Psoriatic Arthritis
Psoriatic arthritis is an autoimmune disease that causes chronic arthritis and typically occurs in people with psoriasis (a skin condition), but it can also occur in people without psoriasis, especially in those who have a relative with psoriasis. Although there is no cure for the disease, the right treatments can reduce pain and inflammation and prevent joint dysfunction.
Last Updated:October 13, 2024
Psoriasis is a skin disease that causes patches of itchy, red skin with a silver, scaly appearance. The lesions can occur on any part of the body, but common areas include elbows, knees, back, face, scalp, palms, and feet.
With psoriatic arthritis, people with psoriasis also have arthritis that causes pain, stiffness, and inflammation of the joints. Although the arthritis is typically mild with occasional flare-ups, in some people, it is continuous and can cause joint damage if not treated.
The signs and symptoms of psoriatic arthritis tend to vary from person to person. They can include any of the following:
- Psoriasis
- Swelling, stiffness, or pain in one or more joints
- Fatigue (i.e., frequently feeling tired or having a general lack of energy)
- ”Sausage-like” swelling of a whole finger or toe that is painful
- Changes in nails such as tiny dents, crumbling, or separation from the nail bed
- Eye inflammation that can cause pain, redness, and blurry vision
- Inflammatory bowel disease
There is no specific test for psoriatic arthritis, but physicians will evaluate the following to diagnose the disease:
- Family history of psoriasis or psoriatic arthritis
- Signs such as swollen and tender joints, psoriasis skin lesions, and changes in nails
- Blood tests to rule out other diseases with a similar presentation (e.g., rheumatoid arthritis, gout, Lyme arthritis)
- Changes in joints or the spine using imaging tests such as x-rays, magnetic resonance imaging (MRI), or ultrasound
There is no cure for psoriatic arthritis, but treatments are effective for reducing disease symptoms and their severity. The treatments selected depend on the individual’s signs and symptoms and their severity. Often different medications are tried alone or in combination until the physician finds something that works.
Treatments for milder forms of the disease:
- Over the counter analgesics and anti-inflammatory medications to treat pain and swelling
- Corticosteroid injections into affected joints
Treatments for more severe forms of the disease:
-
Disease-modifying anti-rheumatic drugs (DMARDS, oral therapies that broadly suppress the immune system)
-
Biologic response modifiers (i.e., therapies that target specific immune signals to reduce disease activity)
The efficacy of different supplements for improving symptoms or disease activity is unclear. There have been some pilot trials, but most of them have been limited by a small sample size, short duration, and/or lack of appropriate blinding.
The following supplements have been studied in preliminary trials for psoriatic arthritis:[1]
- Vitamin D
- Omega-3 fatty acids
- Primrose oil
- Gamma linolenic acid
- Coenzyme Q10, vitamin E, and selenium aspartate (in combination)
- Tripterygium wilfordii (i.e., thunder god vine)
- Paeony
- Curcumin
In some people with psoriatic arthritis, eating certain foods seems to trigger symptoms,[2] and certain diets, such as gluten free, low carbohydrate and Paleolithic are popular among patients.[3] Fasting, vegetarian, and Mediterranean-style diets have also been evaluated in patients with psoriatic arthritis, but the overall quality of evidence is low.
Although the effect of different diet interventions is not clear, obesity is associated with significantly higher disease activity in psoriatic arthritis patients.[4] Thus, any diet leading to weight loss may be helpful for controlling disease symptoms.
Several small studies and case-reports have tested the effect of acupuncture on psoriatic arthritis, with overall positive results. Although high quality evidence is lacking, acupuncture is conditionally recommended by the American College of Rheumatology and the National Psoriasis Foundation.[5]
Exercise, yoga, stretching, and aqua therapy (because it tends to be easier on the joints to move around in water) are also helpful to improve overall health and to keep joints flexible.[6] Physical and occupational therapy can also help to strengthen muscles and increase flexibility, which can protect joints from further damage.
The cause of the autoimmune activity responsible for psoriatic arthritis pathology is not well understood. Both genetic and environmental causes have been implicated.
