If you have been diagnosed with psoriasis, you are probably wondering, is psoriasis and psoriatic arthritis related? Yes, psoriatic arthritis is a rare form of arthritis which often appears in combination with the skin disease known as psoriasis. How the two conditions are connected is still not well understood, though anyone suffering from psoriasis is encouraged to place close attention to the health of their joints.
For people with diagnosed psoriasis, they are at a higher risk of developing psoriatic arthritis. In fact, this chronic disease once developed will rarely go away on their own. But that does not mean the end of the world of course. You can still seek help and support from your doctor or specialist, try out different therapies and treatments, and try to understand what personal triggers you may have.
What Is Psoriasis?
Psoriasis is a common skin condition where the skin cells replicate themselves too quickly, resulting in thickened skin with a white, scaly appearance. In some cases, psoriasis can become irritated, inflamed and itchy. It is advisable not to scratch the scales as it may result in bleeding and infection. In some cases psoriasis is chronic, while in other people psoriasis can come and go, often appearing on the knees, elbows, wrists and scalp.
Psoriasis has no known cause till now, though there are many abounding theories as to possible causes as well as trigger factors. Patients with psoriasis often have poor digestion, decreased liver function, high levels of inflammatory chemicals in the blood stream, as well as a family history of psoriasis. People with psoriasis in the family are over 50 times more likely to develop the condition themselves. Stress, environment, and infection are also known to be contributing factors. In some cases, the condition will progress and begin to affect both the nails and the joints.
Psoriasis And Psoriatic Arthritis
According to the National Psoriasis Foundation, about 30% of cases with diagnosed psoriasis develop a condition, known as psoriatic arthritis. Psoriatic arthritis is a form of arthritis similar to rheumatoid arthritis which occurs in psoriasis sufferers. It can occur at any age, to both men and women equally.
Symptoms of psoriatic arthritis include swollen fingers and toes, tenderness, pain, reduced motion, fatigue, changes in the nails such as discoloration, splitting and thickening. In some cases, the symptoms are minimal and only pose a problem during flare-ups, while in others it can be a severe and disabling condition.
Sometimes having psoriatic arthritis diagnosed can be complicated. The presence of psoriasis has to be diagnosed by a dermatologist, while the arthritis has to be diagnosed by a rheumatologist. In 85% of cases, the joint disease is preceded by the skin disease, standing out in specific ways from osteoarthritis and rheumatoid arthritis. Psoriatic arthritis can affect the distant ends of the fingers and toes, the jaw, cause conjunctivitis and there is no presence of rheumatoid factor in the blood stream.
Causes Of Psoriatic Arthritis
Unfortunately, researchers still do not understand why it develops in some patients and not others. The Psoriasis and Psoriatic Arthritis Alliance in the UK states that both psoriasis and psoriatic arthritis are likely to be caused by a combination of immune problems, genetic traits and environmental factors. There is still much research going on worldwide to better understand the mechanisms behind these conditions.
One theory is that psoriasis is an autoimmune condition where the body is attacking the skin, and eventually moves on to attack other parts of the body, such as the joint tissues. There is some evidence that psoriatic arthritis is triggered by an infection by streptococcus bacteria, though this connection is still not proven.
Other possible causes or triggers include stressful events, low vitamin D3 levels, injury to the joints, and some drugs, such as anti-malarial medications. Nutritional deficiency tests, allergy tests, and a full medical history may reveal patterns in relation to your symptoms and perhaps the very beginning of the disease. Understanding what might be your personal trigger factors is important as this may play an important role later in the treatment of your psoriasis and/or psoriatic arthritis.
What Are The Treatment Options?
Today there is a range of different treatment options available to patients. Though psoriasis and psoriatic arthritis are most definitely interlinked with each other, however, they are often treated as two separate conditions in an effort to manage the individual symptoms. Psoriasis is most often treated topically with tar, petroleum jelly, hydrocortisone cream and possibly internally with non-steroidal anti-inflammatory drugs (NSAIDs).
