psoratic arthritis, how do they know? | Arthritis Information

With tests, what makes the difference, or is there.

I have always had psoriasis and just wondered why when i tell them about it, they never think that type of arthritis.

I was diagnosed by ruling out the other arthritis' and that I have psoriasis in my family. My mum has pustular psoriasis and my aunty has guttate. I dont have psoriasis at all but the arthritis was brought on by trauma. So with just just and the joints affected plus the type of pain,increased sed rate etc. I was diagnosed with PA.Bubba, Six years after my RA diagnosis I was diagnosed with PsA based on the physical findings and xrays of my hands. PsA affects the tendons, and muscle area where tendons connect. There is a different type of swelling of the fingers. The fingers are sausage shaped, as are the toes. Your Achilles tendons are painful and the collaterol ligaments on each side of the knees can be inflammed. Xrays of the digits show a definite deformity of the bone that is only seen with PsA.

It took longer to diagnose me because I didn't have skin psoriasis. I'm one of the 20% with no skin involvement who has been diagnosed with PsA. I developed Psoriasis after I started Enbrel. That happens sometimes when there's no skin involvement initially. It can develop once the immune system is suppressed.

It truly is an ugly disease. Not only do you have the excruciating pain to deal with you have skin changes that can become unsightly. Thankfully, to date I only have one area of skin that's involved and that's on my lower leg. It's very persistent though. It's been there for 2 years and the only way it clears is to have a series of laser treatments. I had 13 treatments at 0 each and it has just started to come back worse than before.

Humira put me in clinical remission for RA but PsA became much worse with Humira. Finally after 4 months of Humira I'm starting to get some relief from PsA.

Many RDs don't ever see a case of PsA. Fortunately, I live in an area where there is a huge geriatric population and only 2 RDs. My RD recognized it right away. If you have skin psoriasis then you should be worked up for PsA by your RD. Lindy

LinB2008-04-17 10:12:50You might also check out a dermatologist if it's severe psoriasis. I was told that I had some psoriasis but it seemed to vanish once I completed my chemo. Sure hope it stays that way.

Am I hearing correctly? The psoriasis that affects your skin is an arthritis?

You can have skin psoriasis without having psoriatic arthritis. You can have psoriatic arthritis without having skin involvement.

PsA is a type of arthritis that predominately affedts the tendons, ligaments, and the muscle area where they are attached. This in turn affects the joints and corrodes bone.

I have been to a dermatologist several times regarding the skin plaque on my leg and I've been through all of their treatment, including a skin biopsy and it's still returned. Right now I'm sitting in the sunlight for 15 minutes everyday and hopefully that and the new cream that I was given will clear it. I've tried everything. I think.

This explains it a little better than I can. Lindy

Psoriatic arthritis is a chronic disease characterized by inflammation of the skin (psoriasis) and joints (arthritis). Psoriasis is a common skin condition affecting 2% of the Caucasian population in the United States. It features patchy, raised, red areas of skin inflammation with scaling. Psoriasis often affects the tips of the elbows and knees, the scalp, the navel, and around the genital areas or anus. Approximately 10% of patients who have psoriasis also develop an associated inflammation of their joints. Patients who have inflammatory arthritis and psoriasis are diagnosed as having psoriatic arthritis.

The onset of psoriatic arthritis generally occurs in the fourth and fifth decades of life. Males and females are affected equally. The skin disease (psoriasis) and the joint disease (arthritis) often appear separately. In fact, the skin disease precedes the arthritis in nearly 80% of patients. The arthritis may precede the psoriasis in up to 15% of patients. In some patients, the diagnosis of psoriatic arthritis can be difficult if the arthritis precedes psoriasis by many years. In fact, some patients have had arthritis for over 20 years before psoriasis eventually appears! Conversely, patients can have psoriasis for over 20 years prior to development of arthritis, leading to the ultimate diagnosis of psoriatic arthritis.

Psoriatic arthritis is a systemic rheumatic disease that can also cause inflammation in body tissues away from the joints other than the skin, such as in the eyes, heart, lungs, and kidneys. Psoriatic arthritis shares many features with several other arthritic conditions, such as ankylosing spondylitis, reactive arthritis (formerly Reiter's syndrome), and arthritis associated with Crohn's disease and ulcerative colitis. All of these conditions can cause inflammation in the spine and other joints, and the eyes, skin, mouth, and various organs. In view of their similarities and tendency to cause inflammation of the spine, these conditions are collectively referred to as "spondyloarthropathies."

LinB2008-04-17 10:55:41Thanks for clarifying LinB. When they were trying to figure out if I had family history of auto immune problems I said no. I have an aunt with skin psoriasis but I never associated it with arthritis and after your explanation I still wouldn't.WTBRAF, that's right. Just because there's skin psoriasis in the family doesn't mean that there will be PsA but this is where it gets tangled. If there is skin psoriasis in the family your RD or primary should know about it. That in itself will alert them to look more closely for PsA symptoms. Lindy

Even though I think I have PsA, my RD says no, because I have a low rheumatod factor of 18, as well as a low CCP of 10. That is the only reason she insists it is RA. But I have had pustular lesions on my hands and feet since I was a child. One dermatologist said I have palmoplantar pustulosis, another called it dyshidrotic eczema. It has settled down somewhat since I quit smoking several years ago, but the joint pain is recent -- started last August.

When my joints hurt, the pain always starts first in the muscle and tendons. My fingernails are pitted, and I read that pitted nails + joint pain always = PsA. But still, I have been diagnosed with RA. Not that it makes much difference, I guess, as the treatment is the same, or is it? Is there any reason to be diagnosed correctly with either RA or PsA, either for insurance purposes or treatment-wise? Is there any comfort in knowing you have one rather than the other....is one less damaging or severe?