Occurrence In The United States
According to the National Psoriasis Foundation, psoriatic arthritis affects about 1 million people in the United States, or about 30% of all persons with psoriasis. However, prevalence rates vary widely among studies. In one population-based study, less than 10% of patients with psoriasis developed clinically recognized psoriatic arthritis during a 30-year period. A random telephone survey of 27,220 US residents found a 0.25% prevalence rate for psoriatic arthritis in the general population and an 11% prevalence rate in patients with psoriasis. However, the exact frequency of the disorder in patients with psoriasis remains uncertain, with the estimated rate ranging from 5-30%.
Moreover, since the late 20th century, the incidence of psoriatic arthritis appears to have been rising in both men and women. Reasons for the increase are unknown it may be related to a true change in incidence or to a greater overall awareness of the diagnosis by physicians.
How Is Pernicious Anemia Diagnosed
A diagnosis of pernicious anemia is based on your medical and family histories, a physical exam, and blood work. Doctors will also determine if your PA is related to a lack of intrinsic factor or if there is another cause. They will want to find out how severe that underlying condition is in order to treat it and get it under control.
If the diagnosis is uncertain, your doctor might suggest a bone marrow test. Bone marrow testing can tell your doctor if your bone marrow is healthy and making enough red blood cells. With PA, the bone marrow cells that turn into blood cells are larger than normal.
Articles On Types Of Psoriasis
Knowing which kind of psoriasis you have helps you and your doctor make a treatment plan. Most people have only one type at a time. Sometimes, after your symptoms go away, a new form of psoriasis will crop up in response to a trigger.
In general, most types of psoriasis result from the same triggers:
Here’s how you can spot the 7 types of psoriasis and what you can do to treat them.
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Types Symptoms And Treatment
Like psoriasis and PsA elsewhere on the body, psoriatic disease in the hands and feet can cause itchy, scaling, reddened skin plaques and painful, swollen joints. Specific types and symptoms of hand and foot psoriasis and PsA, however, can also cause less-familiar skin and joint issues.
Palmoplantar psoriasis, plaque psoriasis on the feet or hands, affects about 40 percent of people with plaque psoriasis, who often donât have much skin disease elsewhere. As noted, its substantial effects on function and quality of life mean dermatologists typically use advanced medications to control symptoms. Treating certain types of palmoplantar psoriasis is still challenging, despite the rapidly expanding list of medications for psoriasis and PsA. Often, palmoplantar psoriasis doesnât respond as well to treatment as does psoriasis on other parts of the body.
Most biologics, which work by targeting specific proteins that turn up inflammation in psoriatic disease, such as tumor necrosis factor or interleukin-17 , have some effect on certain people with palmoplantar psoriasis.
No one treatment works for everyone, and people with palmoplantar psoriasis may have to try several medications or combinations of treatments to relieve symptoms. Gary Bixby, for example, didnât get better with either a TNF or an IL-17 inhibitor. The third biologic he tried blocks another interleukin protein, IL-23, and, three months after his first injection, heâs getting better results.
Symptoms Are Often Slow To Show
According to Dr. Fernandez, the majority of people whodevelop psoriatic arthritis have psoriasis first.
Up to 30 percent of people with psoriasis will develop PsA, but that can take an average of 10 to 12 years after the skin disease appears. It is not known exactly why the condition takes so long to appear, he says.
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Add More Healthy Fats
showed that omega-3 fatty acids in particular can help reduce inflammation in the body. An increased omega-3 intake is one of the benefits of a Mediterranean-style diet. Good sources of omega-3s include:
- fish and seafood, such as salmon, tuna, and sardines
- nuts and seeds, such as walnuts, chia seeds, and flaxseeds
- plant oils, such as flaxseed oil, soybean oil, and canola oil
- foods fortified with omega-3s, such as eggs, milk, or juice
You can also consider taking an omega-3 supplement. Make sure your supplement contains EPA and DHA. Those are the types of omega-3 that are best for reducing inflammation.
Olives and olive oil also have anti-inflammatory properties. Theyre another major part of the Mediterranean diet. If you enjoy olives, simply eat them on their own or add them to pizza, salads, or sandwiches. You can use olive oil for roasting or sautéing, or for making dressings.
Nut butter and avocados are some other sources of healthy fats to incorporate into your diet.
Consider working with a registered dietitian, if you have access to one, to come up with an anti-inflammatory eating plan tailored to your individual needs.
What Is A Psoriatic Arthritis Flare
A PsA flare is a temporary worsening of symptoms. PsA flares are different for everybody. When your PsA flares, symptoms you have had before like rashes and joint pain or swelling typically happen again. In severe cases, a new symptom might also show up.
