What is PSORIATIC ARTHRITIS?

Psoriatic arthritis is a chronic inflammatory arthritis which is typically but not always associated with psoriasis. It may affect large joints, smaller joints such as fingers and toes along with joints in the spine (spondylitis), or sacroiliac joints. Inflammation may be present where ligaments or tendons attach to bone. Typical age of onset is between 30 and 50 years of age with equal incidence of men and women. Psoriasis causes scaly red and white skin patches.

Diagnosis of psoriatic arthritis is made by physical exam looking for swollen joints, nail and skin changes. Changes on x-rays, ultrasound MRI or CT may indicate involvement of joints or spine. A skin biopsy can confirm psoriasis. Blood tests may help to exclude other disease processes.

Treatment

Treatment for mild psoriatic arthritis may involve nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen. If that category of medication does not improve arthritis symptoms, a disease modifying drug may be prescribed. These include sulfasalazine, methotrexate, leflunomide or azathioprine. Other treatments include biologic medications such as TNF inhibitors (adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, IL17 or other classes of inhibitors (secukinumab, exekizumab, ustekinumab, abatacept. Oral medications such as JAK inhibitors (tofacitinib, upadacitinib) may also be effective.

Patients with psoriatic arthritis can help manage their own symptoms with exercise such as walking, biking, yoga of and water exercise. Learning how to protect the joints, strengthen muscles and improve flexibility are important.

arthritis foundation

For additional resources and advice, visit the Arthritis Foundation online.