Psoriatic Arthritis
Medical Author: William C. Shiel Jr., MD, FACP, FACR
What is psoriatic arthritis?
Psoriatic arthritis is a chronic disease characterized by inflammation
of the skin (psoriasis) and joints
(arthritis). Psoriasis is a common skin condition affecting 2% of the Caucasian population in
the United States. It features patchy, raised, red areas of
skin inflammation with scaling. Psoriasis often affects the tips of the elbows
and knees, the scalp, the navel, and around the genital areas or anus.
Approximately 10% of patients who have psoriasis also develop an associated inflammation
of their joints. Patients who have inflammatory arthritis and psoriasis are diagnosed as
having psoriatic arthritis.
The onset of psoriatic arthritis generally occurs in the fourth and
fifth decades of life. Males and females are affected equally. The skin
disease (psoriasis) and the joint disease (arthritis) often appear
separately. In fact, the skin disease precedes the arthritis in nearly 80%
of patients. The arthritis may precede the psoriasis in up to 15% of
patients. In some patients, the diagnosis of psoriatic arthritis can be
difficult if the arthritis precedes psoriasis by many years. In fact, some
patients have had arthritis for over 20 years before psoriasis
eventually appears! Conversely, patients can have psoriasis for over 20
years prior to development of arthritis, leading to the ultimate diagnosis
of psoriatic arthritis.
Psoriatic arthritis is a systemic rheumatic disease that can also cause
inflammation in body tissues away from the joints other than the skin, such as in the eyes, heart, lungs, and kidneys. Psoriatic arthritis
shares many features with several other arthritic conditions, such as
ankylosing spondylitis, reactive arthritis (formerly Reiter's syndrome), and arthritis associated with
Crohn's disease and ulcerative colitis. All of these conditions can cause
inflammation in the spine and other joints, and the eyes, skin, mouth, and
various organs. In view of their similarities and tendency to cause
inflammation of the spine, these conditions are collectively referred to
as "spondyloarthropathies."
Next: What causes psoriatic arthritis? »
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