inflammation, swelling, and discomfort by attacking healthy skin cells and joints.
Risk factors for Psoriasis include:
- Genogram (having one or two parents with the disease)
- Infectious diseases (including recurring strep throat or HIV)
- Stress (high levels can compromise your immune system)
- Obesity (psoriasis lesions/plaques in skin folds).
- Cigarettes (play a role in the risk and severity of the disease)
- Drinking
- Injury (Koebner phenomena)
- Sunburn
- Drugs (including beta blockers, chloroquine, lithium, ACE inhibitors, indomethacin, terbinafine, and interferon-alfa)
Risk factors for PsA include:
- Having Psoriasis (specifically in the scalp, nail, and groin area)
- Family history
- Age (between 30 and 50)
- Obesity
- Smoking
Diagnosing Psoriasis and PsA
There’s no straightforward test for psoriasis or psoriatic arthritis. Your doctor will need to consider your symptoms, risk factors, bloodwork (for inflammation), and X-rays or other imaging studies (MRI, ultrasound, CT scan) to diagnose joint involvement.
During a physical exam, your doctor may search for psoriasis on your elbows, knees, scalp, belly button, intergluteal cleft, palms, and soles. They’ll also look for nail irregularities like pitting or ridging and swelling fingers or toes (dactylitis).
Here are some common steps used to diagnose Psoriasis and PsA:
- A family history, risk factors, and symptoms exam
- Blood testing for inflammatory markers (CRP, ESR) and antibodies (rheumatoid factor, anti-CCP) may rule out other kinds of arthritis, including rheumatoid.
- X-rays and ultrasounds identify joint injury, dislocation, disfiguration (arthritis mutilans), new bone growth, and enthesis inflammation.
- If you have undetected Psoriasis, undergo a skin biopsy.
Surprises of Psoriasis & Psoriatic Arthritis
PsA is often misdiagnosed, particularly if the patient does not have psoriasis. Ninety-six percent of participants suffered at least one mistake before being identified with PsA, according to 2018 research. Thirty percent of psoriasis people require more than five years to be diagnosed with PsA.
As someone who has psoriasis, I had it awfully bad when I was younger. I got bullied and didn’t know how to deal with it. Luckily, as I got older, my psoriasis was less noticeable on my scalp, and it even seemed to decrease and get better as time continued.
RELATED: Which Psoriasis Treatment Is Right For You?
Psoriasis & Psoriatic Arthritis Treatments
Many drugs may treat skin and joints, but some perform better than others. According to the American College of Rheumatology and National Psoriasis Foundation, your treatment strategy should depend on how PsA affects your body and the severity of your symptoms. If your skin worsens, you may start with a better-for-the-skin medicine that still affects the joints.
People with psoriatic arthritis may have skin, joint discomfort, finger and toe swelling (dactylitis), and pain where tendons and ligaments connect to bone (enthesitis). Identifying the most troublesome locations and determining your treatment of choice is vital.
While there are several PsA medications, it’s often a matter of trial and error to find which one works. Sometimes we need to try many medications to find the appropriate one. Medications used to treat both Psoriasis and PsA include:
- NSAIDs cure modest joint pain but not skin psoriasis or nail involvement.
- Glucocorticoids: used sparingly in PsA
- Biologics and biosimilars JAK inhibitors