Psoriasis Australia

What is Psoriatic Arthritis?

Psoriatic arthritis (PsA) is a chronic inflammatory condition that affects some individuals with psoriasis. It primarily targets the joints, causing pain, stiffness, and swelling, but can also affect other parts of the body, including the spine and tendons.

Overview

Psoriatic arthritis (PsA) is a chronic inflammatory condition that affects some individuals with psoriasis. It primarily targets the joints, causing pain, stiffness, and swelling, but can also affect other parts of the body, including the spine and tendons. In Australia, psoriatic arthritis affects an estimated 30% of individuals living with psoriasis, leading to significant challenges in mobility and daily life activities. Early diagnosis and appropriate management are essential to prevent joint damage and improve quality of life.

What Is Psoriatic Arthritis?

Psoriatic arthritis is an autoimmune disease where the body’s immune system mistakenly attacks its own tissues, particularly the joints and skin. While PsA is closely associated with psoriasis, a skin condition characterized by red, scaly patches, not everyone with psoriasis will develop psoriatic arthritis.

There are five primary patterns of PsA:

  1. Oligoarticular PsA: Affects a few joints, often large joints like the knees.
  2. Polyarticular PsA: Involves multiple joints, similar to rheumatoid arthritis.
  3. Distal interphalangeal predominant PsA: Affects the small joints of the fingers and toes.
  4. Spondylitis PsA: Involves inflammation in the spine and neck.
  5. Arthritis mutilans: A severe and rare form, leading to joint deformity.

Symptoms

The symptoms of PsA vary but typically include:

  • Joint pain and swelling: Particularly in the fingers, toes, and spine.
  • Stiffness: Especially in the morning or after periods of inactivity.
  • Dactylitis: A characteristic swelling of an entire finger or toe, often referred to as “sausage digits.”
  • Nail changes: Such as pitting, thickening, or separation of the nail from the nail bed.
  • Fatigue: General tiredness is a common symptom for those with autoimmune diseases.

Diagnosis

There is no single test to diagnose psoriatic arthritis. Instead, rheumatologists in Australia rely on a combination of clinical examinations, patient history, and imaging tests like X-rays, MRIs, or ultrasounds. Blood tests may be used to rule out other forms of arthritis, such as rheumatoid arthritis. Early diagnosis is crucial to prevent irreversible joint damage.

Treatment Options

Treatment of PsA is aimed at reducing inflammation, relieving symptoms, and preventing long-term joint damage. In Australia, treatment strategies include:

  1. Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Commonly used to reduce pain and inflammation.

  2. Disease-Modifying Antirheumatic Drugs (DMARDs): These include methotrexate and sulfasalazine, which help to slow disease progression.

  3. Biologics: Australia has approved several biologic medications, such as TNF inhibitors (e.g., etanercept, adalimumab) and IL-17 inhibitors (e.g., secukinumab), which target specific parts of the immune system responsible for PsA inflammation.

  4. Janus Kinase (JAK) Inhibitors: These newer oral medications (e.g., tofacitinib) can be prescribed to people with moderate to severe PsA in Australia.

  5. Physical Therapy and Lifestyle Changes: Exercise, physiotherapy, and maintaining a healthy weight are essential components of managing PsA. Special attention to cardiovascular health is also important, as people with PsA have an elevated risk of heart disease.

Living with Psoriatic Arthritis

Living with PsA can be challenging, but support is available through organizations like Arthritis Australia and the Australian Rheumatology Association. These groups provide education, resources, and advocacy to help individuals navigate their condition. PsA patients may also benefit from specialized treatment centers in major Australian cities that provide access to rheumatologists and cutting-edge treatments.