Find out what Psoriatic Arthritis is, types of psoriatic arthritis, its causes, symptoms, how its medical diagnosis is performed and Natural treatment.

Learn about the usual medical treatment, its side effects and the benefits of a natural treatment for Psoriatic Arthritis.

Psoriatic Arthritis: What it is, Causes, Symptoms and Treatment

1. What is Psoriatic arthritis

Psoriatic arthritis according to Women’s College Hospital, is a polyarthritis, affects several joints and can be symmetric or asymmetric, present on one or both sides of the body, interchangeably.



Unlike arthritis that is more common in women, psoriatic arthritis occurs equally in men and women and has a negative rheumatoid factor.

The age of onset is generally 36 years old, but it can occur in childhood and old age.

According to another study conducted at Loyola University, psoriatic arthritis is an inflammatory arthritis that affects 30% of patients with psoriasis.

Psoriasis occurs before and 10 years later arthritis can occur. In 15% of patients, these diseases begin at the same time.

In another 15%, arthritis occurs before psoriasis, up to 15 years before.

Psoriatic arthritis is associated with disability and high mortality and is a more serious disease than rheumatoid arthritis. 

2. Types of psoriatic arthritis

Psoriatic arthritis is classified among spondyloarthropathies because it has a high frequency of spondyloarthritis, that is, the involvement of the spine and sacroiliac joints.

Within psoriatic arthritis, there are 5 patterns in which it occurs

2.1. Distal

Where the distal interphalangeal joints are affected, that is, the fingers

2.2. Oligoarticular

Four or fewer joints are involved

2.3. Polyarticular

It affects several joints, making it difficult to distinguish with rheumatoid arthritis.

2.4. Spondyloarthritis

It affects the sacroiliac and back joints

2.5 Arthritis mutilans

A severely deforming form of arthritis.

In the symptoms of psoriatic arthritis, the oligoarticular presentation is the most frequent, being observed in 70% of patients.

The distal pattern and arthritis mutilans are the most infrequent, it only occurs in 5% of patients each.

However, science has currently shown that polyarthritis is the most common, which was observed when patients were followed up for 10 years. 

Causes of Psoriatic Arthritis

3. Causes of Psoriatic Arthritis

According to another study conducted at Loyola University, psoriatic arthritis arises from the interaction between genetic and environmental factors.

3.1. Genetic factors

Although the origin of this disease is still unclear, the role of genetics is important.

An increased prevalence has been found among first-degree relatives with psoriatic arthritis along with immune disorders.  

Psoriatic arthritis is usually transmitted from a single father to a child and if the possibility of being affected by the other brother is high, it occurs in one brother.



People who develop psoriatic arthritis at an early age, before age 40, are more likely to have a family history of psoriatic arthritis.

The presence of HLA in a person indicates an increased risk of psoriatic arthritis.  

In turn, it was shown that inflammation of the skin and joints may appear or worsen due to environmental factors.

3.2. Environmental factors

According to the study mentioned above, trauma or infection are triggers of psoriatic arthritis.

Generally, psoriatic lesions that occur at trauma sites were observed between 23% to 52% of patients with psoriasis.

Among the infections, an association between pharyngitis and tonsillitis, that is, inflammation of the pharynx and tonsils has been found.

These infections increase antibodies in the body in response to the invasion of bacteria that collaborate in the development of psoriasis and later arthritis. 

4. Symptoms

According to a study at Women’s College Hospital, the pain and stiffness that occurs in psoriatic arthritis worsens with rest and improves with activity.

The inflammation that occurs in the joints of the fingers, back, neck and spine produce significant pain, so 11% of patients show restriction of their daily activities.

Patients with psoriatic arthritis may have morning stiffness, active joint inflammation, inflammation, and stiff neck and back.

They can also develop deformities in 1 or more than 5 joints, have dactylitis, inflammation of a whole sausage-shaped finger.

It is also common the appearance of disease of the finger joints that include shortening of the fingers, inflammation, and erosion.

Active inflammation of the joints occurs in 97% of cases and problems in the finger joints occur in 54% of patients.

52% of people with psoriatic arthritis have morning stiffness and 18.6 and 23% have inflammation and back and neck stiffness respectively.

More than a quarter of patients with psoriatic arthritis develop sacroiliitis, inflammation of the sacroiliac joints between the spine and pelvis or spondylitis, inflammation of the spine. 

5. Medical diagnosis

Medical diagnosis

According to another study carried out at Loyola University, the diagnosis is complicated on many occasions because psoriasis lesions are often hidden.

