Tuesday, September 27, 2022

Can You Have Psoriatic Arthritis And Not Have Psoriasis

Challenges Finding Resources And Information

7 Things to Avoid if you have Psoriatic Arthritis

The relief was short-lived, however, as I quickly became disheartened because there is so little information about these cases. Not many rheumatologists have experience with cases of psoriatic arthritis without psoriasis. Consulting Dr. Google was practically useless, yet I had so many questions!

It was unnerving to know so little- especially not knowing the average length of time between developing arthritis and psoriasis. In a lot of ways, I almost felt excluded from resources about psoriatic arthritis because they had little to no information about having psoriatic arthritis without psoriasis.

The Importance Of Seeing A Rheumatologist

In the eight years since I was diagnosed, Ive learned a lot. While I never found a study on the length of time between developing arthritis and psoriasis, it has been almost twenty years since I developed arthritis and I dont have psoriasis yet .

Ive learned to live knowing I could develop psoriasis, but that I shouldnt worry too much. Sometimes doctors still question if my diagnosis is correct, occasionally checking me for lupus, but always conclude its psoriatic arthritis. Though its maddening to have people constantly question my diagnosis, I realize its only because its rare in cases like mine.

Skin And Nail Problems

While its possible to have PsA and AS at the same time, its comparatively rare for AS patients to develop psoriasis or nail issues. Theyre much more common in PsA, reported by the vast majority of patients.

Despite these clues, identifying either disease can be complicated and may take a long time. In fact, waiting between seven and 10 years for a diagnosis is normal for people with AS. This is partly because back pain is so common and patients often wait to bring it up with a physician. Its also due to misdiagnosis many primary care doctors simply dont know much about AS, and may mistake it for a different condition like fibromyalgia.

Similarly, PsA can be misdiagnosed for rheumatoid arthritis, osteoarthritis, or gout.

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Psoriatic Arthritis And Psoriasis Are Both Autoimmune Conditions

Both conditions happen when your autoimmune system mistakenly attacks healthy cells in your body, causing inflammation. With psoriasis, new skin cells grow too quickly and build up, resulting in thick, scaly rashes that can make it painful to move, according to the Cleveland Clinic. People with psoriatic arthritis also have inflammation, but their symptoms generally result in stiff, painful joints, and swollen skin surrounding the joints, according to the Mayo Clinic.

The exact causes of autoimmune diseases are not clear. Some experts theorize that injuries might trigger psoriatic arthritis and that infections could trigger psoriasis, according to John Hopkins University. Doctors commonly suspect that genetics may determine whether someone is susceptible to autoimmune disorders, but the specifics explaining how or why are up in the air.

Both conditions are lifelong diseases that can alternate between periods of remission where you have very few symptoms and flares in which your symptoms are worse.

A Trip To The Physical Therapist Can Feel More Heavenly Than A Massage

Three Ways to Manage Psoriatic Arthritis

A few months after being diagnosed with psoriatic arthritis, Rabe began physical therapy. I went two to three times a week, and the exercises I learned to do helped me cope with the pain, she says. Now any time I feel an ache in a new part of my body, Im right back at the physical therapists office. Exercises recommended by a therapist can help keep your joints flexible while strengthening your muscles and reducing pain.

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Experts Arent Sure Why Psoriasis And Psoriatic Arthritis Are Linked

Psoriasis and psoriatic arthritis are clearly connected, but experts dont know why some people develop both conditions. However, genetics appears to be involved. Researchers have pinpointed a family of genes called the human leukocyte antigen complex as a possible contributor to psoriasis and psoriatic arthritis, according to the U.S. National Library of Medicine. People with psoriasis or psoriatic arthritis have HLA genes that are different from people who dont have either condition, according to a May 2021 paper published in The Journal of Rheumatology. And people with psoriasis who have a specific HLA gene mutation are more likely to develop psoriatic arthritis, according to the same paper.

Medical experts also believe that psoriatic arthritis may be inherited. About 40% of people with psoriatic arthritis have a family member with either psoriasis or psoriatic arthritis, according to the U.S. National Library of Medicine.

