The development of arthritis is promoted not only by processes directly affecting the joints - degenerative diseases, injuries, congenital dysplasia, hereditary predisposition, surgery, etc.:
There are countless reasons, as they say... But not everyone knows that there is another type of arthritis - psoriatic.
The connection of this inflammatory joint disease to dermatosis is obvious from the name, as is the fact that treatment should be aimed at eradicating psoriasis.
Due to the fact that the etiology of psoriasis itself is controversial, psoriatic arthritis is one of the most mysterious, incomprehensible and intractable diseases.
Psoriasis is not an infectious disease; there are two main concepts of this disease.
Viral factors in the pathology are also suspected, but they have not been proven.
The immune concept is supported by the fact that psoriasis responds well to treatment with drugs that suppress the immune system - immunosuppressants.
For this reason, psoriatic arthritis most closely resembles rheumatoid arthritis. It is also a chronic and virtually incurable disease.
Can trigger psoriatic arthritis
Any disease that occurs against the background of a chronic disease is intercurrent, that is, it accelerates the underlying disease.
Psoriatic arthritis usually follows psoriasis, but in some cases it can be the other way around:
First there are inflammatory symptoms in the joints, and then dermatic ones.
10 to 15% of psoriasis patients develop psoriatic arthritis.
Psoriasis is a dermatosis that cannot be confused with anything:
In the photo on the right is a patient with psoriasis.
The disease causes a lot of physical and moral torment:
In addition to itching and discomfort associated with vigorous activity, wearing clothes, and self-care, depression, social phobia, and self-doubt also manifest themselves.
Psoriasis is fraught with complications such as:
When the patient becomes completely bedridden, the life prognosis sharply worsens: bedsores or pneumonia bring a tragic end closer
Other distinctive symptoms:
Diagnosis and treatment of psoriatic arthritis are carried out by a rheumatologist. Treatment of PA can be symptomatic and basic.
When taking both NSAIDs and GCSPs, you need to be careful and protect the gastric mucosa with protectors.
Long-term use of steroids can lead to joint deterioration.
The use of certain drugs that regulate immune activity leads to decreased immunity and an inability to resist simple viral infections.
Treatment of psoriatic arthritis is often toxic, so it is necessary to choose the least harmful and at the same time effective method.
To treat skin dermatosis, not only medicinal ointments are used, but also types of UV irradiation:
The next step, if phototherapy does not lead to anything, is systemic drug therapy (orally or by injection)
Due to cognitive behavioral disorders, patients with psoriasis need serious psychotherapy:
When choosing antidepressants for psoriasis, you need to be very careful, since some of them, for example, serotonergic ones, aggravate the disease.
Many people are interested in how to treat psoriatic arthritis at home. Of course, it is impossible to cure such a complex disease solely at home. The main therapy is complex and is carried out in a clinic.
Psoriasis is prone to attacks, but it can also recede for a long time. It is good during such retreats (remissions) not to sit idly by, but to continue and even intensify the fight against the disease.
Psoriatic arthritis greatly weakens muscles, so it is important to maintain yourself with daily exercise.
Nutrition should be rational, based on an alkaline diet:
With long-term and proper treatment at the doctor and at home, and prevention of infections, it is possible, if not to defeat psoriatic arthritis, then to come to a peaceful agreement with it for a long time.
Psoriatic arthritis is a chronic skin disease that affects the joints. Psoriatic manifestations are a disease formed against the background of rapidly growing cells on the surface of the dermis. The scales are thick in texture and can be white-silver or red. This causes pain and inflammation in the joints, which are characteristic of arthritis.
Signs of psoriatic arthritis often appear in the scalp (forehead, back of the head) and on the knees and elbows. Complications in the form of arthritis occur in people suffering from psoriasis in 30% of cases. And although the cause of the onset of the disease has not been reliably established, the following are considered predisposing trigger factors:
The symptoms of psoriatic arthritis can vary. Depending on the location of joint disorders, arthritis is classified:
In this case, the symptoms of the disease are manifested by bilateral lesions in the joints. This type usually occurs without complications.
This type of psoriatic arthritis occurs in different joints and comes in a variety of sizes. It is characterized by swelling and dysfunction of the mobility of muscle and bone joints.
This type is characterized by the manifestation of symptoms in small joints (often fingers and toes). The disease mostly affects males.
A rare type of disease. Symptoms occur in the area of the intervertebral joints and the hip part of the body.
