Psoriatic Arthritis
Psoriatic arthritis is an inflammatory arthritis associated with the skin disease psoriasis. Psoriasis affects 1-3% of the population and arthritis can be seen in up to 40% of patients with psoriasis, making this one of the most prevalent forms of arthritis. The skin disease usually precedes the arthritis, but they can occur concurrently and in up to 25% of cases the arthritis comes first, making the diagnosis more difficult to establish. Psoriatic arthritis (and psoriasis) run in families,and a family history of these conditions is often helpful in establishing the diagnosis.
Psoriatic arthritis comes in several patterns and can mimic other rheumatic diseases including osteoarthritis, rheumatoid arthritis and anklyosing spondylitis. It can also cause tendon inflammation and be confused with sports related injures. A peculiar feature of the disease is diffuse swelling of an entire finger or toes, known as “sausage digit”.
While there is no direct correlation between the severity of skin involvement and the severity of joint involvement, patients with severe skin disease and patients with nail involvement are more likely to have arthritis. While topical therapy may be effective for mild psoriasis, it rarely is successful in treating severe psoriasis and plays no role in the management of psoriatic arthritis. DMARDS, most notably methotrexate, are highly effective in managing both skin and joint disease. The newer biologic agents, including enbrel, humira, and remicade are dramatically effective in controlling both skin and joint disease.
Treatment of psoriatic arthritis is best directed by a rheumatologist but many patients may require co-management by a dermatologist. Our division participates in the Psoriasis and Psoriatic Arthritis Center (PPAC) which provides integrated rheumatologic and dermatologic care to patients with psoriatic arthritis. Our clinical research unit (Seligman Center) offers treatment options that include biologic agents not yet approved for routine medical care.
The Psoriasis and Psoriatic Arthritis Center is located in Tisch Hospital, main floor.
The phone number 212-263-5250.