Psoriasis is a skin disease characterized by the presence of red patches at various places on the skin. Around 5% of people suffering from psoriasis develop a related medical condition called as “psoriatic arthritis”. It is a type of arthritis which develops after few months or years after psoriasis. Psoriatic arthritis can be differentiated into five types based on the joint which is affected, but in most of the cases is mild in intensity with only some joints getting affected. Deformities in the bones of hands, spine and feet do occur in chronic cases but such cases are few.
Causes
Reasons however, are unknown and are not confirmed even though hereditary factors play a majority role in developing this medical condition. Some specific gene markers like HLA – B27, a surface antigen is found to play a major role in at least half (around 50%) of the existing cases. Some other gene markers were also detected in people suffering from this condition. Fact is that, many people suffering from Psoriasis tend to develop arthritis sooner or later. At the same time there is no evidence to prove a direct link between Psoriasis and Arthritis. But it has been observed that, as one gets cured or had some relief from Psoriasis, there was also a considerable improvement in the existing joint disease or Arthritis.
The exact cause for this disease is still not clear. Role of infectious agents, immune and environmental factors cannot be ruled out in the development of this disease and trials are ongoing to gather more information and to confirm the same. Studies have proved that there is reduction in some specific cells of the immune system – the T-helper cells in people suffering from psoriatic arthritis. These cells play a very important role in the defense mechanism of the body, thus preventing diseases by eliminating antigens. A decline in these helper cells of the immune systems could be facilitating the progression of the disease.
Symptoms
The symptoms are mild in most of the cases affecting the fingertips and toes, but in chronic cases, many joints may be affected resulting in deformation. The finger toes when affected become red, swollen and take a ‘sausage’ form. But the disease in its usual form affects only few a joints. All the affected joints become very painful, inflamed. Symptoms like severe pain with burning sensation, stiffness in the upper and lower back, neck (spondylytis) especially in the morning – are experienced in many patients. In more severe cases, the spine also gets affected.
Changes in nails such as pitting, discoloration, inflamed reddish patches on the skin can be seen in majority of people suffering from Psoriasis. Acne is seen in majority of people suffering from psoriatic arthritis. Arthritis along with the above mentioned typical psoriatic symptoms get worse, more or less at the same rate in psoriatic arthritis.
Changes in the bones (osteitis), lining of the joints (synovitis) can also occur in form of inflammation and thickening. Many such conditions coexist as a syndrome. Inflammation in the tendons (tendinitis), cartilage, eyes and lungs are also seen in some cases. Tendinitis further causes ‘Achilles-tendon’ where you experience pain underneath the foot while walking. A person can have chest pain similar to other cardiac problems, if the cartilage and chest wall get inflamed as a result of this disease. In more serious cases where the aorta are inflamed, it can lead to serious consequences like heart failure as a result of leakage in the valves. Pleuritis – inflammation of the lungs can also occur resulting in chest pain and breathing problems.
When the colored portion of the eye and the iris gets affected by this disease, it results in a very painful condition called ‘iritis’. This condition worsens on exposure to intense light in the mechanism of closing and opening of the iris. Eye, being a very sensitive part, measures should to be taken immediately to prevent blindness. Rapid damage of the joints occurs in the case of a destructive form of this disease called as “mutilans” even though rare in occurrence.
Conclusion
Even in cases of chronic psoriatic arthritis, pain can be relieved with the help of latest treatments so as to prevent damage to the joints provided the condition is detected early. With the availability of aggressive treatment and monitoring tools, condition can be well-controlled for better outcomes. It is equally important to complete the medication given, get yourself evaluated from time to time by your physician to avoid the re-occurrence or further worsening of the disease.
Research is ongoing for better treatment options to enhance the efficiency of the immune system as it defines the occurrence of the disease, medications, early prognosis, etc. All these factors will contribute to effectively tackle this rather debilitating disease in the years to come.
