Sometimes the psoriasis to the joints, what they don’t know but many of those Affected. This targeted therapy can the progression and joint destruction, at least slow down. What evidence there is for psoriatic Arthritis, what can Affected parties do, the treatment, and to what new drugs there are.
Who has the skin disease psoriasis, and at the same time, problems with the joints and/or the tendon has a divorce, you should definitely clarify whether, perhaps, the addition of a psoriatic Arthritis. After all, around every fourth of the two million Psoriatriker in Germany has this distinct disease, at least 400,000 people.
Some studies provide evidence to suggest that it could be even a lot more, the psoriatic Arthritis (Psoriasis arthropathica), or abbreviated as Pso Arthritis PsA. The ironic thing: psoriatic Arthritis is in contrast to the Schuppenfelchte still little known. Many of those Affected to know nothing of this additional disease, miss so that the treatment and forego the Chance of improvement.
Psoriatic Arthritis – what is it?
It is established that it is an inflammatory, chronic disease that progresses and is caused by a dysregulation of the immune system. The immune system to attack the body’s own tissue, similar to the rheumatism. This includes the bones, skins and Tendons. Rheumatism otologists see Psoriasis-Arthritis, and therefore, as a variant of rheumatoid Arthritis, dermatologists as a special form of Psoriasis. In the meantime, psoriatic Arthritis is a distinct disease classified belongs to diseases to form the circle of the auto-immune.
The cause of the Pso Arthritis only in the genes
For the formation of psoriatic Arthritis there is a genetic component, on the other hand, trigger factors play a role, such as an Allergy, an infection or possibly Stress.
Usually the first symptoms between the ages of 30 and 50 years of age occur often psoriasis is on the skin then since an average of ten years. Sometimes, the Pso, however, is a first-Arthritis and, later, it comes to the skin plaques. In other cases, the psoriasis occurs in only one place on the body, such as the scalp, or the back of the pack to the navel, or of the anal fold, but it comes to a marked psoriatic Arthritis.
Symptoms of psoriatic Arthritis – the most typical joint problems
Especially common in psoriatic Arthritis the following complaints:
- The end joints of individual fingers or toes swell or all of the joints of a finger, the Tendons can be inflamed, the entire Finger is no longer thick and red (“sausage fingers”, Dactylitis), often the rings fit, the joints pain.
- Pain in the knee, the ankle joint, but hip or shoulder pain, lower back, virtually any joint can be affected.
- Also typical is the morning stiffness of the joints, which diminish after a few hours of motion.
- Inflammation of individual Tendons such as the Achilles tendon
- Inflammation and changes in the nails, which can be crumbly, or dings and the stains have
Often, a plurality of Finger – and toe-joints are asymmetrically affected, i.e. on both sides of the body (asymmetrical type of psoriatic Arthritis) and, sometimes, the inflammation occur symmetrically on only one side of the body (symmetric type).
This is for psoriatic Arthritis is characteristic that the symptoms initially, but over the years, to increase, if the correct therapy is used.
Psoriatic Arthritis to recognize is not easy
Often the symptoms of Psoriasis can be mistaken for Arthritis with those of gout, rheumatism, fibromyalgia, or ankylosing spondylitis. But even if it is psoriatic Arthritis a chronic inflammatory disease, it is important that the other be excluded. Only then the appropriate therapy can be selected.
For diagnosis of psoriatic Arthritis, therefore, belong to:
- Blood test – this is about looking for rheumatoid factors. They are not available in the case of psoriatic Arthritis. You can demonstrate, it could be used by the rheumatoid Arthritis. In addition, the C-reactive Protein are observed in blood markers of Inflammation,.
- Imaging techniques such as sonography, to check about the condition of the cartilage, magnetic MRI resonance imaging, bone, skin, cartilage, and Tendons, as well as x-ray.
However, A special Test that psoriatic Arthritis can be used to clearly diagnose. An important part of the diagnosis is, therefore, in addition to the laboratory tests and early ultrasound, a questionnaire, the pain around the joint, swelling, morning stiffness discussed.