The most severe type of psoriatic arthritis. Deformation occurs, and subsequently complete destruction of bone tissue. Motor function is impaired and complete paralysis occurs.
Common symptoms that should prompt a person to get tested are:
The synchronicity of the onset of symptoms of the disease on the skin and joints is characteristic of psoriatic arthritis, but there are cases when many years can pass between them.
The disease cannot be completely cured, but if no action is taken, it becomes severe and carries a risk of death.
Severe disease is characterized by:
Visual examination and laboratory tests help recognize psoriatic arthritis. Although tests are often uninformative, a slight increase in ESR in the blood does not directly indicate the disease. It is also necessary to exclude diseases with similar symptoms - Reiter's disease, ankylosing spondylitis, rheumatoid arthritis, gout and osteoarthritis.
X-ray photos help diagnose psoriatic arthritis. Since it will show areas where deformation processes occur in the joints, erosive tissue damage and the formation of osteophytes in places where bones grow together.
A visual examination helps diagnose the disease:
Treatment of psoriatic arthritis is based on restorative manipulation of the motor functions of the joints and reduction of inflammatory signs on the skin.
For treatment, traditional drug therapy is used in combination with folk remedies. However, you should not count on quick results, especially since this disease cannot be completely cured. Only complex step-by-step treatment helps to achieve long-term remission of the disease.
Medicines prescribed for psoriatic arthritis:
The techniques, which are additional measures of the general treatment process, are designed to reduce the skin manifestations of psoriatic arthritis. They help reduce the visible signs of damage to the epidermis and restore joint function. For this, hardware treatment is used:
Recipes based on folk remedies often play a supporting role. Herbs and other plant components are used for external compresses, although the use of tinctures for oral use is also possible.
A good folk remedy that can be used at home for psoriatic arthritis is fresh carrots. It is necessary to grate it and add a teaspoon of pharmaceutical turpentine to the resulting cake in the same ratio to vegetable oil.
Night compresses are also made from chopped aloe leaves.
You can infuse “drinkable” folk medicines using cinquefoil or birch buds. For the first case, for 30 g of herb you need to take 0.5 liters of boiled water. Infuse this decoction for at least a week, shaking it periodically.
In the second case, you only need 5 g of birch buds, which must be boiled over low heat. There is no need to insist on the collection; after cooling it can be used immediately. Both one and the second tincture are used in a spoonful three times a day.
It should be remembered that it is impossible to defeat psoriatic arthritis with folk remedies alone. An integrated approach and constant support of the immune system can yield positive results.
Another important point in treating the disease is proper nutrition for psoriatic arthritis. First of all, meals should be fractional, according to the type of adherence to a certain diet. Alternate fermented milk products with cereals, legumes and plant products.
A complete refusal applies to alcoholic beverages, products containing preservatives, as well as smoked, spicy and fatty foods. A food group that can provoke allergic manifestations is banned - these are citrus fruits and other individually intolerant fruits and vegetables.
Compliance with dietary nutrition is especially beneficial for people with excess body weight, since under the pressure of weight, joints already affected by deformative disorders suffer greatly.
If, against the background of ongoing psoriasis, damage to the joints of the body develops in a person, then the disease is called psoriatic arthritis. Two diseases develop simultaneously or occur separately, the order varies. Psoriasis is a dermatological skin lesion that has a psychosomatic basis; about 1.1% of the world's population is affected by the disease. More than half of patients with psoriasis are at risk of developing psoriatic arthritis in addition. You will find symptoms and treatment, photos in this article.
The disease manifests itself simultaneously in women and men, the former suffer arthritis more easily, the general age range is from 25 to 50 years and above . The definition of “psychosomatic” was given to arthritis by scientists, since the occurrence of the disease is associated with disruptions in the psyche and nervous system. A person notices the first signs of psoriatic arthritis after severe stress or constant tension in the nervous system. In this case, psoriatic arthropathy is added to the existing psoriasis.
A very common disease on earth, the nature of which has not been fully established. It is characterized by focal lesions of the skin in any part of the human body and a recurrent nature. Despite the intensive work of doctors and scientists around the world, the true cause of the disease has not been identified. There are several working hypotheses, according to which treatment is carried out, but they cannot help the patient once and for all. The disease worries a person throughout his life, periods of exacerbation alternate with a calming lull.
