Medical News Today: How does psoriatic arthritis affect the body?

People with psoriatic arthritis may have symptoms of both psoriasis and arthritis. The condition causes widespread inflammation that impacts many systems in the body from the immune system to the digestive system.

Psoriatic arthritis or PsA is a type of arthritis that affects up to 30 percent of people who have the skin condition psoriasis.

Here, we explore the many effects of PsA on the body, including on a person’s vision, digestion, breathing, and movement. We also discuss treatment options for the condition.

1. Effects on the skin, hair, and nails

Nail psoriasis
Thickened nails are a classic symptom of psoriasis that people with PsA may experience.

The skin, hair, and nails are also known as the integumentary system.

People with PsA tend to experience the classic symptoms of psoriasis, including rough, red patches on the skin and thickened nails.

Psoriasis causes these effects by speeding up the life cycle of skin cells. New cells move to the outer layer of skin in a few days rather than weeks.

Doctors think this process occurs because the body tries to heal a wound or fight an infection that is not there.

These new cells rapidly build up on the skin to form the itchy, scaly patches that characterize psoriasis. The skin may feel warm and turn red due to widened or dilated blood vessels. The patches may sometimes be painful.

When psoriasis affects the skin on the scalp, the flakes may be mistaken for dandruff or seborrheic dermatitis.

PsA usually impacts the joints closest to the nail in a person’s fingers and toes. Nails can turn thick, rough, and rigid. They discolor or develop pits. In some cases, the nail can separate from the nail bed, known as onycholysis.


2. Effects on the musculoskeletal system

PsA occurs when the immune system mistakenly launches an attack on the body.

Along with skin changes, this abnormal immune reaction causes inflammation of the joints, affecting the musculoskeletal system in several ways.

Inflammation causes pain, stiffness, and swelling in one or more joints, making it difficult to move the joints. Fingers and toes may swell and take on a sausage-like appearance known as dactylitis.

People with PsA will often experience neck and back pain and have difficulty bending their spine. When these symptoms occur, it is known as spondylitis.

How does it affect cartilage?

The cartilage at the end of the bones can become damaged by long-term, chronic inflammation. The bones eventually rub against each other, causing further pain and joint damage. Inflammation can also lead both to bone erosions and extra bone growth.

In addition to bone damage, chronic inflammation affects the surrounding ligaments and tendons.

3. Effects on the immune system

As PsA is an autoimmune condition, it affects the body’s immune functioning.

When the immune system functions normally, it kicks into action to fight bacteria and viruses. Autoimmune conditions cause the body to turn on itself and attack its own structures when no invaders are present.

In PsA, the body attacks the joints, tendons, and insertion points of tendons and ligaments (entheses), and skin in the case of PsA.

Researchers do not fully understand why this happens. They think some bacterial infections, including strep throat or skin bacteria, may trigger PsA.


4. Effects on the eyes and vision

Inflammation in and around the eyes can affect vision. Approximately 7 percent of people with PsA will develop uveitis, which is a group of diseases related to eye inflammation.

Uveitis is more common in females, and up to 17 percent of children with PsA have uveitis. In comparison, just 0.1 percent of Americans who do not have PsA will get uveitis.

Psoriasis-related eye conditions can cause a loss of vision, in rare cases, if not diagnosed early.

5. Effects on the digestive system

man with ibd in pain
Inflammation links IBD and PsA.

There is a link between inflammatory bowel disease (IBD) or colitis disease and PsA because inflammation underlies both conditions.

Crohn’s disease is another type of inflammatory bowel disease that causes diarrhea and other gastrointestinal problems.

People with PsA are at substantial risk of developing IBD disease in comparison to the general population, according to research. Other studies suggest that psoriasis is eight times more common in people with Crohn’s disease.


6. Effects on the respiratory system

If inflammation spreads to the lungs, it can cause a condition called interstitial lung disease. However, interstitial lung disease has a stronger association with rheumatoid arthritis, which is another form of inflammatory arthritis, than with PsA or psoriasis.

Nevertheless, inflammation in the lungs causes scarring over time. The scarring or fibrosis is irreversible and eventually affects breathing and the ability to get enough oxygen into the body. Other symptoms include coughing and fatigue.

7. Effects on the cardiovascular system

According to the American College of Cardiology, cardiovascular disease is a major cause of illness and death in people with chronic inflammatory disorders, such as psoriasis and rheumatoid arthritis.

Chronic inflammation damages blood vessels by making them thicker, harder, and causing scarring. These effects increase the risk of heart attack and stroke.

Also, people with PsA often have other risk factors that put added stress on the blood vessels and the cardiovascular system, such as obesity, high blood pressure, diabetes, and high cholesterol.


8. Effects on mental health

In addition to causing physical symptoms, having PsA can impact mental and emotional health. People with the condition may experience anxiety and depression as they worry about their health, their future, and their family.

Living with chronic pain may cause people to exhibit symptoms of depression, such as a loss of interest in things they once enjoyed and persistent sadness.

Psoriasis and PsA may also impact self-esteem and cause feelings of embarrassment, especially when treatments do not adequately manage symptoms.

How do you treat PsA?

Family walking in the woods
Regular exercise and maintaining a healthy weight are both beneficial for people with PsA.

There is no cure for PsA, but people with the condition can work with their doctor to formulate a treatment plan. A robust treatment regimen can control symptoms and improve quality of life.

Treatment options include:

  • Medication, primarily nonsteroidal anti-inflammatory drugs or NSAIDS, to control pain, treat skin symptoms, and prevent joint damage.
  • Steroid injections to ease inflammation.
  • Joint replacement surgery to replace damaged joints.

Lifestyle changes and home remedies are also beneficial for people with PsA. These include:

  • changing the way everyday tasks are done to protect joints
  • maintaining a healthy weight
  • engaging in regular exercise
  • resting and relaxing when necessary
  • eating an anti-inflammatory diet
  • seeking support from others, such as family, friends, or a therapist

Takeaway

PsA results in symptoms of both arthritis and psoriasis. It causes widespread, chronic inflammation that affects the joints, entheses, the skin, and other body systems.

Although there is no cure for the condition, people can improve their quality of life by managing their symptoms by finding the correct medical treatments and making lifestyle changes.

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