Lupus Vs Rheumatoid Arthritis

If you test positive for ANA, your doctor may order the AVISE CTD, a blood test that can confirm lupus and other autoimmune diseases such as rheumatoid arthritis, Sjogrens syndrome, or scleroderma.The AVISE test measures the lupus biomarkers called cell-bound complement activation products . 1-3 Anti-dsDNA antibody

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Overview Of Nail Psoriasis

Psoriatic nail disease has many clinical signs. Most psoriatic nail disease occurs in patients with clinically evident psoriasis it only occurs in less than 5% of patients with no other cutaneous findings of psoriasis.

An estimated 10-55% of all patients with psoriasis have psoriatic nail disease, and approximately 7 million people in the United States have psoriasis. About 150,000-260,000 new cases of psoriasis are diagnosed each year. US physicians see 1.5 million patients with psoriasis per year.

Severe psoriatic nail disease can lead to functional and social impairments if left untreated.

See the images of psoriatic nail disease below.

See 15 Fingernail Abnormalities: Nail the Diagnosis, a Critical Images slideshow, to help identify conditions associated with various nail abnormalities.

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Psoriasis And Psoriatic Arthritis Connection

Living With Psoriatic Arthritis and Psoriasis

Psoriatic Arthritis Highlights From ACR 2021 Dr Christopher Ritchlin discusses key reports on psoriatic arthritis from ACR 2021, including results of a brepocitinib efficacy study and data on risk.

Last year, BMO Capital Markets analyst Gary Nachman forecast $350 million in psoriatic arthritis sales for the drug by 2025. “Patients often do not suspect a connection between their psoriasis.

5 People With Psoriasis on How to Self-Advocate at Doctors Appointments If youre living with psoriasis, you know all too well that.

She specializes in the mind-body connection, with a focus on how our mental and emotional well-being impact our physical fitness.

Atopic Dermatitis Highlights From AAD Summer Meeting 2021 Dr Jonathan Silverberg discusses key reports on atopic dermatitis from AAD 2021, including data on dupilumab and how biologic therapies.

A large study, also published in 2014 in the Annals of Rheumatic Diseases, supports the connection between high uric acid levels and psoriasis and suggests an especially strong connection with psoriatic arthritis. The study drew a total of almost 99,000 participants nearly 28,000 men and 71,000 women from two large databases.

Psoriasis and psoriatic arthritis are distinct conditions, but they are connected. In fact, data show that up to 30 percent of people.

Psoriasis and Psoriatic Arthritis With psoriasis.

Learn about the connection between psoriasis and psoriatic arthritis.

National Psoriasis Foundation.

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Article Summary: Scalp Psoriasis Is Highly Bothersome And Hair Makes It Harder To Treat But There Are A Number Of Prescription Treatments In A Variety Of Formats Including Sprays Foams Gels And Shampoos To Help Treat The Scalp Effectively As Well As Treatments For The Whole Body That Have Demonstrated Strong Success In Treating Scalp Psoriasis

Psoriasis of the scalp is very common. Nearly 80% of psoriasis patients develop plaques on the scalp at some point in their life with psoriasis.

Scalp psoriasis is especially distressing to many patients. It can be extremely itchy, and when psoriasis extends beyond the hairline onto the face and around the ears or down the back of the neck, it is highly visible. In some cases, it can also cause temporary loss of hair in places where the psoriasis patches are thick on the scalp. Add to this the difficulty in applying medicine only to psoriasis patches, often covered by hair, without also treating the healthy skin and its not surprising that patients are eager for effective treatments.

Fortunately, there are a variety of medications that when applied directly to scalp psoriasis, are able to reduce or resolve it for a period of time and many of the newest psoriasis treatments, designed to treat psoriasis all over the body, have demonstrated excellent clearance of scalp psoriasis as well. Over-the-counter products can play an important supporting role.

Our message for those suffering with the frustration, itch, and pain of scalp psoriasis is: dont lose hope, as there are options available today that will likely provide you substantial relief from your scalp psoriasis.