Medical specialists make efforts to alleviate the patient’s condition during the exacerbation period and make it, if possible, shorter. During the period of remission, diet and specialist recommendations are used to delay the onset of a subsequent explosion. In some cases, the disease affects not only the skin, but also spreads to the nails, joints and some internal organs, in which case they speak of the development of psoriatic arthritis.
Modern science determines the reasons for the development of psoriasis in an imbalance of chemical substances in the human body. These include a violation of the division of prostaglandins and cyclic nucleotides that regulate the growth of the epidermis. Rapidly dividing skin cells produce epidermopoietin, which causes rapid growth of additional layers in the epithelium . At the same time, scientists state the fact that this violation is only a consequence of a previously launched internal or external signal, and not the root cause.
Working versions of the appearance of the disease are various hypotheses that have the right to exist:
An objective judgment on this issue is that if scientists and specialists name many causes, which upon closer examination refer to effects, then the occurrence of a disease is considered a mystery of nature that has not yet been solved. But the positive side is that doctors can influence the course of the disease and prevent relapses of psoriatic arthritis.
About 70-80% of cases of psoriatic arthritis are the result of skin lesions , but the remaining cases involve joint involvement without dermatic manifestations on the surface of the epithelium. That is, the joints are the first to suffer from the manifestation of psoriasis; diagnosis is difficult because doctors do not see the standard symptoms of the disease. Depending on the variety of symptoms, psoriatic arthritis is divided into:
Despite the fact that the disease affects various joints and the signs of the disease are not always the same , psoriatic arthritis can be distinguished by a set of certain general symptoms:
If you experience strange pain in the joints of your arms, legs or body, you should immediately consult a doctor who will prescribe appropriate treatment.
Most often, the malignant variant of the disease is observed in young men under 35 years of age and is marked by the following symptoms of psoriatic arthritis:
To qualitatively diagnose the disease, medical workers use instrumental and laboratory research methods .
In our time, specific laboratory tests for identifying psoriatic joint damage have not yet been developed. If the disease concerns the small phalanges of the hand , then the analyzes do not show changes related to psoriasis and arthritis. The main differences in laboratory parameters include:
X-ray examination is a common method and not too expensive. In the photographs, inert growths and periostitis . Psoriatic disease resembles rheumatoid arthritis due to erosion at the edge of the epiphyses and manifested by ankylosis of the joint. An x-ray will show a change in the structure of the articulation with a mutilating degree of the disease and a decrease in the gap between the bones. When examining the spinal column for spondyloarthritis, the presence of bone bridges is visible and ossifications are visible near the vertebrae.
Using computed tomography, a layered image of the patient’s body is obtained. This method is ideal for diagnosing spinal diseases. It allows you to obtain copies with high image accuracy and more clearly examine the deformation of the joint.
The list of symptoms that indicate psoriatic arthritis is varied, but doctors note the mandatory criteria:
The fight against psoriatic arthritis is based on the simultaneous treatment of joint damage and skin dermatosis. The danger always remains the possibility of the disease transitioning to a malignant stage. To treat exacerbations in winter, the method of exposure to ultraviolet rays , activating the regeneration and restoration of the skin.
The use of local ointments, creams and lotions is shown as a remedy for arthrosis. Hormonal medications and salicylic ointment are used as active drugs. The anti-inflammatory effect is quite effective; a number of side effects that occur with oral administration are not observed.
For psoriatic disease, sedative drugs are widely used, causing stable remission by their action. Such sedatives are seduxen or valerian; the prescription depends on the severity of the disease. Taking multivitamins helps improve metabolic processes in the body and increases immune defense.
When the disease is not advanced, treatment with inflammatory nonsteroidal drugs . If the joints are severely affected and the disease makes the joint partially or completely immobile, then intra-articular injections are used. An emulsion with hydrocortisone is injected into the gap; the effectiveness of the method depends on the experience and professionalism of the doctor. If he can get to his destination, then recovery will not be long in coming. The injection method into the joint avoids the spread of hormones throughout the human body and prevents side effects.
Severe cases should be treated with cyclophosphamide, which helps eliminate inflammation of the synovial surfaces of the joint and is an effective medicine. Hormonal drugs are used in cases where none of the listed methods has given results; such drugs are not abused and are used only in severe cases. A surgical method for eliminating ankylosis and correcting joint deformation is indicated for chronic synovitis that is not amenable to conservative treatment.
