Flare Warning: Sacroiliac Joint Pain
PsA falls under the umbrella of spondyloarthritis, a term used to describe a group of rheumatic disorders , says Dr. Homsi. As such, there is often stiffness, swelling, and pain in your sacroiliac joints. The sacroiliac joints, which connect the pelvis to the lower spine, consist of the sacrum and the ilium . If you notice an increase in pain in this area, which correlates often to pain deep in the buttocks, without any change in your physical activity, talk with your doc about potential meds to help fight a flare.
Flu And Pneumonia Vaccines Are A Must
We say rheumatoid arthritis, you think joints which, of course, makes sense. Rheumatoid and other forms of inflammatory arthritis are notorious for causing pain, stiffness, and swelling in your hands, feet, lower back, and other joints.
But the same chronic, systemic inflammation that targets those joints can also affect other seemingly unrelated parts of your body such as your heart and your lungs.
Some reports suggest about 10 to 20 percent of patients with rheumatoid arthritis have lung problems. One study published in the journal Rheumatology International found that number may be as high as 67 percent. Most cases of lung disease will occur within five years of being diagnosed.
Psoriatic Arthritis And Your Lungs
The inflammation associated with psoriatic arthritis can also harm your lungs and increase the risk of chronic obstructive pulmonary disease , a group of lung conditions that cause breathing difficulties.
A Taiwanese study published in the Journal of the European Academy of Dermatology and Venereology showed the risk for COPD was even higher in men and those over age 50 with psoriasis.
In a meta-analysis published in the journal Allergy and Asthma Proceedings, researchers looked at the association between psoriasis and asthma in 66,772 people with psoriasis and 577,415 control patients. They found the risk of asthma was greater in individuals with psoriasis, especially among older patients.
If you have psoriatic arthritis, you might want to avoid smoking, lung irritants, and dust, which could raise your chances of developing COPD.
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Treatments For Your Skin
If your psoriasis is affecting your quality of life, or your treatment is not working, you may be referred to a dermatologist.
There are a number of treatment options for psoriasis.
Ointments, creams, and gels that can be applied to the skin include:
- ointments made from a medicine called dithranol
- steroid-based creams and lotions
- vitamin D-like ointments such ascalcipotriol and tacalcitol
- vitamin A-like gels such astazarotene
- tar-based ointments.
For more information about the benefits and disadvantages of any of these talk to your GP, dermatologist, or pharmacist.
If the creams and ointments dont help, your doctor may suggest light therapy, also known as phototherapy. This involves being exposed to short spells of strong ultraviolet light in hospital.
Once this treatment has started, youll need to have it regularly and stick to the appointments youve been given, for it to be successful. This treatment is not suitable for people at high risk of skin cancer or for children. For some people, this treatment can make their psoriasis worse.
Retinoid tablets, such as acitretin, are made from substances related to vitamin A. These can be useful if your psoriasis isnt responding to other treatments. However, they can cause dry skin and you may not be able to take them if you have diabetes.
Some DMARDs used for psoriatic arthritis will also help with psoriasis.
Flare Warning: Nail Changes
Another psoriatic arthritis red flag to look out for: Changes in your nail structure, color, or aberrations. Not everyone with PsA will experience this symptom, but others report abnormalities on their finger or toenailsor both. In fact, nail changes are often an early indicator of PsA in general. Studies say that up to 80% of people with psoriatic arthritis experience nail issues, ranging from pitting and discoloration to loosening of the nail plate and subungual hyperkeratosis .
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Psoriatic Inflammation And The Brain
Studies have shown that people with psoriatic disease are at an increased risk for anxiety and depression.
One survey found that more than 36 percent of people with psoriatic arthritis had anxiety and about 22 percent had depression. These numbers were much higher than what people with only psoriasis reported.
Patients with psoriatic arthritis really have a sort of dysmorphic view of themselves, Ritchlin says. This is a disease thats hard to hide. Other people can see it, and the patient can feel it.
