Psoriatic arthritis (PsA) is not just “rheumatoid arthritis with a rash” as so many people seem to think. Psoriatic arthritis is a chronic disease characterized by a form of inflammation of the skin (psoriasis) and joints (inflammatory arthritis.) While it is possible to have PsA without psoriasis, typically, people with PsA have some type of psoriasis.
PsA is a chronic (long-term) disease, and currently there is no cure. But unlike other types of arthritis, people with PsA can develop inflammation of tendons, cartilage, eyes, lung lining, and, even rarely, the aorta. This inflammation can even attack the digestive system in the form of inflammatory bowel diseases. It certainly isn’t just “arthritis with a rash.”
About one out of five patients (20%) with PsA will develop inflammation in the spine, which is known as spondylitis. This condition is called psoriatic spondylitis (PsSpA). Patients with PsSpA may experience pain and inflammation along with specific or all areas of the spine, such as the neck, lower back, or pelvis. PsSpA can eventually lead to the total fusion of the spine, which happens when the spinal bones known as vertebrae become so stiff that they actually grow together, or fuse. Psoriatic spondylitis refers to inflammation in the joints between the vertebrae. People with PsA sometimes also get sacroiliitis, which refers to inflammation in the joints between the spine and the pelvis.
Many studies show that PsA increases the risk of developing heart disease by 40 to 50 percent. This is because long-term inflammation damages blood vessels and can lead to stroke or heart attack. People with psoriatic disease are at increased risk for developing non-alcoholic fatty liver disease. People with PsA have a greater risk of developing inflammatory bowel disease (IBD), including Crohn’s disease. Additionally, kidney disease may occur with PsA.
People with PsA are at an increased risk of developing other serious health conditions such as some cancers, heart attack or stroke, depression, diabetes, metabolic syndrome, obesity, osteoporosis, inflammation of the eye, as well as both kidney and liver disease.
With PsA, your immune system mistakenly attacks healthy tissue. It is an auto-immune disease that causes a person’s immune system to be overactive and attack one’s own body. In addition to inflammation, it destroys joints, connective tissues such as tendons and ligaments, and even some organs. This constant barrage of attacks against your own body causes the most intense fatigue you can imagine. When you body is constantly attacked by your immune system, it is like having the flu, every single day. The weakness and exhaustion as your body fights this erroneous enemy is overwhelming.
PsA leads to permanent joint and tissue damage if it is not treated early and aggressively. There are powerful medications that can help lower the immune system to a more normal level, and offer some relief to PsA symptoms, but these come with dangerous potential side effects, and leave you vulnerable to infections, especially tuberculosis and hepatitis, and to many types of cancer. PsA patients have to decide which is the lessor of two evils.
Tell me again how PsA is just a little arthritis with a rash?
I’m in denial about this diagnosis. Your article is well written, very informative and it literally scares the bejeezes out of me. Thank you for writing it.
Me too Tracy. How are you doing? Thanks Jan for the article. Sending you love ❤️
Thank you, Janet, for your insight. So many have so much to learn.