They can be hidden in areas such as the navel, anus, ears or hairline and the loss of sensitivity in patients with psoriatic arthritis prevents them from referring to the doctor.

According to the study at the University of Otago for diagnosis, the CASPAR criteria are used, that is, classification criteria for psoriatic arthritis.

For the diagnosis, the presence of inflammatory joint disease in joints, spine or enthesitis is considered (inflammation in the place where the bone joins a tendon)

In addition to more than 3 points of the following characteristics:

  • Current psoriasis, which affects the skin or scalp (which if present adds up 2 points)

The characteristics named below if presented add up to 1 point:

  • History of psoriasis, in a first or second-degree relative (does not add up if there is current psoriasis)
  • Family history of psoriasis (does not add up if there is current psoriasis or a history of psoriasis)
  • Dactylitis or history of dactylitis.
  • Formation of a new bone near a joint that is evaluated with an X-ray of the hands and feet
  • Negative rheumatoid factor found by any method except latex.
  • Alterations in the nails in the form of onycholysis, that is, separation of the tip of the nail from its contour, stinging or increased pigmentation. 

5.1. Laboratory and radiological studies

According to a study at Women´s College Hospital, in blood tests in patients with psoriatic arthritis anemia is found in 14% of cases.

In addition, 41% have a high sedimentation rate, which indicates that both arthritis and active skin disease occur.

17% of people with psoriatic arthritis have an increase in white blood cells.

While 14% of women and 32% of men have an increase in uric acid.

On the other hand, radiological studies in patients with psoriatic arthritis show erosions in 67% of people.

Sacroiliitis can be found in 27% of patients and the syndesmophyte, which is the growth of bone in a ligament is observed in 11% of patients. 


6. Psoriatic Arthritis Treatment

6.1. Medicines

According to another study conducted at Loyola University, treatment should consider both psoriasis with joint disease that also includes dactylitis and enthesitis.

Treatment should not only consider the improvement of symptoms but also modify and improve the disease.

No drug treatment has only managed to reduce the progression or they have no benefits over other symptoms, the combination of medications is necessary and this increases the side effects.

Medicines used

  • Nonsteroidal anti-inflammatory drugs
  • Corticosteroids
  • Disease-modifying antirheumatic:

   Sulfasalazine

  • Methotrexate
  • Gold
  • Leflunomide
  •  Azathioprine and 6-mercaptopurine
  • Ciclosporin A
  • Antimalarial agents
  • Colchicine
  • Mycophenolate Mofetil
  • Retinoids
  • Somatostatin

6.1.1. Side effects medications

  • Gastrointestinal disorders
  • Exacerbation of psoriasis due to medication abandonment
  • Photosensitivity and erythema
  • Pustular psoriasis development (pus pustules on the skin)
  • Exfoliative dermatitis (redness throughout the skin
  • Dry and cracked lips, nosebleeds
  • Muscle pain
  • Recurrence of skin and joint disease within 1 to 4 months
  • Stomatitis: Annoying inflammation in the mouth and appearance of sores
  • Malformations in the fetus in pregnant women 

6.2. Foods with high healing capacity

There are many allergies present in people with psoriatic arthritis, which many times the person has managed to identify, but in most cases, the person does not know their origin and is responsible for the development of psoriasis symptoms in the skin and joints.

That is why in Nueva Evas we have developed an Anti-Arthritis Program, a gluten-free, healthy eating program, the main allergenic food associated with psoriatic arthritis.

According to a study conducted at the University of California, a gluten-free diet is associated with an improvement in psoriasis and the severity of symptoms.

According to another study at Harvard University, weight control, which is possible with the Anti-Arthritis Program, also reduces the severity of psoriatic arthritis by reducing the impact on the joints.

Patients with psoriatic arthritis, according to a study at the University of Hannover have antioxidant deficiencies such as beta carotene, alpha tocopherols, and selenium.

These antioxidants are widely covered with a healthy diet specialized for arthritis that includes fruits and vegetables rich in carotenoids, flavonoids and vitamin C.  

These antioxidants prevent oxidative stress produced by free radicals in the skin, improving psoriasis lesions.  

In addition to this, the change in the type of fats in the diet that is proposed with the program, towards an increase in healthy polyunsaturated fats favors the reduction of joint inflammation.

The Anti-Arthritis Program selects the best foods, always taking care that they are foods of plant origin, rich in enzymes, and with medicinal properties to cure psoriatic arthritis.

 SCIENTIFIC REFERENCES

Categories: ARTHRITIS

4 Comments

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