What are the first signs of psoriatic arthritis

Psoriatic arthritis1 (PsA) is inflammatory arthritis that affects the skin, nail pitting, joints, and other body parts, causing swelling, stiffness, redness, discomfort, and damage. Psoriatic arthritis occurs due to an overactive immune system, which causes inflammation in your joints, skin, and other regions of your body.

It’s a chronic, lifelong disorder that may cause severe joint damage and abnormalities if left untreated. Early diagnosis of psoriatic arthritis is critical, as is urgent therapy. Work with your rheumatologist2 and dermatologist to track your disease activity and change your treatment strategy as needed.

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Psoriatic arthritis may increase your chance of developing cardiovascular diseases, such as heart attack or stroke.

Psoriatic arthritis affects up to a third of patients with psoriasis (PsA). Anyone can develop psoriatic arthritis between the ages of 30 and 50, however, it may strike at any age. It causes inflammation in your joints, especially. It may also affect other sections of the body.

Because certain psoriatic arthritis symptoms3 are similar to those of rheumatoid arthritis, your doctor may order tests to confirm the diagnosis.

8 Symptoms of Psoriatic Arthritis in the Early Stages

Here are some of the most prevalent early indications of PSA. If you are experiencing any of these symptoms, contact your primary care practitioner right away. Preventing further joint deterioration by early identification and treatment of the condition is important.

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1. Exhaustion

People who have psoriasis or psoriatic arthritis might get fatigued for extended periods. Fatigue is defined as a state of exhaustion that continues despite rest. As reported by a 2017 study it is the second most prevalent symptom experienced by patients with PsA, behind the pain.

Excessive tiredness may be caused by a variety of conditions, including chronic inflammation. Certain drugs used to treat psoriatic arthritis, such as methotrexate and leflunomide, have been shown to produce tiredness in certain patients.

2. Nail pitting

According to research, nail alterations may develop in up to 90 percent of patients with PsA, compared to approximately 40 percent of those with psoriasis without arthritis.

Pits are superficial depressions within the nail plate that appear in persons who have psoriatic arthritis and are a sign of the disease. People may note that they have pits adjacent to smoother portions of their nails, which is a common occurrence. This shows that there have been times of symptom flare-ups in the past.

3. Nails with ridges

There is evidence that ridged nails and other nail involvement issues are early symptoms of joint illness, according to a reputable source. These nail issues may manifest themselves many years before the onset of arthritic symptoms.

To avoid complications, individuals should immediately see their doctor if they notice any changes in their nails.

4. Onycholysis.

Onycholysis4 is another common sign of psoriatic arthritis that affects the nails. It is at this point that the nail plate separates from the nail bed. Nail psoriasis is another term used to describe similar nail abnormalities.

Onycholysis is a condition that may develop in conjunction with pitting or ridged nails. In most cases, it is not painful. The nail can change a variety of colors when it peels away from the nail bed. These hues include yellow, white, and purple.

5. Lower back discomfort

People who acquire PsA will have symptoms that are related to the spine in around 20% of the population As a result of the inflammation in the joints of the spine, the spine may become fused. This is known as psoriatic spondylitis.5

6. Dactylitis.

Dactylitis is a condition in which a finger or toe swells up and forms a sausage-like shape. Swelling in the fingers or toes might be painful because of this. Dactylitis may also develop in the presence of gout or pseudogout,6 although it is less prevalent in the presence of other types of arthritis.

When someone with PsA, the swelling affects the entire finger or toe, rather than just the region surrounding the joint, as in most individuals. Individual fingers and toes may also be affected differently as a result of this. If it just affects one hand or foot, this is known as unilateralism.

7. Eyes that are red and swollen

Another early indication of PsA is the development of vision impairments in the affected individuals. These include redness and inflammation, among other things.

PsA patients are at risk for uveitis (inflammation of the front of the eye), which occurs in around 7–25% of cases. The eye might be damaged permanently if this is not treated promptly and correctly.

Other signs and symptoms include:

  • itchiness in the eyes
  • a reduction in peripheral vision
  • light sensitivity blurred eyesight sensitivity to light

8. The stiffness of the joints in the morning

Early in the morning or shortly after a period of rest, joint stiffness may be particularly severe. This stiffness may linger for more than 30 minutes, but it should subside on its own when that time has elapsed.

Some individuals can experience periods throughout the day where they are not stiff at any point, which physicians refer to as remission.

Psoriatic Arthritis Complications

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PSA makes you more prone to acquire various conditions over time, including the following:

Cancer

Lymphoma and nonmelanoma skin cancer 7may be more common in those with PSA.

Heart and circulatory problems. Consult your doctor about your risk and possible remedies.

Crohn’s disease

Mutations in the DNA of people with psoriatic arthritis and Crohn’s disease are comparable. That’s why psoriasis, psoriatic arthritis, and inflammatory bowel diseases including Crohn’s disease and ulcerative colitis have been linked.

Your chances are substantially greater if you have both psoriasis and psoriatic arthritis.

Depression

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Low self-esteem and mood problems such as depression are more common in people with psoriasis and psoriatic arthritis. If you have both psoriatic arthritis and psoriasis, you’re more likely to be depressed. However, treating your psoriasis might help you feel better.

