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Old 09-01-2004, 01:25 PM   #1
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Psoriatic Arthritis

Hi I was told my endo that I have Psoriatic (sp) arthritis. My fingers are swollen (not by the tips) and I thought I was retaining water but turns out it might be Psoriatic Arthritis. I have no pain yet, just swelling. Can anyone tell me anything about this type of arthritis? I also have tingling in my hands when sleeping or leaning on them. I have Psoriasis on my ears, genital area, elbows and knuckles of hands. I don't experience any pain so I am not sure what to do. My doctor didn't say to go see a specialist or anything, he did mention to see a dermatologist for the psoriasis. Any thoughts are greatly appreciated

Last edited by hisdestiny63; 09-01-2004 at 01:47 PM.

 
Old 09-01-2004, 06:54 PM   #2
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Re: Psoriatic Arthritis

The tingling in your hands may be a result of Carpal Tunnel Syndrome or a cervical problem and possibly not the Psoriatic arthritis. Do you work on a computer a lot or do repetative tasks with your hands? If so it may be CTS and bracing often times does help when doing such tasks. It may deem asking your doctor about to be sure.

As far as the arthritis itself here's some basic information. Also has your doctor indicated which type you actually have? There are 5 different types overall.

Psoriatic arthritis is a specific type of arthritis that has been diagnosed in approximately 23 percent of people who have psoriasis.

It commonly affects the ends of the fingers and toes. It can also affect the spine. The disease can be difficult to diagnose, particularly in its milder forms and earlier stages. Early diagnosis, however, is important for preventing long-term damage to joints and tissue.

Most people with psoriatic arthritis also have psoriasis. Rarely, a person can have psoriatic arthritis without having psoriasis.

What are the symptoms?
Stiffness, pain, swelling and tenderness of the joints and surrounding soft tissue
Reduced range of motion
Morning stiffness and tiredness
Nail changes, including pitting (small indentations in the nail) or lifting of the nail—found in 80 percent of people with psoriatic arthritis
Redness and pain of the eye, similar to conjunctivitis

How does it develop?
Psoriatic arthritis can develop at any time. On average, it appears about 10 years after the first signs of psoriasis. For most people it appears between the ages of 30 and 50. It affects men and women equally. In about one of seven people with psoriatic arthritis, arthritis symptoms occur before any skin lesions.

Like rheumatoid arthritis, psoriatic arthritis is thought to be caused by a malfunctioning immune system. Psoriatic arthritis is usually milder than rheumatoid arthritis, but some patients with psoriatic arthritis have as severe a disease as patients with rheumatoid arthritis.

Psoriatic arthritis can start slowly with mild symptoms, or it can develop quickly. It is very important to have as early and accurate a diagnosis as possible. Left untreated, psoriatic arthritis can be a progressively disabling disease. In fact, half of those with psoriatic arthritis already have bone loss by the time the disease is diagnosed.

How is it diagnosed?
Diagnosis is done by process of elimination using medical history, physical examination, blood tests to rule out other diseases and X-rays of the affected joints

There are five types of psoriatic arthritis: symmetric, asymmetric, distal interphalangeal predominant (DIP), spondylitis and arthritis mutilans.

Symmetric Arthritis
Occurs in about half of those with psoriatic arthritis. it is similar to rheumatoid arthritis, but generally milder with less deformity
Usually affects joints on both sides of body
Can be disabling in about half of all cases
Psoriasis that occurs at the same time is often severe

Asymmetric Arthritis
Effects about 35 percent of people with psoriatic arthritis
Generally mild, although some people will develop disabling disease
Not occurring in the same joints on both sides of the body
Usually involves only one to three joints, such as the knee, hip, ankle or wrist
Could involve just one finger or a number of them
Hands and feet have enlarged "sausage" digits, caused by swelling and inflammation of tendons
Joints may be warm, tender and red
Periodic joint pain usually responds to medical therapy

Distal Interphalangeal Predominant (DIP)
Occurs in about 5 percent of people with psoriatic arthritis
Primarily involves the joints closest to the nail of the fingers and toes
Sometimes confused with osteoarthritis, but nail changes are usually prominent
Spondylitis
Inflammation with stiffness of the neck, lower back, pelvic area or spinal vertebrae are common symptoms
Motion is painful and difficult
In about 5 percent of individuals, inflammation of the spinal column is the predominant symptom
May also occur in the hands, arms, hips, legs and feet
When severe, may be associated with generalized symptoms
May lead to iritis—an inflammation of the eye that results in redness and sensitivity

Arthritis Mutilans
Affects fewer than 5 percent of people with psoriatic arthritis
Severe, deforming and destructive arthritis
Principally affects the small joints of the hands and feet
May also cause neck or lower back pain
Can progress over months and years
Arthritic flares and remissions tend to coincide with skin flares and remissions

Treatments

If your psoriasis is mild or moderate, your physician probably will give you topical treatments first. Topical treatments are ointments, gels or lotions that may contain steroids or coal tar. Steroids are man-made drugs that are created to resemble hormones (cortisone, for example) that occur naturally in the body. Coal tar has been used for centuries to treat the scaling, inflammation and itching of psoriasis. You may need to experiment with numerous therapies before you find the treatment that works well for you.

If your psoriasis is moderate to severe, your physician may administer ultraviolet (UVB) light treatment. UVB light treatment involves exposing the skin to a particular wavelength of light. It is a common, safe and very effective treatment for moderate to severe psoriasis.

If your psoriasis doesn't clear after using topical or ultraviolet light treatments, the physician may prescribe systemic medications. They are called "systemic" because they work throughout the body to treat psoriasis, instead of only on top of the skin. They include the prescription drugs methotrexate, cyclosporine and oral retinoids.

If you've been diagnosed with psoriatic arthritis, your physician may give you aspirin, ibuprofen or prescription drugs. These drugs are all called nonsteroidal anti-inflammatory drugs (NSAIDs). Their main purpose is to decrease inflammation, joint pain and stiffness. If you already have some joint or tissue damage, your doctor may give you disease-modifying antirheumatic drugs (DMARDs). These drugs can help to slow or stop joint and tissue damage.

A new category of drugs is called "biologics." These turn off or block certain processes within the immune system that lead to psoriasis and psoriatic arthritis. Amevive and Raptiva were approved for psoriasis treatment in 2003. Enbrel is approved for both psoriasis and psoriatic arthritis. Remicade (generic name infliximab) and Humira (generic name adalimumab) are also in development for psoriatic arthritis and psoriasis. Your physician may prescribe a biologic if other treatments do not work on your psoriasis or psoriatic arthritis.

Last edited by Kissa; 09-01-2004 at 06:54 PM.

 
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