Scaly Skin? Check for Arthritis

Do you suffer from dry, scaly skin? New research shows that psoriasis may be responsible for the development of a form of arthritis, called psoriatic arthritis. This form of arthritis arrives in the presence of psoriasis and can cause stiff joints, pain in the joints, and the eventual deterioration of certain joints. Read more about the connection between your skin and arthritis, and the diagnosis your doctor may be missing, below.

What is Psoriasis?

According to research from UK universities, 1.8 million people in the UK suffer from psoriasis- and research from psoriasis.org shows that nearly 8 million people in the US suffer from the condition. Psoriasis is a condition that causes itchy, red patches of skin around elbows, the scalp, and other areas of the body.

Up to 30 percent of these individuals will develop psoriatic arthritis, which is severe pain and inflammation in the joints which has a similar effect to rheumatoid arthritis. Usually, it affects the back, neck, toes and fingers, knees, and ankles. Severe cases can damage or destroy the joint tissue in these areas.

According to dermatologist Dr. Justine Hextall from the Western Sussex Hospital NHS Trust:

“Psoriasis is far more than just a scaly skin condition. Often patients don't realize that it can affect the whole body. As well as psoriatic arthritis, patients are also at increased risk of heart disease, stroke, and type 2 diabetes. We think this is mainly because it can create widespread inflammation in the body, although we don't know the exact mechanisms involved.”

According to Psoriasis.org, psoriasis is a common skin disorder that affects about 2 percent of the population. It can occur in both men and women at any age. The condition may become itchy, but it is not infectious and usually doesn’t cause scarring. There are several types of psoriasis that are identified by their appearance.

Plaque

Red patches covered in flaky, white scales are called plaque. This is the most common form of psoriasis, and it often is seen on the elbows, scalp, or knees. When scratched, the sores may split and bleed.

Guttate

Teardrop-shaped pink spots can occur on the arms, legs, or torso. Usually, this form of psoriasis comes and goes suddenly after an infection (like strep throat), and may be mistaken for an allergy attack or rash. Usually, guttate psoriasis hits children and young adults.

Inverse (flexural)

This form of psoriasis strikes as a rash-like condition in the folds of the skin, such as near the armpits or groin. Inverse psoriasis is itchy and is made worse by friction and perspiration.

Nail Psoriasis

Nail psoriasis causes the nails to develop dents and become discolored. The nails may grow strangely and the nails may become loose or separate from the nail bed or crumble.

Erythrodermic

Erythrodermic psoriasis is extremely rare. The condition creates plaque-like scales on 90 percent or more of the body. The scales are itchy and the patient usually requires hospitalization. The patient may also have an increased heart rate and a fluctuating body temperature.

Pustular

Pustular psoriasis is a severe form of psoriasis that combines plaque psoriasis with pus-filled blisters. These blisters can affect the palms and soles of the feet, on the fingers and toes, or generalized across the body. When the blisters appear throughout the body, it can cause weight loss, fever, chills, or fatigue.

What is Psoriatic Arthritis?

Psoriatic arthritis is inflammation in and around the joints in people who also have psoriasis. It also affects connective tissue and is very variable. Scientists are not sure why psoriasis may lead to arthritis, although some research suggests that an overactive immune system is responsible for both conditions. The immune system can over-react and produce inflammatory chemicals in both the skin and joints. The extra skin cells created lead to the itching and red patches of skin.

A similar process may be occurring inside the joints, leading to psoriasis arthritis. Research shows that up to 30 percent of individuals with psoriasis may also have psoriasis arthritis. This means that over 2 million Americans may have psoriatic arthritis.

Triggers for developing psoriasis arthritis are genetic, environmental triggers, injuries, infection, or stress- basically, conditions that cause the immune system to react strongly. 40 percent of patients with psoriasis arthritis also have a relative with the condition.

The Missing Link

In many cases, doctors may miss diagnosing psoriasis arthritis. This is because, in many patients, the psoriasis patches are invisible or mild. Sometimes, arthritis develops before the skin condition develops. When the diagnosis does occur, a patient’s joints are also badly damaged.

According to University of Glasgow rheumatologist Dr. Stefan Siebert:

“Patients usually haven't heard of psoriatic arthritis yet it can be just as serious and disabling as rheumatoid arthritis. Some dermatologists and GPs don't make the link or pick it up either - there is a large undiagnosed group of patients out there.”

