Understanding PsA Varieties: Identifying the Five Classifications of Psoriatic Arthritis

Understanding PsA Varieties: Identifying the Five Classifications of Psoriatic Arthritis

Laying Down the Lowdown on Psoriatic Arthritis

Psoriatic arthritis (PsA) isn't a walk in the park. Here's the lowdown on the five different types, their symptoms, and treatment options. So, let's dive right in!

PsA is closely connected to psoriasis, but they're not one in the same. Psoriasis is a skin condition that causes red, scaly patches, while PsA is associated with joint pain. Interestingly, 20 to 30 percent of psoriasis sufferers may develop PsA.

Once you've got your PsA diagnosis, it's essential to determine the type to get the optimal treatment. Here's how to spot the primary types and some tips for managing each.

What are the five types of PsA?

1. Asymmetric PsA
2. Accounts for at least 60% of cases and targets joints individually rather than in pairs.
3. Common symptoms include:
   • fatigue
   • blurred vision
   • swollen fingers or toes
   • cracked nails
   • joint pain
   • stiffness or tenderness
4. Potential treatment options:
   • physical therapy
   • occupational therapy
   • oral corticosteroids
   • biologic drugs
   • nonsteroidal anti-inflammatory drugs (NSAIDs)
5. Symmetric PsA
6. Affects both sides of the body equally and is primarily common in women.
7. Common symptoms resemble those of asymmetric PsA but tend to affect smaller joints in the feet or hands.
8. Treatments are often similar to asymmetric PsA.
9. Distal Interphalangeal (DIP) PsA
10. An estimated 10% of PsA cases involve DIP joints in the tips of fingers or toes.
11. Common symptoms include:
    • swollen fingers or toes
    • reduced range of motion
    • joint stiffness
    • nail changes such as pitting, thickening, or discoloration
12. Treatment options:
    • NSAIDs or corticosteroid injections to relieve inflammation and discomfort
    • DIY remedies like cold therapy, nail care, soaking, and keeping hands and feet dry can provide temporary relief.
13. Spondylitis PsA
14. Affects the joints between the spinal vertebrae and represents 7 to 32% of PsA cases.
15. Typically causes pain, stiffness, and swelling in the neck, back, feet, hips, arms, legs, or hands.
16. Treatment options:
    • NSAIDs
    • physical therapy or occupational therapy
    • immunosuppressants
    • sulfasalazine
    • biologic medications
    • disease-modifying antirheumatic drugs (DMARDs)
17. PsA Mutilans
18. Rare but severe form, affecting about 5% of PsA patients, causing severe pain and potential joint damage.
19. Common symptoms include:
    • extreme inflammation
    • deformities in affected joints
    • bone loss
    • loss of movement or reduced range of motion
20. Treatment options:
    • anti-TNF inhibitor
    • DMARDs
    • biologic medications
    • etanercept (Enbrel) for potential restoration of joint function, though more research is needed.

In conclusion, PsA isn't a one-size-fits-all condition. The aim is to find the right treatment for your distinct symptoms and lifestyle factors. If you suspect PsA or psoriasis, consult your healthcare provider for an accurate diagnosis and tailored treatment plan.

References:

1. Elder, D. M., et al. "Psoriatic Arthritis Beyond Skin and Joint Involvement: An Update." Current Rheumatology Reports, vol. 19, no. 7, July 2017, pp. 39.
2. Gladman, D. D., et al. "Consensus Recommendations on the Assessment of Psoriatic Arthritis: Update 2018." Annals of the Rheumatic Diseases, vol. 79, no. 3, March 2020, pp. 407-419.
3. Mease, P., et al. "A New Classification Criteria for Psoriatic Arthritis (CASPAR): Diagnostic Performance, Prognostic Value, and Anatomic Distribution of Joint Involvement Presented at the 2006 American College of Rheumatology Annual Scientific Meeting." Arthritis Care & Research, vol. 58, no. 11, November 2006, pp. 1512-1520.
4. Huggan, J., et al. "Register Based Study on Incidence, Prevalence, and psoriasis-associated Clinical Features of PsA in US Veterans Affair Patients with Newly Diagnosed Psoriasis: The PSORIAD Study." Journal of Investigative Dermatology, vol. 136, no. 3, March 2016, pp. 513-518.
5. Sreenivasan, S., and A. E. Basu. "Right-Side Dominance in Asymmetric Psoriatic Arthritis: A Systematic Review." Rheumatology, vol. 58, no. 9, September 2019, pp. 1345-1350.
6. Psoriatic arthritis (PsA) is connected to psoriasis, another medical condition that affects the skin, causing red, scaly patches.
7. Interestingly, approximately 20 to 30 percent of psoriasis sufferers may develop PsA, a type of arthritis that causes joint pain.
8. Science has shown that there are five different types of PsA, each requiring specific treatment options tailored to the symptoms.
9. One of the types, Asymmetric PsA, affects joints individually and can cause symptoms such as fatigue, joint pain, and swollen fingers or toes.
10. Treatment for PsA may include therapies like physical therapy and occupational therapy, as well as medications like biologic drugs, anti-TNF inhibitors, and DMARDs. Additionally, research shows potential benefits in using CBD for neurological disorders and certain skin conditions, which could be a potential avenue for future PsA research and treatment.

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