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Psoriatic arthritis

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Chronic inflammation of the joints affecting up to 30% of patients with psoriasis.

It usually affects both large and small joints and is asymmetrical. The distal interphalangeal joints of the hands and feet are very often affected.

The diagnosis is clinical and should be suspected in patients with psoriasis who have symptoms of arthritis.

Anti-rheumatic drugs and biological agents are used for treatment.

Bibliographic references
  1. Bruce IN, Ho PYP. Clinical features of psoriatic arthritis. In: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 128.
  2. Veale DJ, Orr C. Management of psoriatic arthritis. In: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 131.
  3. Smolen JS, Schöls M, Braun J, et al. Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 update of recommendations by an international task force. Ann Rheum Dis. 2018;77(1):3-17. PMID: 28684559
  4. FitzGerald O, Elmamoun M. Psoriatic arthritis. In: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelley and Firestein's Textbook of Rheumatology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2017:chap 77.
  5. Sokka T, Kautiaanenm H, Hannonen P, Pincus T. Changes in Health Assessment Questionnaire disability scores over five years in patients with rheumatoid arthritis compared with the general population. Arthritis Rheum. 2006;54:3113–8.
  6. Boonen A, Sjef M, Linden S van der. The burden of ankylosing spondylitis. J Rheumatol Suppl. 2006;78:4–11.
  7. Salaffi F, De Angelis R, Grassi W, on behalf of the MArche Pain Prevalence Investigation Group (MAPPING) Study Prevalence of musculoskeletal conditions in an Italian population sample: results of a regional community-based study. I. The MAPPING study. Clin Exp Rheumatol. 2005;23:819–28.
  8. Sokka T, Krishnan E, Hakkinen A, Hannonen P. Functional disability in rheumatoid arthritis patients compared with a community population in Finland. Arthritis Rheum. 2003;48:59–63.
  9. Ariza-Ariza R, Hernandez-Cruz B, Navarro-Sarabia F. Physical function and health-related quality of life of Spanish patients with ankylosing spondylitis. Arthritis Rheum. 2003;49:483–487.
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Symptoms

    Finger joint pain

    Toe joint pain

    Swollen, hot, red joint

    Swollen fingers

    Skin patch greater than or equal to 1 cm in diameter

Symptoms to watch out for

Pain that doesn't subside with analgesics
Fever (temperature higher than 38 ºC)
Inability to do movements with the joint

Self-care

If you have pain, take over-the-counter analgesics.
Apply heat to the affected area.
Engage in regular physical activity, adapted to age and physical condition, at least 3 times a week.
Maintain a balanced diet: increase fruit, vegetable, and white meat consumption and reduce the intake of fatty meals and fritters.
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