Some typical PsA flare symptoms include:
Joint pain or swelling
Psoriasis rashes in new areas or areas where you have had rashes before
Pain at the site where tendons attach to bone, like the back of the heel
Swelling of an entire finger or toe, also called sausage digit
Back pain and stiffness due inflammation of the spine or sacroiliac joints
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What To Look For
You are more likely to develop psoriatic arthritis if a family member has the condition. Any type of psoriasis, including plaque, guttate, or pustular psoriasis, can lead to psoriatic arthritis. In very rare cases, arthritis symptoms can appear before plaques or other skin problems. If you have joint pain or weakness, or stiff and aching joints in the morning, speak to your dermatologist. These are the earliest warning signs of psoriatic arthritis.
Next, you may notice a swollen finger or toe. The joints in your affected digit will feel tender and sore. Any joint can be affected by psoriatic arthritis at any time, but fingers and toes are usually the first to experience swelling. Another common warning sign can be seen in the finger and toenails. Nails affected by psoriasis may experience pitting, which appear as small indentations in the nail. Sometimes the nail can even begin to lift off the skin below it. If psoriasis is in your nails, it very well may spread deeper into the body and become psoriatic arthritis.
Dealing With These Conditions Can Be Difficult Enough Without The Added Stress Of Losing Your Hair Luckily Any Loss Is Usually Temporary Heres How To Safeguard Your Strands
If youre one of the roughly 2 percent of Americans who have psoriasis, a chronic condition that typically causes raised, red patches of skin topped with silvery scales, theres a good chance that it has impacted your scalp. This also holds true for the more than 40 percent of people with psoriasis who also have psoriatic arthritis , a form of arthritis that can appear in combination with psoriasis.
Psoriasis causes skin cells to divide about 10 times faster than normal. The excess cells pile up on the surface of the skin, causing scaly patches of itchy, dry skin. Known as plaques, these lesions often itch, burn, and sting.
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Who Is At Risk For Psoriatic Arthritis
Psoriasis affects 2-3 percent of the population or approximately 7 million people in the U.S. and up to 30% of these people can develop psoriatic arthritis. Psoriatic arthritis occurs most commonly in adults between the ages of 35 and 55 however, it can develop at any age. Psoriatic arthritis affects men and women equally.
It is possible to develop psoriatic arthritis with only a family history of psoriasis and while less common, psoriatic arthritis can occur before psoriasis appears. Children of parents with psoriasis are three times more likely to have psoriasis and are at greater risk for developing psoriatic arthritis. The most typical age of juvenile onset is 9-11 years of age.
Treatments To Clear Scalp Psoriasis And Stop Hair Loss
The good news is that there are many effective ways to treat scalp psoriasis. Once your skin clears, your hair will usually grow back.
The bad news is that scalp psoriasis can sometimes be difficult to treat. Hair makes the scalp inaccessible for topical therapies, which are thick and gooey and hard to get in and out of your hair.
The practicality of applying a cream, ointment, or foam into the scalp makes it difficult for topical treatment of psoriasis of the scalp, says Dr. Gohara. If you dont wash your hair every day, who the heck wants to slather creams and ointments on their scalp?
This is especially problematic for Black and brown-skinned people, she says, who tend to wash their hair more infrequently.
Treatment depends on the severity of the condition.
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Treatments For Psoriasis And Psoriatic Arthritis
Many medications can help treat both the skin and joints, but there are definitely medications that work better for one than the other, explains Dr. Haberman. When treating PsA, we focus on both domains. We may start with one medication if your skin is worse that is better on the skin, but it should still have effects on the joints, she says.
According to the clinical treatment guidelines by the American College of Rheumatology and the National Psoriasis Foundation , your personal treatment plan should depend on how PsA is impacting your body as well as the severity of your symptoms.
Since patients with psoriatic arthritis may have different degrees of involvement of skin, joint pain, finger and toe swelling , and pain where tendons and ligaments attach to bone , its important to identify the most problematic areas and choose treatment options that are best suited for them, says Dr. Husni.
For example, if you have little joint pain and a lot of skin involvement, your rheumatologist might try newer biologics called IL-17 inhibitors, like secukinumab and ixekizumab , notes Dr. Haberman.
While we have a lot of medication options for PsA, sometimes it is more of trial and error to see which medication the patient will respond to, she says. Sometimes we need to try more than one medication to find the one that is right for that patient.
Medications use to treat both psoriasis and PsA include:
Early Symptoms Of Psoriatic Arthritis
Here are some common first signs of PsA. If you experience any of these, talk to your primary care provider. Early detection and treatment of the disease can help prevent future joint damage.
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Why Some People With Psoriasis Develop Psa
Although psoriasis and PsA may appear unrelated, both conditions reflect underlying immune system problems.
In psoriasis, your overactive immune system causes your bodys skin cells to develop too rapidly. This can be triggered by many environmental factors, such as stress or smoking.
One thing these triggers have in common is that they stimulate your bodys inflammation response. This same inflammation response can happen in your joints. Inflamed joints are what cause PsA.
