By Dr. Manpreet Sethi, OSMS Board-Certified Rheumatologist

Dr. Sethi is seeing patients at our Fox Valley clinic in Neenah. Schedule an appointment with her here.

The word “psoriasis” most likely conjures up visions of red, itchy, scaly patches of skin; rough elbows, crusty knees, and flaky scalps. Yes, these are common issues associated with psoriasis. But so is arthritis. In fact, approximately 30% of psoriasis cases are linked to arthritis.

What is Psoriasis?

Psoriasis occurs when skin cells are replaced more quickly than they should. Research suggests it’s caused by a problem with the immune system, so it is considered an autoimmune disease. Someone at any age can get develop psoriasis, but it’s usually seen in people ages 30-50.

As with any disease, psoriasis affects different people in different ways. Often times it affects the elbows and knees. But it can also affect the entire body, soles of the feet and even fingernails and toenails. The arthritis associated with psoriasis is called Psoriatic Arthritis, and it too can vary from patient to patient. In some cases, it can be mild. In other cases, it can be severe and even deforming. Psoriasis tends to occur in flare ups, lasting anywhere from a few weeks to a few months. It is chronic, and unfortunately, there is no cure.

Risk Factors

Like other autoimmune disorders, there are more than likely multiple factors involved. The main factor is family history; nearly 40% of patients have had psoriasis in the family. Other risk factors include:

• Smoking
• Alcohol use
• Obesity
• Infections (strep throat or skin infections)
• Certain medications (lithium, high blood pressure, antimalarial)
• Weather (particularly cold, dry conditions)
• Stress

It Needs To Be Taken Seriously

As an autoimmune disorder, psoriasis attacks the body from the inside and is a multisystem chronic disease. This means it manifests in more places than just the skin. Psoriatic arthritis is a prime example. It manifests in the joints and causes swelling, stiffness, and pain to sometimes the point of debilitation. Other ways psoriasis affects the body include:
Obesity and metabolic syndrome (which also create a higher risk for diabetes and heart disease)

• Fatty liver disease
• Kidney disease
• Cancer
• Crohn’s disease
• Bone disorders
• Parkinsonism
• Depression

When To See A Rheumatologist

Although joint pain is common in the same age group (30-50), a certain pattern of inflammation indicates the presence of psoriatic arthritis. A rheumatologist can help determine if the joint pain is from degenerative arthritis, gout, or psoriatic arthritis. An in-office evaluation, clinical exam, and in some cases, a blood draw, x-rays, and the removal of joint fluid can all help determine whether or not a patient has psoriatic arthritis.

Treatment

Because psoriatic arthritis can take many forms, the treatment plan is tailored to each patient. A collaborative approach involving the patient, primary care provider (PCP), dermatologist, and rheumatologist is ideal to assure the best care experience and outcome.

If you have swelling, pain, or stiffness in your joints, please schedule an appointment with me or one of our rheumatologists. We will figure out the cause and work together to determine a treatment plan that’s right for you.