There is growing evidence that the inflammation that causes psoriatic disease can affect the brain. Inflammatory proteins called cytokines are associated with psoriatic arthritis and also commonly found in people with depression.
We used to think inflammation was only in joints and skin, says Theoharis Theoharides, MD, PhD, a professor of immunology at Tufts University School of Medicine in Boston. The type of inflammation present in psoriatic arthritis is probably in action in the part of the brain that regulates mood, given that psoriatic arthritis has a strong nervous system component.
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Work And Psoriatic Arthritis
Having psoriatic arthritis may make some aspects of working life more challenging. But, if youre on the right treatment, its certainly possible to continue working.
Help and support is available, and you have rights and options.
The Government scheme Access to Work is a grant that can pay for equipment to help you with activities such as answering the phone, going to meetings, and getting to and from work.
The 2010 Equality Act, and the Disability Discrimination Act in Northern Ireland makes it unlawful for employers to treat anyone with a disability less favourably than anyone else.
Psoriatic arthritis can be classed as a disability if it:
- makes daily tasks difficult
- lasts for more than 12 months.
Your employer may need to make adjustments to your working environment, so you can do your job comfortably and safely.
You might be able to change some aspects of your job or working arrangements, or train for a different role.
In order to get the support youre entitled to, youll need to tell your employer about your condition. Your manager or HR department might be a good place to start.
Other available support might include:
- your workplace occupational health department, if there is one
- an occupational therapist. You could be referred to one by your GP or you could see one privately
- disability employment advisors, or other staff, at your local JobCentre Plus
- a Citizens Advice bureau particularly if you feel youre not getting the support youre entitled to.
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Data Extraction And Quality Assessment
For each included study two authors independently extracted data and resolved discrepancies by discussion. One author entered the data into a database, and the remaining authors checked these entries.
We extracted several variables: authors, year of publication, population studied, number of patients, mean age and range, sex, disease duration, percentage methotrexate naive, previous immunosuppressive drug use, steroid use at baseline, folic acid or folinic acid usage, study design and duration, comparator drug, and adverse events. Adverse events were extracted as both total respiratory adverse events and individual adverse events in each category reported in any individual trial. The terminology used to describe respiratory adverse events varied widely in the included studies to overcome the lack of standardisation in terminology used, we classified adverse events into two subgroups: infectious adverse events and non-infectious adverse events.
Psoriasis And Interstitial Lung Disease
Interstitial lung disease is a group of lung disorders that affect the tissue surrounding the air sacsthe interstitium. It includes sarcoidosis, idiopathic pulmonary fibrosis, and interstitial pneumonia. ILD causes scarring of the lung tissue and difficulty breathing. In most cases, the cause is not known. However, some medications, such as immunosuppressants that treat psoriasis, can cause it. These links led researchers to examine the relationship between psoriasis and ILD.
Studies looking at imaging exams of the lungs of people with psoriasis have found evidence of ILD. They observed this even for people who had not yet taken any immunosuppressants. This suggests a link between ILD and psoriasis itself, and not just with certain medicines that treat the disease.
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Fatty Liver And Psoriatic Disease
Theres a much higher prevalence of fatty liver disease in people with psoriatic arthritis, says Ritchlin.
A review of studies in the Journal of Clinical and Aesthetic Dermatology found that up to 47 percent of psoriatic patients develop nonalcoholic fatty liver disease a condition that causes fatty deposits to develop on the liver and can lead to permanent scarring or damage. According to a study published in the journal Gastroenterology Review, NAFLD is frequent in patients with psoriasis and is also associated with the duration and severity of the disease.
Researchers believe the inflammation triggered by psoriatic arthritis may also affect different areas of the body, including the liver. Additionally, people with psoriatic arthritis are more likely to have obesity, diabetes, and metabolic syndrome, which are all NAFLD risk factors.
Drugs used to treat psoriatic arthritis, including NSAIDs and methotrexate, can adversely affect your liver. If youre taking these drugs, your doctor will want to monitor your liver function.
