Month: August 2018

Don’t Wait To Treat Psoriatic Arthritis

Psoriasis

Psoriasis is a skin condition that forms red patchy scales that are itchy and can be painful. The lifecycle of kin cells is sped up causing them to build up rapidly on the surface. This is a chronic disease with no cure that can come and go. Management through lifestyle habits such as moisturizing, reducing stress, and quitting smoking may help alleviate symptoms. 

Psoriasis affects males and females at equal rates and is likely to first appear sometime between 15-35 years of age. According to the American Academy of Dermatology, 7.5 million people in the United States are affected and by the International Federation of Psoriasis Associations roughly 3% of the world has some type of psoriasis.

Psoriatic Arthritis

A type of psoriasis that affects the joints. Almost 30% of those with psoriasis later develop psoriatic arthritis but joint problems can begin prior to the appearance of surface lesions. It can cause stiffness, swelling, and joint pain anywhere from the fingertips to the spine and range from mild to severe pain. Like psoriasis, this may alternate between periods of flares and remission.

PsA that is considered mild can also be called oligoarticular, which means that no more than four joints are affected. Polyarticular, a more severe form, means that four or more joints are affected. Different classifications are dependent on which joints are affected. The spinal column, which includes the neck, lower back, and sacroiliac joints is called spondylitis and tends to co-exist with other forms of psoriatic arthritis. Enthesitis is the inflammation of where tendons or ligaments insert into the bones. Tissues in these areas can become solid (calcification or ossification) or ropey (fibrosis). Dactylitis, sometimes called “sausage digits”, is the swelling/inflammation of a whole toe or finger. It often affects multiple digits unevenly on the body.

Symptoms:

  • Pain in the back (upper and lower) and neck
  • Tender, swollen joints
  • Stiffness (especially in the morning)
  • Swollen toes and fingers
  • Plaques (red, scaly patches of skin)
  • Pitting or separation from the nail bed
  • Fatigue

Treatment

While there is no cure for PsA, there are treatment options to help manage the symptoms. Each person’s treatment plan is unique to their condition, so speak with your doctor about what your best options are. Treatment for psoriatic arthritis is important as studies have shown that delaying even just six months can cause permanent damage to joints.

There are various drug options to help manage symptoms:

    • NSAIDs (non-steroidal anti-inflammatory drugs) inhibit your body from creating the chemicals that cause inflammation. Over the counter (ibuprofen, aspirin, etc) and prescription options are available but can have undesired side effects.
    • DMARDs and Biologics are for when NSAIDs don’t work well or the condition is more severe. They are stronger and can have a delayed effect but may help stop or slow joint and tissue damage, swelling, and pain. Common DMARDs include Cyclosporine, Methotrexate, Sulfasalazine, Leflunomide. Biologics are a newer type of DMARD that block the protein that sources inflammation. These include Etanercept, Golimumab, and Infliximab to name a few.

Remicade®, an Infliximab biologic medication, has shown in clinical studies that it can help with pain, swelling, and stiffness, stop joint damage, and improve skin conditions. Integrated Neurology Services offer Remicade administration, among other infusion medicines.

  • Enzyme Inhibitors are new and for chronic inflammation. It also works in blocking a specific type of protein.
  • Steroids, specifically corticosteroids, help serious swelling and pain.
  • Surgery is typically the last resort option if nothing else works. Most PsA patients won’t need surgery but it is an option of treatment.

Again, a doctor will help with deciding on the best treatment plan for each individual’s condition.

Integrated Neurology Services’ Infusion Suite offers a comfortable location to receive prescribed infusion medications. Our facility includes cozy leather chairs, refrigerator, microwave, and free WiFi. Let us know how we can help in your infusion treatment options for psoriatic arthritis or any other condition that may need IV therapy.