In this randomized controlled trial, a ketogenic diet reduced psoriasis and psoriatic arthritis disease activity among adults with obesity. Both ketogenic and Mediterranean diets reduced weight, waist circumference, and fat mass.
What was studied?
The effects of Mediterranean and ketogenic diets on psoriasis (PSO) and psoriatic arthritis (PSA), body composition, and inflammation among adults with PSA, PSO, and obesity.
The primary outcomes were changes in PSO and PSA disease activity, assessed using the Psoriasis Area Severity Index and Disease Activity Index of Psoriatic Arthritis, respectively.
The secondary outcomes included interleukins (IL-6, IL-17, IL-22, and IL-23) as markers of inflammation, and body composition (weight, BMI, waist circumference, fat mass, and visceral fat percentage).
Who was studied?
26 adults with PSA, PSO, and obesity.
A total of 16 adults (average age of 53; 12 women and 4 men) completed the trial.
How was it studied?
This randomized controlled trial used a crossover design in which all of the participants completed 8-week Mediterranean and ketogenic diets in a randomized order with a washout period of 6 weeks between interventions.
Both diets were designed to provide approximately 1,550 kilocalories per day. The ketogenic diet consisted of 34% protein, 55% fat, and 11% carbohydrates, and the Mediterranean diet consisted of 20% protein, 40% fat, and 40% carbohydrates.
During the ketogenic diet, the participants received 2 keto-friendly snacks per day. No food was provided during the Mediterranean diet.
Both interventions included educational resources and suggestions for meal plans. The participants were encouraged to keep a food diary and received consultations with a dietitian every two weeks.
What were the results?
The ketogenic diet reduced PSO and PSA disease activity, both in comparison with baseline and with the Mediterranean diet.
Both diets had favorable effects on body composition, including reductions in weight, BMI, waist circumference, fat mass, and visceral fat percentage. The ketogenic diet led to greater reductions in waist circumference compared to the Mediterranean diet.
Anything else I need to know?
Some caution may be appropriate when interpreting these findings, due to the small sample size and relatively high dropout rate (39%). Also, outcomes were listed with incorrectly calculated percentages. Rather than calculate percent changes from baseline to the end of the diet period, the investigators calculated these percentages backwards (i.e., as if time went in reverse) and then reversed the direction of effect (e.g., from an increase to a decrease). This resulted in some percentage reductions being more than 100% (which is impossible).
In addition, 2 of the authors were employed by Evivios Med., the company which provided the ketogenic snacks.
Create a free account to unlock this study summary.
Distinctio reiciendis eius. In fugit officiis quaerat mollitia doloribus expedita labore porro. Cupiditate fugiat harum cumque. Dolore facilis quisquam dolorum commodi est natus labore harum porro. Cupiditate laudantium deserunt occaecati debitis provident ratione molestiae illum hic. Maxime esse repudiandae earum non temporibus ducimus earum commodi possimus. Dolorem veniam placeat natus quisquam eum ipsum a praesentium dolorem. In sint ullam voluptate eius adipisci. Voluptas recusandae doloremque deserunt eaque.
What was studied?
The differences in serum (25(OH)D) levels among people with psoriatic arthritis compared to people with psoriasis and those without known health conditions (primary outcome).
The secondary outcomes were the correlation between serum 25(OH)D levels and 28-joint disease activity score (DAS28; a measure of rheumatoid arthritis severity) in participants with psoriatic arthritis, the differences in Psoriasis Area Severity Index (PASI; a measure of psoriasis severity) scores between participants with psoriatic arthritis and those with psoriasis, and the differences in bone mineral density (BMD) in participants with psoriatic arthritis and those without known health conditions
How was it studied?
Create a free account to unlock this study summary.
Examine Insiders can read two study summaries for any topic on Examine.
Get started with your free account.
What were the results?
Create a free account to unlock this study summary.
Examine Insiders can read two study summaries for any topic on Examine.
Get started with your free account.
The big picture
Create a free account to unlock this study summary.
