Psoriatic arthritis (PsA) is a type of joint pains, that affects people who have skin psoriasis — a condition with red, raised skin, with white and silvery flakes. Around 30% of psoriasis patients will develop Psoriatic Arthritis. Most people develop psoriasis first and later develop psoriatic arthritis, but the joint problems can sometimes begin before the skin psoriasis. Psoriatic Arthritis can affect any age group (from children to old age group).

1. Psoriatic arthritis
Psoriatic arthritis (PsA) is a type of joint pains, that affects people who have skin psoriasis — a
condition with red, raised skin, with white and silvery flakes. Around 30% of psoriasis patients
will develop Psoriatic Arthritis. Most people develop psoriasis first and later develop psoriatic
arthritis,butthejoint problemscansometimesbeginbeforetheskinpsoriasis.PsoriaticArthritis
canaffect anyage group(fromchildren tooldage group).
Symptoms-
Jointpain,stiffnessandswellingare the main symptoms. Itcanaffect anyjointofbody. Other
commonsymptomsincludepainful, sausage-likeswellingofyourfingersandtoes(Dactylitis),
heelpain (Enthesitis).Spineinvolvement causesneckandbackpain withearlymorningstiffness
similartospondyloarthritis(Ankylosingspondylitis).Somepatientswilldeveloprecurrent
painfulRedeyeswithblurredvision (uveitis/iritis)andBowelinflammation withrepeated
episodesofloose stool(IBD-InflammatoryBoweldisease). Theyarealsoat higherriskof
cardiovasculardiseaseandNon-AlcoholicFattyliverdisease. Arthritismutilansacomplication
ofPsAleadstodestructionofsmallbonesoffingersleadingtosevere,painful deformitiesof
handjoints.Symptomscanrange frommildtosevere.In bothpsoriasisandpsoriaticarthritis,
diseaseflaresmayalternatewithperiodsofremission.
Causes
JPsoriaticarthritisoccurswhenyourbody'simmunesystemmistakenlyattacksthejointandskin.
Genetic and environmental factors play a role. Many people with psoriatic arthritis have a family
history of psoriasis or psoriatic arthritis. Physical trauma, viral or bacterial infection — may
trigger psoriatic arthritis in people with an inherited tendency.
Riskfactors forPsoriatic arthritisinclude-People who have pitted, deformed psoriatic nails and
familyhistoryofpsoriasis.
Diagnosis
Clinical examination of joints, skin and nails helps in diagnosis. No single test can confirm a
diagnosis of psoriatic arthritis. But some tests can rule out other causes of joint pain, such as
rheumatoidarthritisorgout.Imaging-x-raysofhandsandfeet,Ultrasoundofjoints,MRIofjoints
or spine Lab test- ESR, CRP, HLA B27, RA factor (to rule out rheumatoid arthritis), joint fluid
analysisifneededtorule out othercauses.
Treatment

2. Nocure existsforpsoriaticarthritis,sotreatment mainlyfocuseson controllinginflammationin
youraffectedjointstopreventjoint painanddeformities.
Medications
Drugsusedtotreatpsoriaticarthritisinclude:
• NSAIDs.Nonsteroidal anti-inflammatory drugs (NSAIDs) relieves pain and
reduces inflammation. These may be prescribed for short period. Long-term
usageleads to sideeffects likegastritis,liver and kidney damage.
• Disease-modifying anti-rheumatic drugs (DMARDs). These drugs slows the
progression of psoriatic arthritis and save the joints from permanent damage.
Common DMARDs include Methotrexate, Leflunomide, Sulfasalazine and
Apremilast.SometimesAzathioprineandCyclosporinearealsoused.Sideeffects
vary butmay includeliver damage,bonemarrow suppressionand infections.
• Biologic agents. These medications target specific parts of the immune system
that trigger inflammation. This newer class of DMARDs includes Adalimumab,
Etanercept, Golimumab, Infliximab, Ixekizumab, Secukinumab, Tofacitinib and
Ustekinumab.Thesedrugsmayincreasetheriskofinfections.Biologicagentscan
beused aloneor combined withDMARDs suchas methotrexate.
Surgicalandotherprocedures
• Steroid injections - injected into anaffected joint,reduces theinflammation
quickly.
• Jointreplacementsurgery- for severely damaged joints.
Lifestyleandhomeremedies
• Protectyour joints- Avoid straining your joints or lifting weights .
• Maintain ahealthy weight,avoid stress,adequatesleep.
• Thebestway to increasenutrients whilelimiting calories is to eatmoreplant-
based foods — fruits,vegetables and wholegrains.

3. • Exerciseregularly- Tokeep your joints flexible.Types ofexercises thatareless
stressful on joints includebiking,swimming and walking.
• Stop smoking.Smoking is associated withahigher riskofdeveloping severe
psoriasis and arthritis.
• Limitalcohol use. Alcohol canincreaseyour riskofpsoriasis,decreasethe
effectiveness ofyour treatmentand increasesideeffects frommedications.
Copingandsupport
Psoriaticarthritiscanbe particularlydiscouragingbecause oftheemotionalpaindueto
psoriasisandjoint pains. Thesupportoffriendsandfamilymakeatremendousdifference to
overcomethephysicalandpsychologicalchallenges.Forsome people,support groupscan offer
thesamebenefits.