psoriatic arthritis.
Generally, one or more of the following symptoms appears during the initial onset: Generalized fatigue, tenderness, pain and swelling over tendons, swollen fingers and toes, stiffness, pain, throbbing, swelling and tenderness in one or more joints, reduced range of motion, morning stiffness and tiredness and nail changes.
There is no definitive test for psoriatic arthritis. The diagnosis is made mostly on a clinical basis and by a process of elimination. Medical history, physical examination, blood tests, MRIs and X-rays of the joints that have symptoms may be used to diagnose psoriatic arthritis. It is important to communicate your history of psoriasis to your doctor.
There are multiple treatment options, including anti-inflammatory medications, which help symptoms of inflammation. Then there are disease modifying agents that tend to modify the underlying disease to prevent joint damage or halt the joint damage.
There is also a new set of agents called the Biologics that are also very helpful in management. We now have multiple options to choose from, so it is a very promising time for the patients.
Sandeep Varma, MD, is a rheumatologist and Medical Director at the Backus Arthritis Center, located at the Backus Outpatient Care Center in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Varma and all of the Healthy Living columnists at healthyliving@wwbh.org
It can develop at any time, but for most people it appears between the ages of 30-50. In 85 percent of patients, skin disease precedes joint disease.
Therefore, it is important to tell your dermatologist if you have any aches and pains. Psoriatic arthritis seems to affect men at a slightly higher percentage than women.
Both genetic and environmental factors seem to be associated with the development of psoriatic arthritis.
Prompt diagnosis and treatment can relieve pain and inflammation and possibly help prevent progressive joint involvement and damage.
There are five types of psoriatic arthritis: symmetric, asymmetric, distal interphalangeal predominant (DIP), spondylitis and arthritis mutilans.
Symmetric arthritis is similar to rheumatoid arthritis, but generally milder with less deformity. It usually affects multiple symmetric pairs of joints.
Asymmetric arthritis can involve a few or many joints and does not occur in the same joints on both sides of the body. It can affect any joint, such as the knee, hip, ankle or wrist. The hands and feet may have enlarged "sausage" digits.
Distal interphalangeal predominant (DIP). Although considered the "classic" type, occurs in only about 5 percent of people with psoriatic arthritis. Primarily, it involves the distal joints of the fingers and toes (the joint closest to the nail). Nail changes are usually prominent. 4. Spondylitis is inflammation of the spinal column. In about 5 percent of individuals with psoriatic arthritis, spondylitis is the predominant symptom.
Arthritis mutilans is a severe, deforming and destructive arthritis that affects fewer than 5 percent of people with psoriatic arthritis.
Generally, one or more of the following symptoms appears during the initial onset: Generalized fatigue, tenderness, pain and swelling over tendons, swollen fingers and toes, stiffness, pain, throbbing, swelling and tenderness in one or more joints, reduced range of motion, morning stiffness and tiredness and nail changes.
There is no definitive test for psoriatic arthritis. The diagnosis is made mostly on a clinical basis and by a process of elimination. Medical history, physical examination, blood tests, MRIs and X-rays of the joints that have symptoms may be used to diagnose psoriatic arthritis. It is important to communicate your history of psoriasis to your doctor.
There are multiple treatment options, including anti-inflammatory medications, which help symptoms of inflammation. Then there are disease modifying agents that tend to modify the underlying disease to prevent joint damage or halt the joint damage.
There is also a new set of agents called the Biologics that are also very helpful in management. We now have multiple options to choose from, so it is a very promising time for the patients.
Sandeep Varma, MD, is a rheumatologist and Medical Director at the Backus Arthritis Center, located at the Backus Outpatient Care Center in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Varma and all of the Healthy Living columnists at healthyliving@wwbh.org
# posted by ----------------- @ 1:51 PM 