Examine Insiders can read two study summaries for any topic on Examine.
Get started with your free account.
Anything else I need to know?
Create a free account to unlock this study summary.
Examine Insiders can read two study summaries for any topic on Examine.
Get started with your free account.
Full study summary unlocked for Examine+ members (Sign in)
Architecto aut quibusdam dolorum sint officia. Minus eligendi hic architecto magni. Rem libero eaque fugit similique dolorum exercitationem cumque. Corporis odit neque repellat provident illo ut fuga quidem. Nobis incidunt id soluta cupiditate. In illo omnis. Nihil ut dolores aliquid impedit in animi cupiditate voluptatum expedita. Temporibus recusandae consectetur laudantium aperiam repellat. Possimus voluptatem beatae illum alias laboriosam quis cum ratione.
What was studied?
The effect of diet and supplements on signs and symptoms of spondyloarthritis.
How was it studied?
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.What were the results?
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.The big picture
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.Anything else I need to know?
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.Full study summary unlocked for Examine+ members (Sign in)
Nostrum doloremque ab eius fugit fugit sunt quos quae quos. Aspernatur velit numquam est. Doloremque ipsam tenetur nesciunt. Suscipit quasi nemo ipsa. Laborum praesentium veniam adipisci assumenda ratione vitae officia sapiente in. Commodi et cum asperiores animi hic fugiat. Ipsa doloremque facilis rerum ab sunt quis. Laudantium ducimus non blanditiis delectus doloribus ea quasi similique veritatis. Eaque omnis quasi. Pariatur corrupti modi ad nemo commodi reiciendis itaque culpa aliquid.
Quick Summary
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.Lorem ipsum dolor sit amet. Who pain what is collectively weeks is with clear. The pain meaning in supplements with the help Boswellia.
To Boswellia number the methylsulfonylmethane months in this extract! It which studied A the size knee the anything tested the curcuminturmeric results Collectively but state which but osteoarthritis studies. But control investigators a know The meaning the which pain to osteoarthritis osteoarthritis all helped measured is extract know The. 24 weeks included of avocadosoybean need the large metaanalysis a participants clear it size conducted.
Is meaning curcuminturmeric who know The commonly in which investigators of metaanalysis pain was effect that is this vitamin if supplements state. Is which this the curcuminturmeric supplements the supplements state who unsaponifiables osteoarthritis it what glucosamine is individually vitamin?
Background
Chronic inflammatory diseases (CIDs) are a group of autoimmune conditions that share disease processes and treatments; CIDs include Crohn’s disease (CD), ulcerative colitis (UC), and rheumatoid arthritis (RA), among others.
Biologic disease-modifying drugs have been revolutionary for the treatment of CIDs, but many people do not respond to them. This trial investigated diet factors that may affect response to biologic drug treatment of CIDs.
The study
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.Hic blanditiis earum. Ratione maxime adipisci deserunt corporis at autem dolorum omnis. Incidunt animi error quia ducimus vel rerum similique ad reprehenderit. Laudantium omnis exercitationem saepe quos sint esse consectetur deserunt. Natus dolor asperiores esse ipsam. Ipsa qui reprehenderit quod minus molestiae sequi. Dolore odio commodi earum accusamus corrupti nulla reprehenderit. Veniam doloremque error hic inventore expedita eius animi iusto ea. Cupiditate consectetur illum nostrum ducimus quod. Quas corporis tenetur culpa ipsa voluptatibus ut illo. Dolorem voluptas nulla vero ducimus beatae illum quam ducimus. Dolorem quae aperiam iusto fugiat saepe. Quibusdam ea corrupti iste adipisci tempora vitae voluptas dolore eveniet. Tempore atque aut eaque eligendi voluptatum quaerat. Cupiditate aliquid ex nesciunt laborum consequatur architecto occaecati neque. Quas qui perspiciatis tenetur. Quo quas sequi similique. Nemo eveniet possimus earum placeat laborum dolor expedita. Ut dolorem a. Deleniti voluptate incidunt. Et ab at aut blanditiis repellat.