How Psoriatic Arthritis Affects The Lungs
Psoriasis and psoriatic arthritis are thought to lead to lung conditions due to inflammation. Inflammation is the bodys response to harmful substances. It is normally how we heal. However, in diseases like psoriasis, the inflammation becomes widespread, affecting healthy tissues.
In psoriatic arthritis, inflammation-causing substances are released into the blood system. These then affect tissues throughout the body.
Ongoing inflammation can produce changes in the structures of the respiratory system, leading to different lung conditions. Depending on how the airways and lungs are affected, various outcomes can occur. Breathing problems can develop when the tissues of the lungs and respiratory system are affected.
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Psoriatic Arthritis And Lung Nodules
Gut Bacteria May Cause Rheumatoid Arthritis It can also destroy bone and cartilage and damage organs like the lungs and kidneys. Scientists arent sure what causes rheumatoid arthritis, but they do know that its an autoimmune disorder, meaning that the bodys immune system is.
The drug can reduce the symptoms of rheumatoid arthritis, severe juvenile idiopathic arthritis, psoriasis and psoriatic arthritis, and exert a sustained effect on malignant growth in ALL, the CHMP noted. Two biosimilars medicines were.
Rheumatoid Arthritis has a number of symptoms that patients should be aware of including inflamed joints, pain, fatigue and over time joint damage.
Editorial. Respiratory disorders are common in general practice. Most practices now have spirometers and the diagnosis and management of lung disorders has advanced considerably within primary care. The link between rheumatological conditions and the lung is poorly understood in primary care. Many GPs will not be.
Learn about rheumatoid arthritis including Information on the signs, syptoms and treatment of Rheumatoid Arthritis from the Johns Hopkins Arthritis Center.
GUWAHATI: A recent study has found that gall bladder cancer is affecting more women than men in the northeast. As per the Population Based Cancer Registry , in the state, Kamrup has the highest incidence of gall bladder.
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Suffering From Psoriatic Arthritis? Ask Your Doctor About A Pill.
Joint Warmth And Swelling
A common sign of psoriatic arthritis is swelling and inflammation in your joints. These joints may also be warm to the touch.
The smaller joints are typically affected first like your fingers and toes. Fingers and toes may resemble sausages.
You will then typically notice the swelling in your hands, ankles, hips, elbows, feet, and knees. More than one joint may be inflamed at the same time.
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Swollen Joints Fingers And Toes
Often you’ll notice swelling in your knees, ankles, feet, and hands. Usually, a few joints are inflamed at a time. They get painful and puffy, and sometimes hot and red. When your fingers or toes are affected, they might take on a sausage shape. Psoriatic arthritis might affect pairs of joints on both sides of your body, like both of your knees, ankles, hips, and elbows.
What We Do And Dont Know About The Association Between Psoriasis Psoriatic Arthritis And Respiratory Disease
Medically reviewed in December 2020
Psoriasis and psoriatic arthritiscollectively known as psoriatic diseaseare associated with a number of serious health conditions. Cardiovascular disease, type 2 diabetes, obesity, psychiatric and mood disorders, and other inflammatory autoimmune disorders are some of the well-known examples.
Psoriatic disease is also associated with a number of diseases and disorders that affect the lungs. These include:
- Asthma. People with psoriasis, especially people who are older, are at an increased risk of having asthma, a chronic condition of the respiratory system characterized by inflammation of the airways.
- COPD. Chronic obstructive pulmonary disease refers to a collection of diseases that make it difficult to breathe. The two main types are chronic bronchitis and emphysema. People with psoriasis are at a greater risk of having COPD.
- Sarcoidosis. This is an inflammatory disease characterized by the formation of small nodules called granulomas. Granulomas can form in the lungs, lymph nodes, and other organs. The cause is unknown, but research shows people with psoriasis are at a higher risk.
- Lung cancer. Research has shown that people with psoriasis, and especially people with severe psoriasis, have a slightly higher risk of certain cancers, including lung cancer. A significant percentage of psoriasis patients are also smokers, and smoking is the number one risk factor for lung cancer.