Some doctors may also misdiagnose psoriasis arthritis as another form of arthritis. Patients may get the wrong treatment, leading to joint deformity. According to Dr. Deibert, there are clear signs that a patient may have psoriasis arthritis:

According to Dr. Siebert, psoriatic arthritis affects not only the joints but also tendons. Usually, the condition affects individuals with high blood pressure, obesity, fatty liver disease, or diabetes.

Scientists have not uncovered the precise link between these conditions, but some research has suggested that all of these conditions arise from chronic inflammation in the body, usually caused by an unhealthy diet full of unhealthy fats and sugars. Currently, there is no blood test to identify psoriatic arthritis, because according to Dr. Siebert, 50 percent or more individuals with psoriatic arthritis show normal blood work.

Instead, doctors must work to diagnose the problem by eliminating other types of arthritis. Dr. Siebert believes that all patients with joint pain should be asked if they ever suffer from psoriasis and ask all psoriasis patients if they suffer from joint pain. Psoriatic arthritis will get worse over time, which is why early diagnosis is essential to prevent further joint degeneration.

Treatment for Psoriatic Arthritis

In the United States, patients with psoriatic arthritis currently have five treatment options. These include DMARDs, alternative medicine, biologics, oral medication, and NSAIDs.

DMARDs

Disease modifying anti-rheumatic drugs (DMARDs) are popular medications for psoriatic arthritis. These medications suppress joint inflammation through the use of drugs. These medications are some of the most commonly used to treat the disease. 

Biologics

Biologics are used for the more severe cases of PA. Biologics are protein-based drugs made from living cells cultured in a lab. Biologics are designed to target specific parts of the immune system by blocking T cells, tumor necrosis factor-alpha (TNF-alpha), or interleukins 12 and 23. These cells are heavily involved in the production of psoriatic arthritis.

NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that are used to block and repress inflammation. Many forms of this medication are available over-the-counter. Usually, NSAIDs are only used in mild cases, since they mainly relieve pain rather than slow degeneration.

Oral Medication

The newest form of treatment for PA is oral medications that specifically target the immune cells that break down joints and cause pain. These treatments target molecules and correct the overactive immune response.

Alternative Medicine

Psoriasis.org lists several alternative treatment options for individuals who do not want to take medications. In general, alternative medicines are best to use when the disease is still mild, simply because it can take time to reverse problematic symptoms and joint degeneration. Most alternative processes involve controlling inflammation through diet, de-stressing, and exercise.

Alternative Therapies: According to Psoriasis.org, massage, acupuncture, acupressure, Reiki, meditation, and aromatherapy may all be effective in helping promote health in the body. Most of these therapies focus on eliminating stress and relaxing the body. Some studies indicate that a stressed lifestyle can promote inflammation in the body, leading to the overabundance of hormones like cortisol, which leads to weight gain. Since stress and many weight-related disorders are linked with psoriasis, reducing the effects of a stressful lifestyle can only help in reducing symptoms.

Exercise: Exercise will promote health in the body and can also help regenerate the joints. Strength exercises have been shown to help improve joint health, which may be able to counteract some of the effects of PA. Exercise will also help prevent obesity and other common health problems linked with the development of PA.

Herbal Remedies: Herbs and supplements have been shown in some studies to benefit the health of the joints and fight inflammation throughout the body. 

Diet: According to Psoriasis.org, individuals who follow an anti-inflammatory diet show reduced symptoms of psoriasis and PA. Avoid foods that increase inflammation in the body, like red meat, processed foods, vegetable oils, and nightshade vegetables (like tomatoes, potatoes, and peppers). Foods that reduce inflammation include fatty fish, walnuts, olive oil, carrots, squash, blueberries, and other berries, figs, and leafy greens.

Have Psoriasis? Watch for Joint Pain

Although some doctors miss the connection, there is a vital link between psoriasis and the development of PA. An undiagnosed joint condition can lead to degeneration which can have debilitating effects. Both psoriasis and PA are linked to an overactive immune system, which may be caused by an unhealthy diet and a high-stress lifestyle. The best way to prevent psoriasis from developing into PA is to eliminate stress, exercise regularly, and eat a healthy diet filled with anti-inflammatory foods. If you suspect you may already have PA, consult with a doctor right away. Supplementing with herbs and vitamins that promote joint health and fight inflammation may also help reduce or eliminate PA symptoms.