Psoriatic arthritis is a painful and often debilitating form of arthritis that affects some people who suffer from psoriasis, a common autoimmune disorder that causes the immune system to attack healthy cells and tissue in the body’s skin and joints. This abnormal immune response causes inflammation in the joints and overproduction of skin cells, often causing the skin to form red, scaly patches that may be itchy and painful. Both psoriatic arthritis and psoriasis are chronic diseases that get worse over time, but the symptoms of the diseases often fluctuate, with many patients experiencing periods of unbearably intense symptoms alternating with periods of remission in which the symptoms largely disappear.
Although there is no known cure for psoriasis or psoriatic arthritis, both conditions can be effectively managed with a range of treatments including medications and lifestyle measures such as moisturizing, quitting smoking, and managing stress. Most people experience significant relief when their psoriasis and psoriatic arthritis are properly treated. For example, since announcing that he was being treated for a diagnosis of psoriatic arthritis in late 2010, professional golfer Phil Mickelson has gone on to win five tournaments, including the 2013 British Open. However, in some cases the disabling symptoms of psoriatic arthritis may persist despite treatment.
Because the persistent inflammation associated with psoriatic arthritis can cause permanent joint damage over time, early detection is essential to an effective treatment regimen. When the disease is not diagnosed promptly, it is much more likely to lead to severe and permanent symptoms that may be permanently disabling. To diagnose psoriatic arthritis, rheumatologists look for swollen and painful joints, certain patterns of arthritis, and skin and nail changes typical of psoriasis. X-rays often are taken to look for joint damage. MRI, ultrasound or CT scans can be used to look at the joints in more detail. Blood tests may be done to rule out other types of arthritis that have similar signs and symptoms, including gout, osteoarthritis, and rheumatoid arthritis. In patients with psoriatic arthritis, blood tests may reveal high levels of inflammation and mild anemia but labs may also be normal. Anemia is a condition that occurs when the body lacks red blood cells or has dysfunctional red blood cells. Occasionally skin biopsies (small samples of skin removed for analysis) are needed to confirm the psoriasis.