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November 24, 2009
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Psoriatic Arthritis

Medical Author: William C. Shiel Jr., MD, FACP, FACR

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Featured patient discussions on psoriatic arthritis

"I first started with psoriasis near my 50th birthday. I did not end up with psoriatic arthritis until about four years later. My psoriasis at times has been severe with pustules on my palms and feet, making it difficult to walk or use my hands for work. I was treated with Soriatane which helped, but I lost my hair. About three years after the Soriatane, the psoriasis returned full force and so did the psoriatic arthritis. I was then treated with methotrexate, which helped but now everything is flaring up again including my Achilles tendon. I strove to lose weight and have lost 28 lbs. which helps the arthritis, and I eat mostly vegetables and fruits and low-gluten grains. I am allergic to fish, so I cannot eat that. I eat very little meat, only chicken (turkey makes my psoriasis flare). I do yoga every day and take long walks. Having retired last year at 62 has relieved some of the stress, and I am mostly able to manage my symptoms with only OTC drugs. The psoriasis condition does run in my family, starting with my grandparents on both sides. We also have many auto immune conditions in our family, including Hashimoto's, lupus and RA."


Patient Discussions are not a substitute for professional medical advice, or treatment.
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What is psoriatic arthritis?

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."

Inflammation of Spondyloarthropathy Illustration


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Psoriatic Arthritis - Describe Your Experience

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The ankle is a "hinged" joint capable of moving the foot in two primary directions: away from the body (plantar flexion) and toward the body (dorsiflexion). It is formed by the meeting of three bones. The end of the shinbone of the leg (tibia) and a small bone in the leg (fibula) meet a large bone in the foot, called the talus, to form the ankle. The end of the shin bone (tibia) forms the inner portion of the ankle, while the end of the fibula forms the outer portion of the ankle. The hard bony knobs on each side of the ankle are called the malleoli. These provide stability to the ankle joints, which function as weight-bearing joints for the body during standing and walking.

Ligaments on each side of the ankle also provide stability by tightly strapping the outside of the ankle (lateral malleolus) with the lateral collateral ligaments and the inner portion of the ankle (medial malleolus)...

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