Psoriatic arthritis is a form of arthritis that affects some people who have psoriasis primarily in the skin and joints. It presents itself as itchy, scaly red patches that appear on the skin and scalp as well as swollen and sore joints. Most individuals develop psoriasis first and later they are diagnosed with psoriatic arthritis. Although sometimes the joint problems can begin before the skin patches appear.

Types of Psoriatic Arthritis

There are five types of psoriasis arthritis:

• Symmetric psoriatic arthritis: This type tends to affect the same joints on both sides of the body and its symptoms are like those of rheumatoid arthritis (RA). Symmetric psoriasis arthritis is milder and causes minimal joint deformity than RA. It can however be disabling.
• Asymmetric psoriatic arthritis: This can affect a joint or joints on one side of the body only.
• Distal interphalangeal predominant psoriatic arthritis: This type affects the joints closest to the nails known as the distal joints.
• Spondylitis psoriatic arthritis: This affects the spine and it can make movement very painful. The hands, arms, legs, feet and hips may also be affected.
• Psoriatic arthritis mutilans: This is a severe form of psoriatic arthritis that usually affects the hands and feet. It can also cause pain and discomfort in the neck and lower back.

Causes of Psoriatic Arthritis

Psoriatic arthritis is an autoimmune disease meaning the body’s immune system mistakenly attacks healthy cells and tissue causing pain and inflammation resulting in damage. It is not exactly known what causes these attacks, but researchers think it stems from a combination of environmental factors and genetics.

Symptoms of Psoriatic Arthritis

Symptoms of psoriatic arthritis can range from mild to severe and they are different for each person. Depending on the type of psoriatic arthritis one may have, the symptoms might include:

• Morning stiffness
• Swollen, tender spine or joints on one or on each side of the body
• Painful tendons and muscles
• Swollen toes and fingers
• Scaly itchy patches which can get worse when the joints flare up
• Flaky scalp
• Nail pitting
• Fatigue
• Nail separation from the nail bed
• Eye redness
• Eye pain (uveitis)

Diagnosis of Psoriatic Arthritis

A prompt diagnosis for psoriatic arthritis is an important first step in managing the condition. As of now there is no single test that can confirm if someone has psoriatic arthritis, but the first symptoms can determine which type of doctor makes the diagnosis.

A primary physician or a rheumatologist may be seen first if arthritis is the main complaint and a dermatologist may also be seen first if skin and/nail problems are the first to appear. The doctor will use your medical history, perform a physical examination and lab tests to make a diagnosis.

Medical history will involve discussing your symptoms with your doctor and whether anyone in your family has psoriasis, psoriatic arthritis or another autoimmune disease.

Physical examination involves the doctor looking for tenderness, swelling, joint pain, warmth or limited movement and nail or skin changes.

Tests that may be done include x-rays to look for changes in joints and bones, blood tests like C-reactive protein and rheumatoid factor (RF) to check for signs of inflammation. Individuals with psoriatic arthritis test RF-negative hence if the blood tests come out positive for RF, the doctor will most likely suspect RA. Fluid tests around the joint also help to rule out infectious arthritis or gout.

Treatment of Psoriatic Arthritis

The goal for psoriatic arthritis treatment is to improve the symptoms therefore it focuses on:

• Reducing inflammation
• Stopping the disease’s progression
• Relieving pain and discomfort
• Treating the symptoms on the skin
• Keeping the joints as mobile as possible

The treatments include medication, surgery, occupational therapy and assistive devices.

Next Step

At King’s College Hospital Dubai, we focus on offering an exemplary service, from initial consultation through to final diagnosis and treatment and beyond. Our multidisciplinary team of expert doctors, nurses, physio therapists are here to offer tailored management and treatment of your condition, and to answer any questions that you might have throughout your time with us. Whatever you need us for, we’re only a phone-call away.

Back to Rheumatology Centre page

Back to Inflammatory Arthritis page