Prevention Of Nail Psoriasis

Good nail care is the best way to treat nail psoriasis. Try these prevention tips:

  • Keep your nails trimmed short.
  • Use a nail file to keep nail edges smooth.
  • Wear gloves to clean and do other work with your hands.
  • Moisturize your nails and cuticles every day and after theyâve been in contact with water.
  • Wear comfortable shoes with enough room for your toes.

If youâre unhappy with the way your nails look, try nail varnish or artificial nails. They can also protect your nails from more damage. Some people are sensitive to the chemicals in varnish and nail adhesive. Talk to your doctor about whether these are right for you.

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But Wait Psa Gets More Complicated: Symptoms And Causes

Psoriatic arthritis can progress over time. In some people, it only causes mild disease punctuated by severe symptoms during periods of more disease activity . In others, disease activity is more persistent. No matter which camp youre in, early treatment is critical to relieve pain from affected joints, prevent joint damage, and to maintain your ability to walk and be active.5

Treatment will also help to reduce or prevent other health-related problems from developing, such as fatigue and depression .

The good news is that if diagnosed and treated early , many of these problems can be avoided or reduced. Learning to recognize the symptoms of PsA will help you and your doctor intervene to lessen the impact of the disease on your life and prevent potentially irreversible changes to your joints and bones.

What Does Nail Psoriasis Look Like

Psoriasis: Symptoms and Treatment Infographic

Nail psoriasis can affect your fingernails and toenails and will often manifest in these ways:

  • Discoloration. Your nails are starting to brown, yellow or turn completely white.
  • Damaged nail surface. You will notice lines, cracks, pits, holes or ridges. Basically, any nail surface that isnt smooth.
  • Lifted nails. With nail psoriasis, white debris can begin to form under your nail, pushing it up and away from your skin. This is usually painful.
  • Thinning or thickening texture. If your nails feels brittle or too thick, this can be the buildup of psoriatic skin cells under the nails, or it can be a fungal infection that can more easily invade the already-lifted nail. You will need a culture to determine the best treatment.
  • Nail separation. Again, pretty painful. Depending on the severity of your nail psoriasis, your nail may start to separate itself from the nail bed.

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A Good Day Doesnt Mean Youre Better

Many people who live with psoriatic arthritis have good days and bad days. Although good days don’t mean youre healed, its important to work with your doctor to find ways to have more good days than bad. Tracking your symptoms and their impact on your life, as well as your ability to participate in everyday activities, may help your healthcare provider identify new ways to help you, says Markenson, including potential lifestyle changes and additional treatments.

Psoriatic Arthritis Vs Rheumatoid Arthritis

Psoriatic arthritis and rheumatoid arthritis are both inflammatory, autoimmune conditions. Their symptoms are similar, including joint stiffness, pain, inflammation, and exhaustion.

Because theyre both types of arthritis, many people arent sure about the differences and relationship between PsA and RA. As one MyPsoriasisTeam member asked, Is there a link between psoriasis and rheumatoid arthritis?

Ultimately, there are a few key similarities and differences between the causes, symptoms, and treatment of PsA and RA.

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How Psoriasis Affects The Nails

Nail psoriasis occurs because psoriasis affects the process of nail formation. People who have nail psoriasis usually have psoriasis on other parts of their body, such as the skin and joints. Rarely does someone have only psoriasis of the nails.

Symptoms of nail psoriasis vary but may include:

  • Discoloration of the nail to yellow-brown
  • Pitting in the surface of the nails
  • Horizontal lines across the nails
  • White patches on the nails
  • Thickening of the nails

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Six Symptoms You Shouldnt Ignore

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The symptoms of psoriatic arthritis can vary in severity, from person to person and can even come and go . Here are six symptoms you should watch out for.

1. Its hard to move in the morning

Psoriatic arthritis can make getting up in the morning a challenge, especially after you havent moved around for a while. It can cause stiffness and pain in one or more joints, from your toes to your fingers. It can even cause pain and swelling in the tendons and surrounding structures that connect to your bone, a condition called enthesitis.

2. Your fingers look like warm sausages

About 30 to 50 percent of patients with psoriatic arthritis will experience the symptoms of dactylitis, or extreme swelling in their fingers and toes, Dr. Aquino said. This is when the entire fingers and toes swell to resemble sausages.

