What is it ?
Psoriatic arthritis, also called psoriatic arthritis, is a chronic inflammatory arthritis that has the peculiarity of being associated with psoriasis. the psoriasisis an autoimmune disease in which the immune system goes awry and attacks the skin, causing skin inflammation. With psoriatic arthritis, the immune system also attacks the joints, causing their inflammation and can cause joint damage in the absence of early treatment. Epidemiological data do not agree from one study to another because the diagnosis is difficult and its criteria do not reach consensus in the scientific community. Its prevalence is 0.1 to 1% in the total population.About 15% of people with psoriasis develop psoriatic arthritis.
Symptoms of psoriatic arthritis
This arthritis can affect all joints, but it most often affects the big joints of the lower limbs, the joints of the fingers and toes, the back and the pelvis:
- The affected person suffers from nocturnal pain and morning stiffness;
- The inflammation of all the joints and phalanges of the fingers and toes (to the distal interphalangeal joint at the end of the finger), giving them the appearance of a sausage is characteristic, but not systematic;
- As with rheumatoid arthritis, asymmetric oligoarthritis is often observed, evolving into distal and symmetrical polyarthritis;
- More rarely, the inflammatory affects the spine and pelvis (the sacroiliac joints), as is the case with ankylosing spondylitis ;
- Psoriatic arthritis sometimes causes episodes of fatigue, anemia and mood disorders.
In the majority of cases, cutaneous involvement precedes psoriatic arthritis, but the appearance of skin and joint involvement may be simultaneous. More rarely, joint damage occurs first. It is important to note that psoriatic arthritis can occur in people without psoriasis (it is usually observed that parents are affected). The diagnosis is sometimes difficult to establish, the symptoms sometimes leading the doctor, wrongly, to other types of rheumatism such as rheumatoid arthritis or gout .
The origins of the disease
We do not know the origin of the disease. 40% of patients have a family member with psoriasis or arthritis, suggesting a hereditary character. Psoriatic arthritis can also result from an infection that triggers an immune response, such as a streptococcal infection. The factors of the disease would be genetic, environmental, and immunological.
Risk factors for psoriatic arthritis
Psoriatic arthritis affects both men and women, and the peak of clinical manifestations is between 30 and 50 years of age. Note that there is juvenile psoriatic arthritis, which is estimated to be between 3 and 30 children per 100,000 and is sometimes associated with uveitis .
Prevention and treatment of psoriatic arthritis
Early diagnosis followed by appropriate treatment will prevent damage to the joints caused by persistent inflammation. In most cases, psoriatic arthritis treatments are effective in protecting the joints and relieving pain. They rely on taking non-steroidal anti-inflammatory drugs and local injections of corticosteroids to relieve symptoms. Physical activity and rehabilitation helps to maintain the good ability of joints. When a joint has suffered damage resulting in loss of mobility, surgery is used. Weight, high blood pressure and cholesterol should be given special attention.