In PsA, white blood cells target your bodys tissues instead of protecting your body against foreign substances. Though PsA is connected to psoriasis, it has very distinctive symptoms of its own. For this reason, some researchers have referred to PsA as a disease within a disease.
The Centers for Disease Control and Prevention calculates that 10 to 20 percent of people with psoriasis will go on to develop PsA. This is slightly lower than the figures provided by the National Psoriasis Foundation, which put the risk at about 1 in 3, or 30 percent.
Psoriasis is typically diagnosed by the onset of plaques. These are scaly patches of raised, silver-white or reddish skin. PsA affects your joints, typically those in your fingers, toes, and lower back.
PsA can come in many forms. It can trigger other side effects such as fatigue and decreased range of motion. Because psoriasis is more visibly apparent, its often easier to diagnosis than PsA.
How Do You Treat Pernicious Anemia
Doctors treat pernicious anemia by replacing vitamin B12 in the body. Once a person has been diagnosed with the condition, they will need lifelong treatment. Treatment of PA aims to prevent or treat anemia and its signs and symptoms, prevent complications, and treat underlying causes if a cause can be determined.
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Treatments For Skin Injuries With Psoriasis Flare
Koebner lesions from scratches and other skin injuries are treated the same as regular psoriasis plaques. Treatments include:
- Oral medications
- Over-the-counter moisturizers
- Ultraviolet light therapy that slows the growth of psoriasis
Because Koebnerized skin can crack, bleed, and lead to infection, its important to treat the area as soon as possible.
Here are some tips for preventing or managing skin injuries and lesions:
- Avoid bruising or cutting your skin.
- Clean and cover any wounds or scratches to prevent infection.
- Protect your skin from the sun by wearing sunscreen.
- Prevent dry skin with lotions and moisturizing creams, and use a humidifier in dry, cold weather.
- Dont touch, pick, or scratch lesions.
- Follow your prescribed psoriasis treatment.
Consult your doctor for medical advice before starting any new treatment.
When To Seek Medical Advice
You should speak to your GP if you experience constant pain, swelling or stiffness in your joints even if you haven’t been diagnosed with psoriasis.
If you have been diagnosed with psoriasis, you should have check-ups at least once a year to monitor your condition. Make sure you let your doctor know if you’re experiencing any problems with your joints.
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What Causes Psoriasis And Psoriatic Arthritis
The symptoms of both psoriasis and psoriatic arthritis arise when the bodys immune system malfunctions, leading to inflammation.
In psoriasis, the faulty reaction causes skin cells to grow too fast, promoting a buildup of skin cells on the surface. These cells appear as a scaly rash.
In psoriatic arthritis, the inflammation affects the joints. Permanent damage can result if the person does not seek treatment.
Doctors do not yet know the exact causes of psoriasis and psoriatic arthritis. However, they do know that genetics contribute to both conditions.
An estimated 1 out of 3 people with psoriasis say that they have a family member with psoriasis. Also, around 40 percent of people with psoriatic arthritis have a family member with psoriatic disease.
Still, many people have genes for psoriatic disease and never develop it. To develop psoriatic disease, a person must have the specific genes for it, as well as a trigger that activates it.
Possible triggers for psoriatic disease include:
- an infection, such as strep throat or a cold
- use of tobacco or smoking
- heavy alcohol use
These triggers may bring on psoriasis, and they can also cause flares. Flares are cycles during which symptoms become worse. Triggers vary from person to person and may change over time.
Psoriasis and psoriatic arthritis symptoms often come and go in cycles. They may get worse during a flare and then improve. Symptoms may also move around, affecting different areas of the body at different times.
Does The Severity Of Skin Or Nail Psoriasis Matter
- Nail changes are found in 2 out of 5 individuals with psoriatic arthritis, compared with around half in those with psoriasis alone.
- Nail changes include pitting and discolouration of the nail due to abnormalities in the growth of tissue in the nailbed.
- The risk of developing psoriatic arthritis is greater in individuals with severe psoriasis, yet severe psoriatic arthritis may occur with minimal skin disease.
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What Treatment Is Right For Me
The type of treatment will depend on how severe your symptoms are at the time of diagnosis with the goal being to control the disease to the point of remission and avoid complications. Medications may need to be changed over time to continue to maintain control and avoid disease progression and systemic effects. Some early indicators of more severe disease include onset at a young age, multiple joint involvement, and spinal involvement. Good control of the skin is important in the management of psoriatic arthritis. In many cases, you may be seen by two different types of healthcare providers, one in rheumatology and one in dermatology.
Early diagnosis and treatment can relieve pain and inflammation and help prevent progressive joint involvement and damage. Without treatment psoriatic arthritis can potentially be disabling, cause chronic pain, affect quality of life, and increase risk of heart disease. It is important to update your healthcare provider when you have a change in symptoms or if your medication regimen is no longer effective.