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Pregnancy Fertility And Breastfeeding
Psoriatic arthritis wont affect your chances of having children. But if youre thinking of starting a family, its important to discuss your drug treatment with a doctor well in advance. If you become pregnant unexpectedly, talk to your rheumatology department as soon as possible.
The following treatments must be avoided when trying to start a family, during pregnancy and when breastfeeding:
- retinoid tablets and creams.
Theres growing evidence that some other drugs for psoriatic arthritis are safe to take during pregnancy. Your rheumatology department will be able to tell you which ones.
It will help if you try for a baby when your arthritis is under control.
Its also important that your arthritis is kept under control as much as possible during pregnancy. A flare-up of your arthritis during pregnancy can be harmful for you and your baby.
Psoriasis and psoriatic arthritis can run in families. If you have either condition, you could pass on genes that may increase your childrens risk though its difficult to predict.
As treatments continue to improve, people with psoriatic arthritis in years to come can expect a better outlook. If you have any questions or concerns, talk to your doctor.
Flare Warning: Eye Problems
Although its not a common symptom, some psoriatic arthritis patients report vision problems at the onset of a flare. An eye condition called anterior uveitis is found in 7% of patients who have psoriatic arthritis, says Brian Toy, M.D., a board-certified dermatologist at Providence Mission Hospital in Mission Viejo, CA. Your eye doctor will know you have this eye issue by an increase in inflammation around the iris in the middle layer of the eye wall. If your eyes are affected by PsA, its important to consult an eye doctor as well as your rheumatologist.
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Symptoms Of Psoriatic Arthritis
- Patchy, raised, red areas of skin inflammation with scaling or silvery patches
- Swelling of an entire finger or toe that makes it look like a sausage
- General joint pain, stiffness and swelling
- Back pain and stiffness
- Changes in the nails such as pitting or separation from the nail bed
- Extreme exhaustion that does not go away
Increased Risk Of Pancreatitis And Diabetes
A study published in the journal PLoS One found that psoriatic disease is associated with a significantly increased risk of chronic pancreatitis, an inflammatory disease of the pancreas. Chronic pancreatitis can lead to permanent damage of the pancreas.
The researchers found that the incidence of chronic pancreatitis was roughly twofold in people with psoriasis compared with those without psoriasis. They also determined that psoriasis patients using nonsteroidal anti-inflammatory drugs and methotrexate , commonly used to treat psoriatic arthritis, had a lower risk of developing chronic pancreatitis.
The pancreas produces insulin, which helps maintain the bodys blood glucose levels. If the pancreas isnt functioning properly, it can lead to type 1 or type 2 diabetes. Research suggests the prevalence of diabetes mellitus is higher in patients with psoriatic arthritis. The risk of developing diabetes was shown to increase with elevated levels of psoriatic arthritis activity.
A review published in Rheumatology and Therapy found that people with psoriatic arthritis have a higher prevalence of type 2 diabetes compared to the general population. The authors of the study suggest that certain treatments for psoriatic arthritis may affect how the body maintains blood sugar.
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What Is Psoriatic Arthritis Video
Psoriatic arthritis can cause pain, swelling and stiffness inand around your joints.
It usually affects 3 in 10 people who already have the skin condition psoriasis .
Psoriasis causes patches of red, flaky skin which is covered with silvery-like patches.
Some people may develop psoriatic arthritis before the psoriasis is even present. In rare cases people have psoriatic arthritis and never have any noticeable patches of psoriasis.
Psoriatic arthritis and psoriasis are both autoimmune conditions, caused by a fault in the immune system.
Our immune system protects us from illness and infection. But in autoimmune conditions, the immune system becomes confused and attacks healthy parts of the body, often causing inflammation.
Psoriatic arthritis is a type of spondylarthritis. This is a group of conditions with some similar symptoms.
People with psoriasis are as likely as anyone else to get othertypes of arthritis, such asosteoarthritisorrheumatoid arthritis. Theseconditionsare not linkedto psoriasis.