Treatment is prescribed by a specialist, he is guided by many factors:
During the period of remission, you should try to do everything possible to avoid a period of exacerbation . At this time, the patient follows a diet and preventive measures. A holiday at a resort or treatment in a sanatorium is very helpful for improving well-being if psoriasis does not worsen upon contact with sea water.
It would seem that every movement with arthritis causes pain, which means it is advisable to keep the joints at rest. But if you select special movements that help increase blood circulation in the periarticular area, then they are recommended for patients as treatment. Psoriatic arthropathy recedes with a reasonable motor regimen, the amplitude of rotation of the joint in some cases increases, and flexibility gradually appears. Gymnastic exercises are recommended to be performed three times a day for 15–20 minutes per session.
In conclusion, it should be said that psoriatic arthritis requires a serious approach to treatment; self-administration of various drugs can only aggravate the disease. Before choosing treatment, all patients undergo an examination that influences the plan for combating the disease.
The launch of autoimmune processes, which are based on the destruction of the body’s own structural elements by the protective cells, is accompanied by the appearance of external and internal signs. In some clinical cases, specialists are faced with a separate variant of the course of psoriatic pathology, manifested not only by characteristic lesions of various areas of the patient’s skin, but also by destructive changes in the musculoskeletal system.
If at the time of visiting a doctor the patient has pronounced signs of two diseases - arthritis, psoriasis - there will be no difficulties in making a diagnosis even before an in-depth examination. The characteristic clinical picture of the development of pathological disorders allows one to accurately diagnose psoriatic arthritis even before the start of diagnostic measures.
The mechanism of activation of autoimmune processes in the human body has not been studied to date, so experts do not know the true reasons why the psoriasis process and, accordingly, psoriatic arthritis are formed. A pronounced dependence of the development of pathological changes in the epidermal layer of the skin and articular tissues on hereditary predisposition has been noted. However, in each case, the frequency of occurrence of disease manifestations is asynchronous; only 10% of patients experience a simultaneous exacerbation of psoriasis and inflammatory reaction in the joints. In the vast majority of clinical cases, the interval between the formation and manifestation of these pathologies is several years.
Psoriatic polyarthritis is not characterized by a direct type of inheritance - the threat of its occurrence and progression exists, first of all, in that category of patients, among whose relatives - both immediate and distant - there are patients with psoriasis. In this case, the risk of activation of pathogenic processes in the patient increases by 2 times.
In addition to the number of provoking factors, the impact of which can trigger the initiation of destructive changes in various joints in a patient, experts include:
In some cases, psoriatic polyarthritis in the patient’s joints may occur against the background of prolonged depression.
Systematization of psoriatic arthritis is carried out on the basis of various characteristics, therefore in modern medical practice there are several types of classification of this pathology.
Depending on the nature of the disease process:
Depending on the location of the pathological focus, the form of the disease can be:
Depending on the spread of the pathological process to other organs and systems of the patient’s body, psoriatic polyarthritis can develop as follows:
Depending on the intensity of the formation of pathological changes in the joints, doctors distinguish the following stages of development of psoriatic arthritis:
Additionally, the systematization of psoriatic arthritis is carried out on the basis of X-ray examination data, depending on the degree of preservation of the functionality of the affected joints, on the stage and form of psoriasis.
When a patient develops psoriatic polyarthritis, the localization of inflammatory foci in most cases is not topographically tied to the location of psoriatic rashes. There are the following types of arthritis of this type:
A direct relationship with skin lesions by psoriasis exists only when the distal interphalangeal joints are affected
Due to the progression of the disease, there is a complete loss of mobility in the affected joints, which leads to disability of the patient. In some clinical cases, an inflammatory reaction develops in the cervical and lumbar spine.
The determination of treatment tactics for the patient is directly dependent on the type of diagnosed psoriatic arthritis.
The characteristic symptoms of the development of autoimmune joint damage are divided into 2 categories - extra-articular and articular. The latter include the following pathological signs:
Extra-articular symptoms include:
An accurate diagnosis requires a detailed examination of the patient using laboratory and instrumental methods.
When identifying a pathological process, family history data and the results of an external examination of the patient are of great importance. A laboratory blood test is carried out to differentiate psoriatic arthritis from rheumatism - in the case of joint damage, there are no rheumatoid factors in the vascular bed. To visualize pathological changes in the structure of the affected joints, radiographic examination methods are used.