You may notice your swollen joints feel warm to the touch because inflammation and swelling cause heat.

3. You have lower back pain

When you think of psoriatic arthritis, you typically think about skin symptoms, but many people experience lower back pain as well. About 20 percent of those with psoriatic arthritis will develop a subtype called spinal involvement or psoriatic spondylitis, which may result in pain and stiffness in the back and hips, Dr. Aquino said.

4. Your nails have grooves and ridges
5. You experience eye problems
6. Youre always tired

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Comparing Psoriatic Arthritis And Osteoarthritis Treatment

While there is no cure for psoriatic arthritis, doctors have been able to focus on treating symptoms to help patients control the pain associated with the condition. The kind of treatment depends on how severe a persons symptoms are and how much damage there is to the joints.

Here are three main treatments for PsA:

  • Medications prescriptions and over-the-counter medications to reduce inflammation and pain. Medications to suppress the bodys immune system.
  • Steroid injections inserted directly into the joint to reduce inflammation.
  • Surgery joint replacement in severe cases.

Like psoriatic arthritis, the treatment for osteoarthritis is all about reducing pain so the patient can lead a more comfortable and mobile life.

OA treatments include some of the following:

  • Medications prescription and over-the-counter. More severe cases require stronger medications.
  • Lifestyle adjustments diet and exercise to alleviate pressure on joints.
  • Injections corticosteroids and hyaluronic acid to reduce inflammation and increase mobility.
  • Complementary therapies physical therapy, occupational therapy, canes, braces, and other assistance devices to help with changes in abilities.
  • Surgery badly damaged joints replaced with artificial option to decrease pain and improve mobility.

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Four Main Types Of Psoriatic Arthritis

There are 78 major joints in the body and psoriatic arthritis can affect any one of these. Usually, however, certain joints are more likely to be affected . Different patterns are found. Sometimes just one or two joints are a problem but often several joints, both large and small and on both sides of the body, are involved. About a third of people with psoriatic arthritis also have spondylitis which can result in a painful, stiff back or neck. Psoriasis can affect the nails with pitting, discolouration and thickening and this may be associated with inflammation in the joints at the end of the finger or toe. Another way in which psoriatic arthritis can be recognized is the finding of a sausage-like swelling of a finger or toe, called dactylitis. This is caused by inflammation occurring simultaneously in joints and tendons, painful heels and other bony prominence can also occur and this is caused by inflammation where gristle attaches to bone.

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Causes Of Psoriatic Arthritis

Almost 1 in 3 people with psoriasis also have psoriatic arthritis.

It tends to develop 5 to 10 years after psoriasis is diagnosed, although some people may have problems with their joints before they notice any skin-related symptoms.

Like psoriasis, psoriatic arthritis is thought to happen as a result of the immune system mistakenly attacking healthy tissue.

But its not clear why some people with psoriasis develop psoriatic arthritis and others do not.

Do Doctors And Patients Care About The Same Issues When It Comes To Treating Psa Mostly

Pin by Linda Walter on Psoriatic arthritis

When it comes to treating PsA, how much do rheumatologists and patients prioritize the same issues? A study ledy by Phillip Mease, MD, looked at this by running focus groups with 53 PsA patients and by conducting interviews with 13 PsA expert doctors.

Researchers found that patients and doctors aligned on their main concerns: treating joint pain and swelling, fatigue, and disease activity. But while doctors ranked clinical symptoms such as enthesitis, dactylitis, and skin disease more highly, patients considered items such as access to care, future health uncertainty, and sleep quality to be more important than doctors did.

While its not surprising that doctor and patients prioritize different aspects of caring for a complex disease like PsA, its important for everyone to be aware of where these differences play out, so doctors can make sure theyre treating the whole patient, and patients can make sure they share their most important concerns with their doctor.

This poster highlights the need to consider an approach to patient care in a holistic manner, rheumatologist Swetha Ann Alexander, MD, said on RheumNow. Some ways this can be addressed are better ancillary support such as social work to improve access to care, psychiatry, or sleep counseling to address insomnia and other comorbid psychiatric illnesses. Finally, empowering patients by disease education decreases future health uncertainty.

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