Types of Psoriatic Arthritis (PsA)
What is Psoriatic Arthritis?
About 30% of people diagnosed with psoriasis later develop psoriatic arthritis (PsA) approximately ten years later. Psoriatic arthritis is a kind of arthritis that affects people with psoriasis. It is an inflammatory musculoskeletal disease associated with psoriasis. Chronic PsA could be lifelong or last for years. PsA is a kind of arthritis condition that can cause inflammation of the spine.
PsA as well as psoriasis involves an interplay of environmental, genetic, and immune system factors. PsA can come up at any time, but most often, it is usually between 30 – 50 years old. Unlike most arthritis cases, which are most predominant among females. PsA is common with males.
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The affected joint is usually painful, stiff, swollen, and red. Some symptoms of PsA are:
Conjunctivitis, fatigue, reduced motion, swelling of the toes, and fingers (dactylitis), etc. It is usually challenging to tell the difference between rheumatoid arthritis and psoriatic arthritis. PsA is traditionally associated with concurrent psoriasis. People with psoriasis can have any other kind of arthritis that affects every other person. This has nothing to do with psoriasis. Joints mostly affected are:
In rare cases, people who do not have psoriasis develop PsA. This may be caused by a combination of genetic and environmental factors such as an accident, infection, or being overweight. PsA, like psoriasis, is not contagious.
Five types of psoriatic arthritis have been identified. They are categorized based on the location of the joints which they affect.
1. Asymmetric Oligoarticular Arthritis
In this type of PsA, fewer than five joints on one side of the body are affected. Asymmetric PsA is usually mild and accounts for about 35% of PsA. The joints affected are often the small joints of the hands and legs. Signs may include:
- Stiff joints in the morning
- Red patches of skin
- Difficulty in flexing joints
2. Symmetrical Polyarthritis
Also known as symmetric PsA. This type of PsA affects five or more joints. It is symmetrical because it affects both matching pairs of a joint on both sides. For example, you can have it on both knees, feet, both elbows, or on the right and left the side of your hips.
This type of PsA mirrors rheumatoid arthritis (RA), a different kind of autoimmune disorder that affects matching body parts on both sides. Their primary difference is that the swelling associated with PsA is more prominent. This is the most common type of PsA, accounting for more than half of PsA cases. The symptoms are the same as asymmetric oligoarticular arthritis, causing redness and stiffness.
3. Distal Interphalangeal Predominant
‘Distal’ means ‘away from the center.’ This type of PsA affects the phalanges, the tips of the nails and toes, that is, the joints closest to the ends of the nails and toes. It can disfigure your nails. This type of PsA accounts for about 20% of PsA cases. It is often mistaken with osteoarthritis. Signs include:
- Lifting from the nail bed
- Difficulty in motion
- Nail pitting
This type of PsA causes pain to the lower back, buttocks, and spine. It causes inflammation that poses a challenge in moving the neck, lower back, sacroiliac joint, and pelvis. Spondylitis can affect joints in the feet, hands, and legs, as well. It can also affect connective tissues such as ligaments. The most common symptom associated with spondylitis is back pain. It is common with males. Signs include:
- Stiffness in your shoulders
- Weakness in arms and legs
- Problems with your bladder or bowels
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5. Arthritis mutilans
This is the most severe and rare form of PsA. It can damage the joints of the hands and feet. Affecting about 5% of PsA patients, it can lead to shortening or loss of digits due to destruction of bones. There are even lesser cases of arthritis mutilans due to improvement in medicine. Signs include:
- Loss of range of motion
- Discoloration in the nails
- Disfigured digits
- Severe pain and stiffness around joints
Just like psoriasis, PsA is non-contagious and incurable. People with PsA should not be stigmatized as it can bear down on their mental health and other systems in their bodies. As soon as any of the signs of PsA are detected, you should see your doctor immediately. Regardless of your PsA type, the goal of treatment is to prevent joint damage, curb the effects, and reduce inflammation.
Your doctor may prescribe some over the counter drugs or may suggest therapy. In worse case scenarios, you may need to undergo joint replacement surgery.
Home remedies can also help. For instance,
- Reduce your level of stress
- Do exercises that focus less on your joints
- Try to lose weight to reduce muscle strain
- Don’t carry heavy things on one side of your body
- Get enough rest
- Get a massage
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