Psoriatic arthritis of the ankle
Psoriatic arthritis has a chronic course with a pronounced tendency to worsen pathological changes in the articular elements. In order to achieve stable remission of the disease and slow down the development of destructive processes, drug therapy, exercise therapy, physiotherapy, and sanatorium treatment are used. Surgical treatment is a last resort and is carried out only in the presence of strict indications in the absence of a positive effect in the conservative treatment of this form of arthritis.
Drug therapy is based on the use of the following groups of medications:
Along with the use of medications, a prerequisite for maintaining mobility in the affected joints is the daily performance of a special set of gymnastic exercises, which is developed by the attending physician individually for each patient.
In case of malignant progression of the disease and lack of effectiveness from previously used treatment methods, the attending physician may decide on the advisability of surgical correction of the pathological condition - surgical removal of the affected tissues and replacing them with artificial analogues.
Since the true reasons for the activation of autoimmune mechanisms in medical practice have not been established to date, polyarthritis of the joints cannot be completely cured, just like psoriasis. However, by strictly following all the recommendations of the attending physician, the patient can achieve stable remission of this disease and avoid worsening destructive changes in the joints.
Psoriatic arthritis is an inflammation of the joints that precedes the development of joint damage due to psoriasis. Psoriatic arthritis has severe symptoms. If qualified and timely treatment is not provided, the disease can deform the joints in such a way that the person becomes disabled. This disease often affects women.
Causes of the disease:
Psoriatic arthritis manifests itself with characteristic symptoms that are difficult to confuse with other diseases.
Psoriatic arthritis is similar in its course to rheumatoid arthritis, but has such distinctive features as:
The development of psoriatic arthritis occurs over a very long time, but in some cases the disease can appear suddenly. The course of the disease is chronic, sometimes internal organs are affected.
Important! Psoriatic arthritis in ICD 10 has code 07 and is classified as “Disease of the musculoskeletal system and connective tissues.”
Diagnosis of psoriatic arthritis is carried out using x-rays, analysis of synovial fluid of the joint, and analysis to detect rheumatoid factor.
The doctor decides how to treat this disease in a particular person after a full course of examination. Psoriatic arthritis is incurable; therapy will be aimed at stopping the progression of the disease. Sometimes even partial restoration of the functionality of the joint is provided.
Drug treatment will be aimed at eliminating acute symptoms, restoring the functions of the musculoskeletal system, and reducing the inflammatory process.
Drugs for treatment:
The disease has a chronic course, which can lead to disability. Thanks to modern treatment methods, it is possible to achieve remission and eliminate the progression of the disease.
It is impossible to prevent psoriatic arthritis, but the functionality of the joints can be preserved with the help of properly selected treatment and monitoring by a doctor.
Important! If you do not pay due attention to the disease in a timely manner and do not consult a doctor, this can be fraught with loss of ability to work and complete disability of the person.
Treatment with folk remedies can have a positive effect, but such therapy should only be an auxiliary method. There are proven home treatment recipes:
Diet plays a very important role in the treatment of this disease. The following rules must be followed:
Important! The diet should be low-calorie. It is very important to monitor your weight to avoid stress on your joints. Since physical activity is contraindicated for psoriatic arthritis, in order to lose weight, you must adhere to a proper diet.
Fasting treatment is also a very effective method. It is carried out with the permission of the doctor after a thorough examination, and under strict supervision. The optimal period for fasting is ten days. It is not recommended to start or break fasting on your own, since at this time all chronic diseases may worsen. For prevention, you can do a one-day fast for 24 hours once a week.
It is an integral part in the treatment of psoriatic arthritis. It is carried out to maintain flexibility and mobility of the joints. It is very important to expand your physical activity, that is, take daily walks and also perform gymnastic exercises several times a day. Gymnastics includes the following set of exercises:
Important! Physiotherapy exercises must be prescribed by the attending physician.
Psoriatic arthritis is quite rare in children. The peak incidence occurs in adolescence. Symptoms manifest themselves in the presence of plaques that are covered with silvery scales. The area of the elbows, knees, groin, and scalp under the hairline is often affected.
In half of the cases in children, the appearance of psoriasis is preceded by arthritis. But since the dermatological manifestation of the disease is much more subtle than in adults, it can be extremely difficult to make a diagnosis. The disease process begins with damage to the joints of the hands, and then moves to other joints.
Psoriatic arthritis can begin gradually and have the following symptoms:
Physical activity plays a very important role in the treatment of childhood psoriatic arthritis. In this case, the treatment will be more effective. Also, sanatorium-resort treatment will help reduce symptoms and remission of the disease.