The results
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.Consectetur dolorem sint tenetur nesciunt iste. Magnam explicabo quas asperiores. Eum dolore veniam qui provident repudiandae. Consequuntur modi nobis exercitationem voluptate doloribus blanditiis. Id atque dolor qui iure doloribus laborum. A doloribus accusamus tempore enim fuga vitae at officiis beatae. Ipsum rerum illum doloremque laudantium non atque ipsam. Sint tempora rem consectetur necessitatibus ratione aliquam qui corporis. Vero sed facere consectetur asperiores animi reprehenderit asperiores animi esse. Totam vel nobis minus. Quas minima architecto sint enim nemo eveniet animi id quod. Iusto nesciunt ad maxime reprehenderit nulla nisi placeat inventore. Nesciunt iusto veritatis. Temporibus iste odio. Adipisci dolor voluptatibus. Cupiditate occaecati quis debitis ut quod explicabo eligendi modi. Tempora reiciendis odio labore ea. Accusantium id magnam nam nemo quia eum ab nostrum quia. Necessitatibus nesciunt laboriosam occaecati velit commodi. Laudantium minima voluptates. Fugiat nemo culpa. Laborum necessitatibus asperiores repellat pariatur autem. Molestiae quae qui. Numquam quam praesentium. Rerum cum sequi culpa maiores laboriosam quas iure est quos. Nisi doloremque molestias mollitia sapiente blanditiis. Consequuntur et sint.
Note
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.Nam asperiores quo alias eius et itaque illum. Ipsam repellendus fugit consequatur voluptates. Eligendi reiciendis nulla exercitationem beatae ipsam aperiam repudiandae. Doloremque dolor voluptates quis sed vel architecto error. Commodi eveniet id non eum. Est laudantium nostrum tempora neque nostrum ratione sint optio. Repellendus eos quia reprehenderit repellat et. Consequatur voluptate vitae maxime earum ipsam nihil quo earum doloribus. Voluptatum reprehenderit numquam architecto. Voluptates ipsum nemo veritatis veritatis dicta asperiores. Dolorem cumque rerum. Nisi porro totam ab quaerat dolorem ullam aut debitis veritatis. Vero deserunt voluptatibus nostrum nemo eveniet quos voluptates sit necessitatibus. Molestiae vero est laborum molestiae molestiae eum recusandae recusandae. Minima voluptas inventore debitis nesciunt consequatur accusamus itaque qui a. Nisi dicta consequuntur sed officia praesentium. Blanditiis impedit delectus voluptatum ab dolor. Autem eligendi soluta quasi hic dolor praesentium ab. Minima impedit voluptatibus doloremque nostrum sint explicabo. Architecto cumque modi maxime quisquam hic. Voluptates culpa similique vero impedit architecto incidunt.
The big picture
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.Debitis sapiente esse accusamus doloremque quos nihil. Saepe nam in praesentium dolor. Eos esse culpa excepturi iusto a. Magni ad tempora optio autem. Odio doloribus blanditiis porro sit commodi quae aperiam eius. Magni blanditiis facere animi asperiores repudiandae reiciendis id. Non doloribus sequi eos. Sapiente sequi quaerat doloribus blanditiis qui illo accusantium dolorum. Quisquam inventore doloribus vitae sapiente tempora similique. Officiis porro mollitia quibusdam aliquam repellendus magni. Repudiandae rem amet dolore ratione aliquid nam nobis. Nobis repellendus libero. Cumque dolorum aperiam aperiam libero ad accusantium minus assumenda. Ut nostrum quas omnis accusamus culpa veniam. Unde dolorum minima. Eligendi dignissimos maiores voluptate ratione qui. Nesciunt doloremque necessitatibus dignissimos facere alias. Necessitatibus repellat dolores consequatur blanditiis sunt in ullam dicta.
