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The Doctor Is In: The connection between psoriasis and arthritis

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Paul Afek, M.D.

Posted: Wednesday, January 16, 2013 4:00 am

If you or a loved one suffers from psoriasis, a chronic skin condition characterized by a painful, red, scaly rash, you may not realize that the effects may be more than skin deep. Many people with psoriasis develop inflammation below the skin’s surface, in the joints – causing arthritis, joint destruction, and disability. 

What’s the link between a skin rash and a joint problem? The answer lies in the body’s immune system. Psoriasis is not just a cosmetic problem – it is actually an immune system disorder that affects the skin. According to the National Psoriasis Foundation, as many as 7.5 million Americans have psoriasis. Those who are not immediately diagnosed suffer with symptoms for many years before formal diagnosis. 

Psoriasis is autoimmune disease in which the immune system sends out faulty signals that speeds up the production of skin cells. The disease affects the rate at which normal skin cells die, flake off, and renew themselves. Instead, skin cells affected by psoriasis die and flake off at an accelerated pace – in days, rather than weeks. This causes patches of thick, red skin covered with scales of dead skin on the elbows, knees, legs, lower back and scalp. 

Psoriasis can affect the joints, too, if not diagnosed and treated early. When a person has psoriasis, the body’s immune system goes into action to fight the skin disease. But sometimes it targets the joints instead, causing joint pain and redness and swelling, a condition known as psoriatic arthritis. 

Up to 30 percent of people with psoriasis will develop psoriatic arthritis, which can show up years later – sometimes 10 to 20 years after the onset of the skin disease. Psoriatic arthritis typically develops between the ages of 30 and 50, with both men and women equally at risk. Besides affecting the joints, psoriatic arthritis can cause inflammation in other body tissues such as tendons, cartilage, eyes, heart, spine, lungs and kidneys. 

It is not clear why some people with psoriasis develop arthritis and others do not. Nearly half of those individuals who develop psoriatic arthritis have a family history, and 85 percent have experienced psoriasis first. Other factors such as infections, injuries and smoking are also linked to the development of psoriatic arthritis.

Early diagnosis and treatment is important to relieve pain and inflammation, and help prevent progressive joint degeneration and damage to other body tissues and organs. If you have developed psoriasis, and are experiencing certain symptoms, see your doctor. Symptoms can include -fatigue, tenderness, pain and swelling in tendon areas, swollen fingers and toes, stiffness, pain, throbbing, swelling and tenderness in one or more joints, reduced range of motion, morning stiffness and tiredness, and nail changes, for example, the separation of the nail from the nail bed, or a pitted or discolored appearance (similar to a fungal infection)

-Eye redness and pain, such as conjunctivitis 

Psoriatic arthritis is diagnosed by blood tests, x-rays or imaging scans, joint examination, and other symptoms. Your primary care physician may refer you to a dermatologist for further treatment of psoriasis or, if psoriatic arthritis is suspected, to a rheumatologist, a specialist who treats bone, muscle and joint disorders and diseases. 

There is no cure for psoriasis – or for psoriatic arthritis – but pain, swelling and other symptoms can be controlled with exercise, ice applications, medication, and surgery. 

(Editor’s Note:  Dr. Paul Afek, can be reached at 744-2441.)

© 2014 Tucson Local Media. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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