Psoriatic arthritis

Az arthritis psoriatica (AP) is a complex and chronic inflammatory disease that involves simultaneous involvement of the skin and joints. This condition is associated with psoriasis and can have serious consequences if left untreated. AP not only affects the physical condition but also has a significant impact on the quality of life of those affected, making it important to recognize its symptoms as early as possible and to initiate appropriate treatment.

A betegség jellemzői

The disease is characterized by the fact that arthritis usually occurs asymmetrically, particularly affecting the distal joints of the fingers. In men, inflammation of the spinal joints is more commonly observed, while in women, the small joints of the hands and feet are more affected. Psoriasis affects a small portion of the population, but the prevalence of AP among those suffering from psoriasis can be significant, reaching up to 10%.

Due to the diversity of symptoms and risk factors, the treatment of psoriatic arthritis is a complex task that requires close collaboration among medical professionals.

Az arthritis psoriatica kialakulása

The history of the development of psoriatic arthritis dates back several centuries. The first documented cases appeared in the Middle Ages when the disease was referred to as “biblical leprosy,” and one of the treatments was sending patients to monasteries. Centuries later, specialists considered it a form of leprosy until the late 19th century. At that time, it was discovered that immunosuppressive treatment in patients who had undergone bone marrow transplantation led to improvements in psoriatic skin diseases.

This observation shed new light on the disease and initiated the process through which AP was classified as an immune-mediated condition. In addition to genetic predisposition, various external factors, such as infections, obesity, smoking, stress, or certain medications, can contribute to the development of the disease. These factors influence not only the onset of the disease but also the worsening of symptoms.

A prominent role among the risk factors is played by family clustering. It is common for a close relative to also be affected among patients with psoriasis. For example, if one parent suffers from psoriasis, children have about a 10% chance of inheriting the disease, while if both parents are affected, this chance can increase to as much as 50%.

A betegség tünetei

The symptoms of psoriatic arthritis are diverse and have a significant impact on the daily lives of those affected. One of the most characteristic symptoms of the disease is lower back pain, which typically occurs at night or in the early morning and can be alleviated by movement. This complaint is particularly common before the age of 40 and can be a warning sign of the disease’s presence.

Additionally, arthritis occurs asymmetrically, most frequently affecting the last joints of the fingers or the lower limbs. As the disease progresses, pain may also be experienced at the attachment sites of tendons and ligaments, such as around the Achilles tendon, especially under load. Furthermore, nails affected by psoriasis are also among the signs of the disease, and swelling of the fingers or toes, known as “sausage digits,” may occur.

Psoriatic arthritis not only causes musculoskeletal complaints but can also be associated with other complications, such as cardiovascular problems, intestinal inflammations, and eye inflammations. Considering these complications, establishing a diagnosis is particularly important, as timely treatment of the disease can significantly improve quality of life.

A diagnózis és a kezelés folyamata

The diagnosis of psoriatic arthritis is a complex task that requires close collaboration between dermatologists and rheumatologists. The diagnosis must take into account the medical history, current complaints, physical examinations, as well as the results of laboratory and imaging tests. AP can be classified into several subgroups, making an accurate diagnosis essential for appropriate treatment.

The goal of treatment is to eliminate symptoms and prevent the progression of the disease. To achieve this, it is also important to influence environmental factors, such as reducing stress, maintaining proper nutrition, quitting smoking, and engaging in regular physical activity. For obese patients, weight loss also plays a significant role in the treatment of the disease.

Treatment options vary widely, including pharmacotherapy, which may involve steroids, immunomodulators, and biological therapies. Physical therapy, heat or cold treatments, and surgical interventions may also play a role in treatment. The aim is for patients to achieve as complete symptom relief as possible, thereby improving their quality of life.