Knowing Psoriatic arthritis The basic “know-how” Introduction and background Psoriatic arthritis (PsA) is a chronic (long-term, slow and progressive) inflammatory disorder characterized by the association of arthritis with psoriasis. Although some patients with PsA have mild disease, in others the disease may be progressive despite treatment. Psoriatic arthritis occurs in about 15 percent of patients who have a skin rash called psoriasis. In many cases, it is mild, with just occasional flare ups. However, in many other cases, it is consistent and can result in severe joint damage if not addressed early and properly. Thus, health treatment strategies aimed at the suppression of inflammatory joint and skin disease and with maintenance of good function may permit a good quality of life and a reduction in both disability and early death. Definition of psoriasis Psoriasis is a disease in which scaly red and white patches develop on the skin. Risk factors for psoriatic arthritis Psoriatic arthritis usually appears in people between the ages of 30 to 50, but can begin as early as childhood. Men and women are equally at risk. Approximately 15 percent of people with psoriasis develop psoriatic arthritis. At times, the arthritis can appear before the skin disorder. Causes of psoriatic arthritis What causes psoriatic arthritis is not known exactly. Of those with psoriatic arthritis, 40 percent have a family member with psoriasis or arthritis, suggesting heredity may play a role. Psoriatic arthritis can also result from an infection that activates the immune system. While psoriasis itself is not infectious, it might be triggere by a streptococcal throat infection. Common sites for psoriatic arthritis Psoriatic arthritis can affect any joint within the body, either in a single joint or in the same joint on both sides of the body, e.g., one or both knees. Affected fingers and toes can resemble swollen sausages, a condition often referred to as dactylitis. Signs and symptoms of psoriatic arthritis Whereas some patients may present with predominant spinal disease, other patients may present with a mixture of all of the features at the same time. In most cases, however, early symptoms may include swelling, heat, tenderness, pain or stiffness in your joints. Fatigue and anemia are also common. Some psoriatic arthritis patients also experience mood changes. Diagnosis of psoriatic arthritis To diagnose psoriatic arthritis, rheumatologists (joint specialists) look for swollen and painful joints, certain patterns of arthritis, and skin and nail changes typical of psoriasis. X‐rays are often taken to look for joint damage. Other types of scans such as MRI or CT scans can also be used to look at the joints in more detail. Psoriatic arthritis is easy to confuse with other diseases. As specialists in musculoskeletal disorders, rheumatologists are more likely to make a proper diagnosis. Treatment of psoriatic arthritis When considering treatment for PsA it is important to note that PsA is a complex, multifaceted disease, with some treatments having discordant effects on different disease features. In many cases, non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticosteroids, disease-modifying antirheumatic drugs (DMARDs) and biological agents are used as initial treatment. If the arthritis does not respond, disease modifying anti‐rheumatic drugs (DMARDs) may be prescribed. These include sulfasalazine (Azulfidine), methotrexate (Rheumatrex), cyclosporine (Neoral, Sandimmune), leflunomide (Arava) and the more recently available “anti‐TNF agents” such as etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira). Conclusion Psoriatic arthritis affects people of all ages and walks of life. However, the good news is that most people can control their psoriatic arthritis with safe and effective treatment and continue to lead active and healthy lives. Provailen is one such supplement that has been found to be highly effective and safe for the treatment of psoriatic arthritis. For most people, Provailen will relieve pain, protect the joints, and maintain mobility in almost all kinds of arthritis, including psoriatic arthritis.