dpain, swelling and stiffness in the joints: these are just some of the symptoms ofpsoriatic arthritisa disease chronic inflammatory that affects people affected by psoriasis.
Indeed, it is estimated that in About 30% of casespsoriasis, a skin disease from which almost 1,500,000 Italians suffercan also affect the joints. If today, with the advent of the biological medicines, the disease can be kept under control, it is essential recognize symptoms early. In fact, it must be considered that, unlike psoriasis, whose skin manifestations are quite evident, psoriatic arthritis is not immediately recognizable and if not diagnosed in time it can severely damage your joints causing permanent disability.
What is Psoriatic Arthritis?
“There psoriasis should be understood as one syndromearound which other diseases can arise – explains Dr Piergiorgio Malagoli, dermatologist and head of the Psocare Unit at the IRCCS Policlinico San Donato – some of the metabolic type and others of the cardiovascular type. However, the best known is certainly psoriatic arthritisor an arthritis that has a trigger mechanism identical to that of the cutaneous form ».
Some patients more at risk
At the base, as in the case of psoriasis, one genetic predisposition to which triggering factors add up which lead the immune system to attack the skin, in the case of psoriasis, and the joints, in the case of psoriatic arthritis.
In most cases (about 75%) the cutaneous manifestation precedes that affecting the joints but not only. Some people with psoriasis have a greater risk to also develop psoriatic arthritis.
«Patients who suffer from psoriasis in particular venues such as the scalp, genitals and nails – explains Dr. Malagoli – they are more at risk of developing arthritis».
Psoriatic arthritis: early symptoms to watch out for
So what are the alarm bells that should not be underestimated?
«First of all it must be said that psoriatic arthritis must be treated when it is still in an early form – specifies the dermatologist – The first signs are generally a tiredness felt in the morning, upon waking up, together with episodes of swollen fingers and toes. We talk about ‘sausage finger’ because it becomes swollen, sore and hot, a condition that tends to go away on its own. Psoriatic arthritis can also manifest as pain in some joints, especially the Achilles tendon and the joints of the hands and feet. They may be interested too knee and elbow but it is there dactylitisin particular, or the swelling of the hands and feet, to be considered a specific sign of the disease».
Two types of psoriatic arthritis
But be careful: in some cases, episodes of low back pain may also occur.
«However, it is necessary to distinguish two different types of psoriatic arthritis – explains Dr. Malagoli – One is that peripheral which affects the joints, such as the hands, elbows, knees, feet and shoulders. Another, defined axialinstead determines manifestations affecting the spine with neck pain and low back pain».
The importance of early diagnosis
Locate i symptoms time can make a difference: the early diagnosis in fact, it is much more important for psoriatic arthritis than for psoriasis itself.
“If a patient presents with a picture of psoriasis that has lasted for twenty years, we can intervene with biological drugs, bringing the skin back to twenty years earlier – explains Dr. Malagoli – Unfortunately, the same is not true with arthritis because there disease causes bone degeneration on which it is not possible to obtain an improvement. Once diagnosed, the disease can only be prevented from progressing. This also explains why most psoriatic arthritis patients see a dermatologist first. The alarm bell for patients are the skin signs of psoriasis. Then it is we dermatologists who, through the anamnesis, bring out what may be the pictures at risk of arthritis ».
How the diagnosis is made
The early symptoms should therefore not be ignored but require the expert opinion who can make a correct diagnosis.
“Besides an accurate medical historyto be sure that the symptoms reported by the patient are attributable to psoriatic arthritis, we proceed with the instrumental diagnosis – explains the dermatologist – for peripheral forms it is a question of performing a simple one ultrasound to evaluate the presence of inflammatory conditions that are defined as enthesitis, or tendon inflammation specific to psoriatic arthritis. For the axial form, however, one is needed resonance magnetic».
How is psoriatic arthritis treated?
The good news though is that today you can count on it effective drugs, able to intervene both on the typical skin manifestation of psoriasis and on the inflammation of the joints.
“THE Biological medicines today make it possible to cure both forms well – explains the dermatologist – Up to 10 or 15 years ago therapies for psoriasis and those for psoriatic arthritis were distinct. It meant that if the skin condition improved with the use of creams, topicals or oral medications, the same treatment did not allow to intervene also on the psoriatic arthritis. It needed one double management: on the one hand the rheumatologist who treated the joints, on the other the dermatologist who treated the skin. Now that we are able to detect arthritis at a very early stage, psoriatic arthritis can also be treated by the dermatologist».
How do biologics work?
Young woman scratching her arm
Once diagnosed, psoriatic arthritis can therefore be kept under control with biological drugs that also act on the skin.
“However, not all biological drugs have a dual indication for psoriasis and psoriatic arthritis – concludes Dr. Malagoli – therefore the research must be done depending on whether you are faced with a predominantly arthritic or, on the contrary, cutaneous picture. In any case, today, as I said, with a single drug we are able to control both of these forms».
Psoriatic arthritis: help from artificial intelligence
Patients suffering from psoriasis can now also count onartificial intelligence to recognize the signs of psoriatic arthritis early and refer to a specialist.
In fact, it has been launched for some time now AdaHealth (developed and provided by Ada Health GmbH in collaboration with Novartis). It is a tool based on an online testavailable on the site LaPelleContawhich, considering the answers to some specific questions, allows you to identify the possible cause of various symptoms attributable to various diseases including, of course, psoriatic arthritis.
Although the result of the test cannot replace, in any case, a consultation or a visit to a specialist, answering the questions in the questionnaire i patients can print the pdf with the results and then share them with your doctor. There is also a list on the site Reference centers for the treatment of psoriatic arthritis.
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