psoriatic arthritis

Arthritis is a condition that affects the joints?the cushioning surfaces between bones?that leads to pain, stiffness, swelling, and reduced range of motion. Psoriatic arthritis is a form of the disease that causes not only sore and swollen joints, but also patches of red and silvery scales, called plaques, to form on the skin.

Lifestyle changes such as starting an exercise program can also help people manage psoriatic arthritis. Exercise is a good way to maintain flexibility and range of motion in the joints. Walking, cycling, swimming, and yoga are all low-impact exercises that strengthen joints.

About 15 percent of people with the skin condition, psoriasis, will also develop psoriatic arthritis. Psoriatic arthritis is caused by an overactive immune response, which attacks the joints and leads to the excess production of skin cells. The joints?especially those in the fingers, toes, spine, and pelvis?become inflamed. Excess skin cells die, slough off, and form scaly patches on the skin. Some people also develop nail changes like pits in the nail or a separation of the nail from its bed. Skin symptoms usually start before the joints become affected.

Treatment for psoriatic arthritis aims to slow disease progression, bring down swelling, reduce pain, and prevent permanent joint damage. Often the first step is to take a nonsteroidal anti-inflammatory drug (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve) to control pain and swelling. Some people with psoriatic arthritis take disease modifying anti-rheumatic drugs (DMARDs) to slow the rate of joint damage. These medicines include sulfasalazine (Azulfidine), methotrexate (Rheumatrex, Trexall, Otrexup), or leflunomide (Arava). Recently introduced biologic drugs such as adalimumab (Humira), etanercept (Enbrel), golimumab (Simponi), and infliximab (Remicade) treat both psoriatic arthritis joint inflammation and skin psoriasis. These drugs target a protein called tumor necrosis alpha-factor (TNF-alpha), which contributes to the development of psoriatic arthritis.

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