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What are the primary symptoms of psoriatic arthritis? How is it treated?

By Carol & Richard Eustice, About.com

Updated July 05, 2006

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Question: What are the primary symptoms of psoriatic arthritis? How is it treated?
What are the primary symptoms of psoriatic arthritis? Are there overlapping symptoms with other rheumatic diseases? How is psoriatic arthritis diagnosed and treated? Are new treatments on the horizon for psoriatic arthritis?
Answer: Psoriatic arthritis is a type of arthritis which occurs in association with the skin disease psoriasis. Psoriasis is a skin condition characterized by red, scaly raised areas. It may occur in localized areas or all over the body. In some cases, arthritis may develop before the skin disease is apparent.

Variable symptoms of psoriatic arthritis

There are typically 6 variants of psoriatic arthritis:

(1) Swelling of both the joint and tendon so that the involved toe or finger resembles a sausage

(2) Involvement of the joints next to the finger nails - often those nails will contain tiny pits

(3) Similar appearance to rheumatoid arthritis (RA) - eg. symmetrical involvement of the hands, feet, knees or ankles

(4) Involvement of the spine - typically associated with the HLA-B27 gene

(5) A very destructive, deforming arthritis - rare

(6) Associated with the HIV infection - while uncommon, this typically occurs with a very severe form of psoriasis

  • HIV and Arthritis: What's The Connection?
  • Treatment of psoriatic arthritis

    Medications used to treat psoriatic arthritis are similar to those used to treat rheumatoid arthritis. They include the NSAIDs (nonsteroidal anti-inflammatory drugs), as well as DMARDs (disease modifying anti-rheumatic drugs) including:

  • sulfasalazine
  • methothrexate
  • TNF blockers
  • While all three TNF blockers can be used for this condition, to date, only etanercept (Enbrel) and infliximab (Remicade) are FDA approved for treatment of psoriatic arthritis.

    As opposed to rheumatoid arthritis, there is no definitive study showing that early treatment with the disease modifying drugs makes a diffence in long term outcome, so the choice of therapy is often based on the patients symptoms.

    Related Resources - Psoriatic Arthritis

  • Psoriatic Arthritis
  • Psoriatic Arthritis Screening Quiz
  • Psoriatic Arthritis: Test Your Knowledge
  • Answer provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of Anti-TNF Blockers. The book is a must-have for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read my review of the book.

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