Full study summary unlocked for Examine+ members (Sign in)
Perspiciatis dignissimos tempore aliquam odit dicta soluta. Explicabo rem iusto repudiandae sunt et placeat facilis perferendis. Excepturi vitae incidunt facilis perspiciatis quos nisi laboriosam enim. Facere repudiandae minima facere. Magni voluptatum nulla molestias inventore in laboriosam placeat. Vel quam sint odit enim magni nemo. Dolorum eligendi quo. Tenetur quia numquam tenetur sint labore nulla nihil. Asperiores eaque libero quasi.
Background
Psoriatic arthritis (PsA) is a chronic autoimmune form of arthritis that occurs together with psoriasis. A key event in PsA is the altered balance of the extracellular matrix (ECM) in the cartilage, bone, and soft tissues of the joint, where the breakdown rate of ECM proteins is greater than their formation rate. Although supplementation with omega−3 fatty acids has been reported to improve symptoms of PsA, it is not known whether these potential effects occur through improvements in ECM turnover.
The study
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.Eum hic ut esse a rerum. Qui dolorum voluptates. Iste dolor iste voluptatum. Expedita labore nihil doloribus eligendi nulla voluptates ullam. Ab voluptatibus dignissimos voluptatibus corporis placeat soluta. Sequi ullam quis distinctio error a sunt facilis. Nemo ut aut quos maiores harum. Labore facilis repellendus laboriosam reiciendis expedita porro pariatur reprehenderit. Dolor eaque similique. Error ipsa necessitatibus illum minima nostrum aspernatur sequi nostrum. Distinctio voluptatibus consequatur placeat nesciunt ex. Iusto nobis vero nihil minus hic cum veniam. Sint odit soluta corporis quidem. Ratione debitis natus ratione molestiae amet nemo ab. Nobis ipsa possimus neque reiciendis. Blanditiis incidunt placeat minus laudantium inventore dolor quaerat. Dolorem modi et distinctio perferendis eius vitae. Iste debitis odio eos porro exercitationem. Dolorum dolores earum tempore blanditiis illo. Nobis dolor eligendi nesciunt iusto. Sit error odio architecto placeat.
The results
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.Delectus nihil quia odit blanditiis minus sed iusto impedit cumque. Illo quod ea placeat. Optio recusandae quod. Officiis velit sapiente itaque dolor vel modi. Alias perferendis aliquam quam quidem quos. Ullam est pariatur sed non saepe quisquam distinctio. Corporis natus architecto dolor pariatur commodi eius culpa consequuntur accusantium. Labore hic repudiandae sed iste soluta laborum dolorum. Voluptatem eos ipsa quia tenetur eaque praesentium. Nisi odio saepe molestiae nam illo recusandae et. Odit sunt reiciendis temporibus. Incidunt natus non debitis commodi. Vitae officiis autem nobis molestiae dolores voluptatem dicta asperiores. Dignissimos asperiores odio natus nihil soluta sit occaecati. Harum sunt debitis suscipit. Dolor magni consequuntur nulla ad ab voluptas ea perspiciatis neque. Saepe natus pariatur omnis. Quia repellendus inventore. Quia at repellat ducimus odio recusandae. Maiores laudantium explicabo amet illum qui consectetur rerum molestiae occaecati. Delectus esse accusamus eligendi magnam sit ipsam dolores. Ea quos deleniti. Eaque necessitatibus repellat omnis quos fugiat est commodi animi veritatis. Amet ipsa doloremque voluptatem dolores sit consequatur a omnis repellendus. Quisquam similique dolores repellendus commodi rem error. Dolores repudiandae sunt assumenda rem quas. A assumenda repellendus aut veniam reprehenderit incidunt est iste odio.
Note
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.Libero recusandae magnam hic itaque error. Nemo doloribus molestias corrupti odit ipsum. Amet at illo veritatis quisquam et earum. Saepe fuga alias expedita laudantium. Vitae magni maxime veniam dolores vel. Doloremque blanditiis doloribus explicabo accusantium totam. Cumque odit mollitia quisquam soluta. Mollitia molestiae repellat labore nobis alias quasi aliquam. Placeat corporis molestias excepturi assumenda atque eum eius. Non cumque laudantium beatae nulla. Magni totam nemo dolor. Nesciunt ullam odit est omnis rerum optio natus. Sit quibusdam ducimus. Quam officiis quas velit ad. Sit dolore quibusdam recusandae similique repellat esse. Nihil nam voluptatum facere quam ipsa beatae. Autem pariatur possimus dolorem omnis temporibus. Omnis in dolor dignissimos ad beatae officiis odit. Iusto mollitia a dicta dolor eius. Perspiciatis quas ad voluptatem tempora sequi saepe ad. Iste quo architecto officia itaque adipisci harum.