For psoriatic arthritis, doctors may prescribe a range of drugs and medications to help control the symptoms depending on the severity of the condition. Most commonly, patients will be given non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, but in some cases they are given anti-rheumatic drugs, anti-tumor necrosis factor agents, and medications to reduce interleukin chemicals in the body. For badly swollen joints, injections of corticosteroids can also be administered.
If the presence of psoriatic arthritis causes ongoing degeneration of joints and disabling pain, doctors may recommend their patients to visit occupational therapists, podiatrists and counsellors. Psoriatic arthritis does not always develop into severe condition that one cannot live a normal life, but it is a chronic disease that rarely goes away by itself. Therefore, learning the strategies for managing the symptoms and improving quality of life are important.
Available to patients are also a wide range of natural and alternative treatments which may offer extra symptomatic relief. Many patients with psoriasis and psoriatic arthritis take fish oils as a source for Omega-3 essential fatty acids, that is known to reduce inflammation in the body. Studies have confirmed that fish oils reduce inflammation-causing chemicals in the blood, such as prostaglandins and leukotrienes.
High doses of fish oils (up to 10,000mg) may be required in order to reduce stiffness and pain in patients with psoriatic arthritis. One clinical trial found that psoriasis patients who are given 10,000mg of fish oil daily had significantly less scaling, itching and redness after 8 weeks of omega-3 supplementation.
Glucosamine sulfate is one possibility of a supplement that may support psoriatic arthritis. It has been well researched in patients suffering from osteoarthritis and rheumatoid arthritis to reduce inflammation, prevent joint degeneration, improve range of motion and ease stiffness.
However, there are still no clinical studies to date to test the effects of glucosamine sulfate on patients with psoriatic arthritis. Despite the lack of evidence for this particular condition, The National Psoriasis Foundation in the USA suggests that glucosamine, along with chondroitin, MSM and adenosylmethionine may be useful supplements in cases of psoriatic arthritis.
For topical cream treatment, natural anti-inflammatories such as licorice root, aloe vera gel, gotu kola, lavender oil, comfrey root, chamomile flower and calendula flower extract have been known to reduce swelling and support healthy tissue healing. Gotu kola in particular has been researched as a topical treatment for psoriasis with some good evidence of it being effective in reducing symptoms. In cases of itchy psoriasis, these products may also be antiseptic enough to protect against skin infections.
The Gut-Joint-Skin Connection
Many naturopathic doctors and practitioners urge patients with psoriasis and psoriatic arthritis to go for examination on the health of their detoxification system. There is evidence that psoriasis increases the risk of liver disease in many people, possibly explaining the traditional prescriptions of liver herbs, such as dandelion root, gentian root, burdock root and milk thistle seeds, in cases of psoriasis and psoriatic arthritis.
While the traditional naturopathic theory is that toxins are created by poor digestion and continue to cause inflammation in the skin and joints. Recent research also highlights the role of the liver in mediating pro-inflammatory chemicals, such as leukotrienes and tumor necrosis factor.
Healthy digestive microflora is also important in protecting against joint and skin disease. Having a balance of healthy probiotic bacteria in the gut may help to prevent streptococcus infections which are linked to psoriatic arthritis. Digestive enzymes, liver-tonic herbal formulations and probiotics may be useful supplements which helps to support healthy skin and joint.
The Future Of Psoriasis And Psoriatic Arthritis
Both psoriasis and psoriatic arthritis are difficult conditions to live with. To many patients, it feels as though there is no answer and no real treatment. In addition, treatment or remedies that works for one person may not work on the others. While doctors may not understand fully if psoriasis and psoriatic arthritis are related, there are variety treatment options, remedies and healthcare support for patients. Perhaps, the first step to appropriate treatment is to understand your own condition, your own body, and what really works for you as an individual.