Psoriatic Arthritis - April 28, 2009 Newsletter

Psoriatic Arthritis

EHE Newsletter, Volume 9, Number 9
April 28, 2009

Psoriatic (pronounced "sorry attic") arthritis is a chronic autoimmune disease that affects both the skin and joints. This disease causes antibodies — immune cells that help to prevent disease — to attack cells and fight healthy tissue.

There are five types of psoriatic arthritis, with each type being defined by the location where joint inflammation occurs. It is estimated that one million people in the U.S. (2.5 % of Caucasians) are affected by psoriatic arthritis. The disease is less prevalent among African Americans and Native Americans. Although it can develop at any age, psoriatic arthritis usually occurs between the ages of 35 and 55 and affects both men and women equally.

Psoriatic arthritis should not be confused with psoriasis — a chronic skin condition characterized by thick, white, silvery or red patches of skin accompanied by inflammation and flaking. Psoriasis is thought to be the result of an overactive immune system that causes skin cells to grow too quickly. While the exact cause of psoriatic arthritis is unknown, it is known that four out of ten individuals with psoriasis go on to develop psoriatic arthritis.

The onset of psoriatic arthritis may be triggered by stress, infection, a skin injury, or a reaction to a medication. When the disease develops, it attacks the joints, usually beginning with inflammation in the hands and feet. It is this inflammation that can eventually give one’s hands and feet a "sausage–like" appearance. Other psoriatic arthritic symptoms include painful limited motion, morning fatigue and stiffness, and conjunctivitis — an ailment that is more commonly known as "pink eye."

Diagnosing psoriatic arthritis can be a challenge as there are no specific tests that can be used to detect the disease. A health care provider will often review one’s health history, ask about symptoms, conduct a physical exam, examine fluid from an affected joint, take X–rays or an MRI (magnetic resonance imaging) of an affected joint, and run blood tests. Early diagnosis is vital in preventing joint and tissue damage as well as possible bone loss.

Psoriatic arthritis is treated by both a rheumatologist (a specialist who treats joint symptoms) and a dermatologist (a specialist who treats the skin). As there is no cure or method of preventing the disease, the goal of both specialists is to manage the symptoms and slow the progression of the disease. Topical ointments and creams are used to address the symptoms on the skin, and pain management techniques — including the application of hot and cold compresses, the use of over–the–counter ibuprofen, and the practice of good posture — are used to address joint involvement. Prescription disease–modifying anti–rheumatic drugs (DMARDS) treat both the skin and joints.

In managing the symptoms and slowing the disease’s progression, it is equally important to address one’s health–related lifestyle choices. Changes to diet, increased exercise, and stress management are significant ways in which those who are affected with psoriatic arthritis can help themselves to manage the illness.

• While there is no special recommended diet for those who have psoriatic arthritis, a diet that includes plenty of water, is rich in calcium and folic acid, and low in saturated fats is advised.
• Physical activity assists in keeping joints flexible and may reduce stress.
• Maintaining an optimal weight through healthy eating habits and increased physical activity will lead to less weight applied to the joints, which, in turn, leads to less pain and increased mobility.
• Relaxing, keeping life simple, or otherwise managing stress can be highly beneficial. It is recommended that those with psoriatic arthritis need not be afraid to seek support from friends, family, support groups, or individual therapy.

Remember: EHE International’s comprehensive health exam is an important first step that one can take towards health maintenance and disease prevention. Additionally, the EHE International Personal Health Coach Program assists patients in setting positive goals to address nutrition habits, physical activity, stress management, and tobacco use.

Additional Resources

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

National Psoriasis Foundation Affiliated Supports (to help locate support groups in your area)

MEDICAL DISCLAIMER: The information is not intended to constitute medical advice and is not a substitute for consultation with a physician or other health care provider. Individuals with specific complaints should seek immediate consultation from their personal physicians.