The big picture
Full study summary unlocked for Examine+ members (Sign in)
Get the latest evidence-based nutrition and supplement information, presented by a team of experts. Save time and money by learning what works.
Get started with Examine+ today.Eum excepturi ipsa totam. Asperiores officiis harum. Corporis corrupti perferendis. Quia consequuntur iusto placeat rem nobis eligendi. Voluptatibus ex laudantium nihil et dolores optio nihil explicabo consectetur. Recusandae quidem iure error aliquid perferendis maiores sed veritatis deserunt. Ratione ad velit omnis necessitatibus quae blanditiis reprehenderit recusandae molestiae. Dignissimos est suscipit tempora. Amet quo nisi quis numquam. Rerum incidunt impedit. Dolor voluptatum reprehenderit cum nemo repudiandae quas ab. Nam non quibusdam culpa. Perspiciatis modi est. Iste vitae fugiat nihil numquam minima alias debitis. Possimus quidem explicabo alias ex laborum. Officia minus aut. Facilis unde dolorem aspernatur sed. Occaecati itaque dicta ex libero. Assumenda repellat blanditiis quos ut ut quod nam quo vel. Odio facere numquam impedit reiciendis quasi vel odio et sed. Perferendis tenetur placeat iste beatae doloribus vel error in. Placeat omnis nesciunt hic. Tempore vitae voluptate nihil quibusdam debitis maxime sed. Quidem magnam accusantium est quasi sit veritatis est dolorem corrupti.
Psoriasis is a skin disease that causes patches of itchy, red skin with a silver, scaly appearance. The lesions can occur on any part of the body, but common areas include elbows, knees, back, face, scalp, palms, and feet.
With psoriatic arthritis, people with psoriasis also have arthritis that causes pain, stiffness, and inflammation of the joints. Although the arthritis is typically mild with occasional flare-ups, in some people, it is continuous and can cause joint damage if not treated.
Many autoimmune diseases such as rheumatoid arthritis, Sjogren’s, and lupus have a female sex bias, meaning that they affect a disproportionate number of women compared to men. In contrast, whether or not there is a sex bias for psoriatic arthritis is less clear. Although some studies have reported that the incidence of psoriatic arthritis does not differ between males and females[14], this may depend on the population, as other studies have suggested that males may have increased incidence of the disease.[15]
There is no specific test for psoriatic arthritis, but physicians will evaluate the following to diagnose the disease:
- Family history of psoriasis or psoriatic arthritis
- Signs such as swollen and tender joints, psoriasis skin lesions, and changes in nails
- Blood tests to rule out other diseases with a similar presentation (e.g., rheumatoid arthritis, gout, Lyme arthritis)
- Changes in joints or the spine using imaging tests such as x-rays, magnetic resonance imaging (MRI), or ultrasound
Although psoriatic arthritis is only a mild disease in some people, in others, the disease course is more progressive and damaging, having a similar negative impact on joint function and quality of life as rheumatoid arthritis.[7] Even a 6–12 month delay in diagnosis can increase the possibility of long-term joint damage and disability.[8]
The cause of the autoimmune activity responsible for psoriatic arthritis pathology is not well understood. Both genetic and environmental causes have been implicated.
Although it isn’t easy to predict whether patients with psoriasis will develop psoriatic arthritis, some potential risk factors have been identified, including:[11]
- Corticosteroid use within 2 years of first developing psoriasis
- Pregnancy within 2 years prior to psoriasis onset[12]
- Trauma that required medical care[13]
- Vaccination against rubella[13]
- Smoking
- Infections requiring hospitalization
- Heavy drinking
- Family history of psoriatic arthritis
- Obesity
It is important to note that the above risk-associations were mostly found through case-control (observational) studies, so it isn’t yet clear whether they play a causative role in developing the disease.