Often, years pass until the correct diagnosis
In practice, however, often so that the Affected often go from doctor to doctor, and long years elapse, until the correct diagnosis is made. “The Problem for me was that the doctor I went because of my back pain, knew I had psoriasis,” says Bianca S. (Name known to the editors). The 45-Year-old had psoriasis as a young adult, later, the back pain began, and her fingers were sometimes swollen. That psoriatic Arthritis was the cause of the problems and the correct diagnosis was made only long after the appearance of the first symptoms, for you to the Problem. Because some of the inflamed joints were attacked by the inflammation.
Therapy of Psoriasis-Arthritis, and in milder cases
It is important, therefore, that in the case of psoriasis, the Doctors replace, such as family physician, dermatologist, rheumatologist, and orthopedist. Through this interdisciplinary collaboration, all of the manifestations of psoriasis are recognized and the best possible treatment can be initiated.
Early diagnosis and rapid initiation of therapy are crucial to ensure that the joints are not affected in duration, about stiffen. The good news: With proper treatment, every second of the patients can be even years of complaint-free, as the German rheumatism-League emphasized.
For the therapy, anti-inflammatory and pain-still playing-relieving medicines have an important role, especially in milder cases of psoriatic Arthritis. The agents such as Ibuprofen or Diclofenac, however, you should be in accordance with medical orders taken. Also cortisone can come at a sharp, acute inflammation of the thrust.
The basis of therapy in Pso Arthritis
In addition, depending on the severity of the psoriatic Arthritis the guidelines of the professional societies, to the base therapy, so-called DMARDs suggest that the acronym stands for Disease-modifying antirheumatic drugs. Its active ingredients can reduce symptoms in many cases, at the same time the skin. For some time the medications are:
- Methotrexate (MTX)
- Cyclosporine A
- Sulfasalazine or
- Leflunomide
You brake the sonic was the end of the immune response in psoriatic Arthritis.
Biologics revolutionize treatment of psoriatic Arthritis
In addition, is constantly looking for new drugs to improve the treatment of psoriatic Arthritis. So as a new substance group have been developed the biologics. They are produced biotechnologically. The active substances can block certain messengers, which are for the inflammation responsible. In order for the inflammation and joint destruction in the ideal can be the case to a standstill. Include biologics:
- Adalimumab
- Certolizumab
- Etanercept
- Golimumab
- Infliximab
This is the so-called Tumor-necrosis-factor(TNF)-alpha inhibitors. TNF-alpha is a proinflammatory cytokine, supporting inflammation. In psoriatic Arthritis, TNF-alpha occurs in membranes in infected Synovial, cartilage, Tendons in large quantity.
In addition, other substances that block other inflammatory messengers are still in the Pipeline. They are directed against certain Interleukins, such as the active ingredient Guselkumab. All these medicines are usually given as an Infusion or subcutaneously injected under the skin.
Physical and occupational therapy in psoriatic Arthritis
But there are still a number of other treatment options that have proven themselves in the case of psoriatic Arthritis, often in combination, in addition with the drugs. Heat and cold treatments, such as cryotherapy.
An important aspect is also to maintain flexibility, and to cope if necessary with AIDS the everyday requirements. Physiotherapy, joint Swimming sports such as and occupational therapy are therefore also important aspects of treatment.
Rounding out the range of therapy options, exercises for relaxation, to reduce Stress and relieve tension, resulting in joint problems often by a posture because of the pain.
Diet against inflammation
Last but not least is proper nutrition, which helps to take the inflammation of the fire. This means, primarily, meat – and sausage waiver, at least during the week, a lot of fresh fruit and vegetables, and adequate Omega-3 fatty acids, such as cold-water fish such as salmon and herring.
Psoriatic Arthritis can be so easy to treat. The best way to ensure an interdisciplinary cooperation of Physicians, to develop the appropriate treatment plan, as well as the cooperation of the patient. This is not only one of the medicines, but to also be active – with joint-friendly exercise and diet, the inflammation not supported.
