Psoriatic arthritis: what it is, symptoms and treatment

Psoriatic arthritis, commonly called psoriatic or psoriasis, is a type of chronic arthritis that can appear in the joints of people with psoriasis, which is a disease that normally affects the skin, characterized by the appearance of reddish plaques that itch and peel.

The main symptoms of psoriatic arthritis, in addition to the presence of red patches on the skin, common in psoriasis, include swelling of the joints, deformation of the joints and difficulty in moving them.

Psoriatic arthritis can appear at any age, however it is more common in adults between 30 and 50 years old, with almost 30% of people diagnosed with psoriasis on the skin develop this type of arthritis. See what the first signs of psoriasis are.

Main signs and symptoms

Signs and symptoms that may indicate that psoriatic arthritis is developing include:

  • Swelling and deformity in the affected joints;
  • Pain and difficulty in moving the affected joints;
  • Tendonitis;
  • Presence of red spots on the skin, nails or scalp that itch and peel;
  • Eye, cardiac, pulmonary and renal changes.

Often, the first signs of this type of arthritis are pain and difficulty in moving the joints, especially the hands, without the need for swelling or the presence of spots on the skin. Thus, people who suffer from psoriasis and have symptoms related to joint problems should consult the doctor who is treating psoriasis, to confirm the diagnosis and start the most appropriate treatment.

What tests confirm the diagnosis

The diagnosis of psoriatic arthritis is usually made through an evaluation of the clinical history, observation of skin lesions caused by psoriasis and an X-ray examination to help confirm arthritis.

However, examination of the rheumatoid factor is also important to differentiate it from rheumatoid arthritis, and what indicates that arthritis may be a consequence of psoriasis is if the rheumatoid factor is negative and arthritis symptoms are present. If the result of the rheumatoid factor is positive, it usually indicates that it is rheumatoid arthritis, and not related to psoriasis.

Types of psoriatic arthritis

There are 5 main types of psoriatic arthritis:

  • Symmetrical: This type affects the joints on both sides of the body.
  • Asymmetric: In this type the symptoms are moderate, generally affecting a maximum of 4 joints on either side of the body.
  • Mutilating Arthritis: This is the most aggressive type and tends to destroy the joints of the hands and feet, especially affecting the fingers;
  • Spondylitis: This type is characterized by the stiffness of the neck and spine.
  • Predominant distal interphalangeal: This type is characterized by stiffness in the joints of the fingers and toes. Nail deformities can develop.

The rheumatologist will be able to identify the type of arthritis that the person has and indicate the best treatment for each case.

How the treatment is done

Psoriasis has no cure yet, so treatment is aimed at reducing and controlling symptoms and is important to prevent the disease from getting worse.

Thus, one of the first treatment guidelines is to make lifestyle changes that help prevent risk factors such as obesity, hypertension or diabetes, including smoking cessation and other drugs, as well as regular practice of light exercise and food. balanced.

In addition, other treatment options include:

1. Use of anti-inflammatories

The main drugs used for the disease are non-steroidal anti-inflammatory drugs such as Ibuprofen or Naproxen, which allow an improvement in the signs and symptoms of the disease in the short term, relieving discomfort.

In the most severe cases, or when treatment with anti-inflammatory drugs is unsuccessful, other types of medication can be used, mainly corticosteroids and modifiers of the disease course, such as sulfasalazine, methotrexate or cyclosporine.

2. Surgery

Surgery for psoriatic arthritis is indicated when the disease is very aggressive and causes damage to the joints. The purpose of surgery is to improve or replace the injured joint, improving the quality of life.

3. Physiotherapy sessions

Physiotherapy is another very important part of the treatment, since there are exercises that can be done to help improve joint movements, relieve tendonitis symptoms and improve quality of life in general. Check out what types of exercises can help.

Thus, the ideal is that the treatment be done with a multidisciplinary team, constituted by the medical team, with a rheumatologist, orthopedist and general practitioner, as well as a physical therapist, psychologist and any other health professional who can help in improving the quality of life.