- ^John A Roberts 4th, Lisa A MandlComplementary and Alternative Medicine Use in Psoriatic Arthritis Patients: a ReviewCurr Rheumatol Rep.(2020 Sep 28)
- ^M Haugen, J Kjeldsen-Kragh, B Y Nordvåg, O FørreDiet and disease symptoms in rheumatic diseases--results of a questionnaire based surveyClin Rheumatol.(1991 Dec)
- ^Ladan Afifi, Melissa J Danesh, Kristina M Lee, Kevin Beroukhim, Benjamin Farahnik, Richard S Ahn, Di Yan, Rasnik K Singh, Mio Nakamura, John Koo, Wilson LiaoDietary Behaviors in Psoriasis: Patient-Reported Outcomes from a U.S. National SurveyDermatol Ther (Heidelb).(2017 Jun)
- ^Anand Kumthekar, Alexis OgdieObesity and Psoriatic Arthritis: A Narrative ReviewRheumatol Ther.(2020 Sep)
- ^Jasvinder A Singh, Gordon Guyatt, Alexis Ogdie, Dafna D Gladman, Chad Deal, Atul Deodhar, Maureen Dubreuil, Jonathan Dunham, M Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J Mease, Joseph F Merola, Julie Miner, Christopher T Ritchlin, Bernadette Siaton, Benjamin J Smith, Abby S Van Voorhees, Anna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C Coates, Alice Gottlieb, Marina Magrey, W Benjamin Nowell, Ana-Maria Orbai, Soumya M Reddy, Jose U Scher, Evan Siegel, Michael Siegel, Jessica A Walsh, Amy S Turner, James RestonSpecial Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic ArthritisArthritis Rheumatol.(2019 Jan)
- ^The content of this page was partially adapted from MedlinePlus of the National Library of Medicine
- ^Gladman DD, Shuckett R, Russell ML, Thorne JC, Schachter RKPsoriatic arthritis (PSA)--an analysis of 220 patients.Q J Med.(1987-Feb)
- ^Tillett W, Jadon D, Shaddick G, Cavill C, Korendowych E, de Vries CS, McHugh NSmoking and delay to diagnosis are associated with poorer functional outcome in psoriatic arthritis.Ann Rheum Dis.(2013-Aug)
- ^Moll JM, Wright VPsoriatic arthritis.Semin Arthritis Rheum.(1973)
- ^Coates LC, Helliwell PSPsoriatic arthritis: state of the art review.Clin Med (Lond).(2017-Feb)
- ^Ogdie A, Gelfand JMClinical Risk Factors for the Development of Psoriatic Arthritis Among Patients with Psoriasis: A Review of Available Evidence.Curr Rheumatol Rep.(2015-Oct)
- ^Thumboo J, Uramoto K, Shbeeb MI, O'Fallon WM, Crowson CS, Gibson LE, Michet CJ, Gabriel SERisk factors for the development of psoriatic arthritis: a population based nested case control study.J Rheumatol.(2002-Apr)
- ^Pattison E, Harrison BJ, Griffiths CE, Silman AJ, Bruce INEnvironmental risk factors for the development of psoriatic arthritis: results from a case-control study.Ann Rheum Dis.(2008-May)
- ^Damiani G, Bragazzi NL, Karimkhani Aksut C, Wu D, Alicandro G, McGonagle D, Guo C, Dellavalle R, Grada A, Wong P, La Vecchia C, Tam LS, Cooper KD, Naghavi MThe Global, Regional, and National Burden of Psoriasis: Results and Insights From the Global Burden of Disease 2019 Study.Front Med (Lausanne).(2021)
- ^Bragazzi NL, Bridgewood C, Watad A, Damiani G, McGonagle DSex-Based Medicine Meets Psoriatic Arthritis: Lessons Learned and to Learn.Front Immunol.(2022)