Diabetes

Psoriasis and psoriatic arthritis increase your chances of developing type 2 diabetes. Having severe psoriasis exacerbates the problem.

If you develop signs of type 2 diabetes, such as excessive thirst, hunger, blurred vision, or exhaustion, tell your doctor.

Inflammation

Inflammation of the iris, the colorful area of the eye, may produce discomfort that is exacerbated by bright light. This may result in eyesight issues. This ailment, known as uveitis, will most likely need treatment by an eye doctor.

Gout

When uric acid crystals accumulate in your joints, you get this kind of inflammatory arthritis. Even though uric acid may be obtained from the diet, experts believe it is a consequence of psoriasis and psoriatic arthritis.

Joint pain

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Arthritis mutilans, an uncommon but serious complication of psoriatic arthritis, cause fast destruction to the swollen joints at the tips of your fingers and toes. Severe damage may make basic tasks like walking and clothing difficult because of joint pain.

Syndrome metabolique.

Psoriasis, psoriatic disease, and metabolic syndrome — a group of disorders that includes heart disease, obesity, and high blood pressure — have been linked by researchers. Women with psoriasis and those with severe psoriatic arthritis are roughly twice as likely to get it as the general population.

Diagnose and treat psoriatic arthritis as soon as possible.

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The first step in diagnosing and treating psoriatic arthritis is to have a physical examination. If you are experiencing persistent symptoms, your doctor will discuss them with you. You should tell your doctor if your family has ever suffered from PsA, psoriasis, or any of the other autoimmune illnesses.

Tenderness, swelling, restricted mobility, and changes in the skin or nails will all be checked for by your health care professional.

There is currently no treatment for PsA. However, this does not rule out the possibility of managing the condition while maintaining a healthy and active lifestyle. You may collaborate with your healthcare team to choose the most appropriate therapy for you.

Prevention

It is not always feasible to prevent the development of psoriatic arthritis from occurring and the first step is to have psoriatic arthritis medically reviewed.

Many individuals acquire psoriatic arthritis (PsA) roughly 10 years after first experiencing the symptoms of psoriasis. Other persons may acquire PsA even if they have no indications of psoriasis at the time of diagnosis.

Consequently, determining who will acquire the illness may be challenging for healthcare providers.

Conclusion

If someone has psoriasis, they should be aware of the signs and symptoms of PsA in the early stages of the disease. So that they may talk with a healthcare expert as soon as new symptoms appear, they should do so right away. It is critical to treat PsA as soon as possible in order to reduce the risk of lasting harm.

It is crucial to be aware of the signs of PsA if you have psoriasis, although not everyone who has psoriasis will acquire the condition.

It is important to note any new or unusual joint symptoms during your medical appointments so that your doctor can begin treating your PsA as soon as possible to prevent additional joint damage.

FAQs

Q. Where does psoriatic arthritis first appear?
  • Mainly occurs in the fingers (in the joints closest to the nail), wrists, ankles, and knees. Symptoms such as pain, tenderness, warmth, and swelling, may affect different sides of the body (right hand and left knee). This may be referred to as peripheral arthritis.
Q. At what age does psoriatic arthritis start?
  • It most often starts in those aged 15 to 30, with psoriatic arthritis commonly developing between the ages of 25 and 50. However, both conditions can start at any age. In about one in five cases, joint problems are diagnosed before any obvious signs of psoriasis.
Q. Is there a blood test for psoriatic arthritis?
  • Psoriatic Arthritis Blood Test: Anti-Cyclic Citrullinated Peptide Test. Blood tests that look for the presence of anti-cylic citrullinated peptide antibodies (anti-CCPs), which are inflammatory, are commonly used to diagnose rheumatoid arthritis, but anti-CCPs can also indicate psoriatic arthritis.
  1. Moll, J. M. H., and V. Wright. “Psoriatic arthritis.” Seminars in arthritis and rheumatism. Vol. 3. No. 1. WB Saunders, 1973. ↩︎
  2. Kolasinski, Sharon L., et al. “Subspecialty choice: why did you become a rheumatologist?.” Arthritis Care & Research 57.8 (2007): 1546-1551. ↩︎
  3. Antoni, Christian, et al. “Infliximab improves signs and symptoms of psoriatic arthritis: results of the IMPACT 2 trial.” Annals of the rheumatic diseases 64.8 (2005): 1150-1157. ↩︎
  4. Baran, Robert. “Onycholysis.” Nail Therapies (2021): 89-94. ↩︎
  5. Chandran, Vinod. “Psoriatic spondylitis or ankylosing spondylitis with psoriasis: same or different?.” Current opinion in rheumatology 31.4 (2019): 329-334. ↩︎
  6. Sidari, Anthony, and Erica Hill. “Diagnosis and treatment of gout and pseudogout for everyday practice.” Primary Care: Clinics in Office Practice 45.2 (2018): 213-236. ↩︎
  7. Hu, Shasa, et al. “Skin cancer and non‐Hodgkin’s lymphoma: examining the link.” Dermatologic surgery 31.1 (2005): 76-82. ↩︎

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