Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects joints and connective tissue. It occurs when your immune system attacks healthy cells in your body. This causes inflammation and swelling in your joints. The condition usually starts around age 40 and may last for many years.
Psoriatic arthritis is a type of arthritis that is especially likely to affect people with psoriasis. People with psoriatic arthritis experience joint pain and chronic inflammation. This disease can also cause more or less serious complications.
While most people who develop psoriatic arthritis (PsA) already have psoriasis, it is possible to develop it without having psoriasis first. Psoriasis is a skin condition caused by an autoimmune reaction.
A 2015 analysis found that estimates of its prevalence among people with psoriasis ranged from 6% to 41%, depending on the definition used by the expert.
Possible Complications of Psoriatic Arthritis
Diabetes
Results from a 2018 rheumatology study suggest PA increases the risk of type 2 diabetes.
The researchers compared people with psoriasis with people with PA and with the general population.
The risk of type 2 diabetes in people with PA was about 40% higher than in the general population and more than 50% higher than in people with psoriasis.
Eye problems
According to the Arthritis Foundation, between 7% and 25% of people with AP will develop uveitis, which is inflammation of the uvea – the middle layer of the eye between the retina and the sclera. Uveitis is painful and can also threaten a person’s sight. AP can also affect the skin around the eyes.
Steroids can help reduce inflammation and protect eyesight, but they also have side effects. It is important to discuss the risks and benefits of this treatment with a doctor.
Some people also develop eye infections, such as conjunctivitis.
Cardiovascular problems
Psoriasis can cause chronic inflammation that over time can damage blood vessels, increasing the risk of heart disease, stroke, and heart attack.
People with AP have an even higher risk of heart disease than those with psoriasis alone, according to the authors of a review published in 2018 .
A healthy lifestyle can help reduce the risk of heart health problems.
- maintain a healthy weight;
- be physically active;
- have a balanced and diversified diet.
Depression
Severe joint pain is a common symptom of PA. For some people, joint pain can affect mobility and daily task performance. It can also have a serious impact on a person’s mental health.
Some people with chronic pain develop depression or anxiety. Pain-induced depression may be more resistant to treatment than typical depression, according to an analysis published in 2017.
In another analysis from 2017, of 186,552 people with psoriatic arthritis, the prevalence of depression was 21.2%.
Lung problems
Chronic inflammation can damage the lungs, which can lead to a lung health condition called interstitial pneumonia.
Interstitial pneumonia is a life-threatening complication of ILD. A 2018 analysis found that 2% of 392 people with psoriasis had interstitial pneumonia. However, only a fifth of the participants also had psoriatic arthritis.
Stomach and digestion problems
Chronic inflammation can make digestion more difficult, causing problems such as diarrhea and constipation. People with psoriatic arthritis are also more vulnerable to inflammatory bowel disease.
A study found that people with both psoriasis and PsA had a higher risk of Crohn’s disease than those with psoriasis alone.
Liver and kidney problems
PA also increases the risk of kidney disease and non-alcoholic fatty liver disease.
The risk of liver disease may be higher in people with other risk factors for liver disease, such as obesity and metabolic syndrome.
Since drinking alcohol can damage the liver, a doctor may recommend cutting down on alcohol intake.
Prevention
Regular exercise can help fight the complications of APS.
To prevent complications from psoriatic arthritis, people with psoriasis should consult a medical specialist.
Psoriasis is a complicated disease. Many people with the disease notice that environmental factors, such as diet, seasonal changes, or infections, trigger symptoms. Controlling these factors can reduce the risk of psoriasis flare-ups, as well as minimize symptoms of AP.
Comprehensive psoriasis treatment, including the use of psoriasis medications, can help. The authors of a study indicate that targeting specific inflammatory markers may improve psoriasis outcomes, although there is no evidence that this strategy reduces the overall risk of PA.
It is not always possible to prevent PA or its complications. For people who develop joint pain despite prevention strategies, treatment can minimize the risk of serious joint damage and other complications.
Treatments that may be recommended are:
- anti-inflammatory drugs;
- corticosteroids;
- light therapy;
- antirheumatics.
Certain lifestyle strategies, such as regular exercise, eating a nutritious diet, and maintaining a healthy body weight can reduce the risk of serious complications.
People who develop complications may need to adopt additional strategies to prevent these complications from causing serious health problems.
For example, a person with diabetes may need to follow a low glycemic index diet or use insulin to control blood sugar. A person with heart disease may need to take blood pressure medication.
Summary
Psoriatic arthritis is a serious autoimmune disease that causes the body’s immune system to attack healthy tissue in the joints.
Comprehensive medical care can significantly reduce the risk of serious complications while making it easier to manage symptoms.
Most people with psoriatic arthritis should see a rheumatologist or autoimmune disease specialist to get the best possible care.