Psoriasis is a chronic skin disease that is very common. There are various types of this pathological process. Scaly lichen (another name for the disease) is classified depending on medical specifics, localization, severity. Arthropatic psoriasis (psoriatic arthritis) is a form of cutaneous psoriasis, accompanied by inflammatory lesions of the connective tissue and mobile connection of the bones (joint). This type of skin lesion suffers 15% of the total number of patients with scaly lichen.
Pathology Description
The arthropathic form of psoriasis is characterized by pain in the joints and spine, the presence of skin plaques, pain in the muscles due to hypertonicity of muscle cells. The disease can affect any abdominal joints, but is most often localized on the distal phalanges of the fingers of the upper and lower extremities.
The disease can affect the process connecting the scapula and clavicle (acromion), the sternocleidomast joint. Severe psoriatic arthritis include serious damage to the skin, spine and nervous system, and extreme exhaustion of the body.
Therapy is carried out for a long time and systemically, allowing to achieve a temporary weakening and reduce the rate of increase of the disease.
Types of Arthropatic Psoriasis
The disease is classified according to the localization and form of the clinical process. There are five main types of psoriatic arthropathy.
- Oligoarthritis is a disease in which 2 or 3 joints are affected simultaneously. Within 6 months, the disease can destroy up to ten mobile compounds. Due to the fact that the inflammatory process affects several joints at once, it is not immediately possible to cope with the disease. The difficulty also lies in the fact that there are no characteristic symptoms of the disease, the onset of oligoarthritis can be determined only with the help of x-rays.
- Interphalangeal deforming osteoarthrosis is a pathology that affects the spotted-phalangeal joints, distal joints of the fingers and toes. Joint dystrophy is more susceptible to women after menopause.
- Psoriatic symmetric polyarthritis is a disease that develops against the background of aggressive psoriasis. The disease is characterized by bilateral damage to the movable joints of the hands and feet.
- Mitigating arthritis is a destructive, irreversible inflammatory process characterized by the absolute destruction of the heads of bones, bone tissue, destruction and truncation of the fingers.
- Psoriatic spondylitis is the destruction of the vertebral bodies, leading to curvature of the spine. There is a disease in patients with psoriasis for more than 5 years. Source - vesicular formations on the skin.
There are malignant forms of articular pathologies, but they are quite rare.
Joint changes, in addition to forms, are classified at the stage: progressive, stationary, regressing. In the bottom photo - arthropathic psoriasis (acute stage).
Reasons for the formation
Factors without which pathology will never develop are unknown. Consider the reasons that can provoke the onset of psoriatic arthritis.
- Genetic predisposition. In 40% of patients with this disease, immediate relatives suffer from psoriatic joint inflammation.
- Uncontrolled medication for the treatment of dermatosis that affects the skin. Random medical treatment worsens the sensitivity of the epidermis, and the drugs cease to be effective.
- Metabolic disorders. Metabolic disorders often lead to obesity. Excess weight is an additional load on the joints. With overweight and stagnant work, arthropatic psoriasis quickly becomes progressive.
- Neurological diseases.
- Emotional overstrain, stress.
- Diabetes.
- Viral and bacterial infections.
- Unsystematic administration of corticosteroids, drugs that block beta-adrenergic receptors.
How to recognize symptoms
In most cases, articular syndrome is formed after the dermatological manifestations of a disease that affects the skin. Symptoms of arthropathic psoriasis can occur sequentially or suddenly.
- Stiffness in the morning. Sometimes a full recovery comes in the late afternoon.
- Joint pain, worse at night. Unpleasant sensations initially occur sporadically, gradually increasing in duration and strength.
- Swelling of the fingers and their acquisition of a “sausage-like” shape.
- The skin above the joints is colored first in pink and then in purple-blue.
- Joint destruction and multidirectional axes of the fingers.
- Pain in muscles and fascia adjacent to them.
Which specialist should I contact?
If you have the above symptoms (one or more), you should consult a dermatovenerologist, arthrologist or rheumatologist. An experienced specialist after a visual examination and anamnesis will give a guessing conclusion.
To confirm the diagnosis, it is necessary to undergo a set of diagnostic measures. If the results of the examinations are positive, the patient is registered and therapeutic procedures are prescribed.
According to ICD-10, this disease is isolated as a separate species. The doctor in the medical history indicates arthropatic psoriasis with a special code - L40.5.
Diagnostics
The main method of confirming the diagnosis is radiography. Basically, they take pictures of the sacro-air joint, joints of the feet, hands, sternoclavicular joint. The images show defects in the cartilage and bone structure of the bone, misaligned displacement of the damaged bones. In addition to a non-invasive study of the structure of the joints using x-rays, the patient is prescribed a number of additional procedures:
- General blood analysis.
- Rheumatoid factor test.
- The study of synovial fluid.
- Determination of the circulating immune complex - a quantitative analysis of antigens and immunoglobulins.
- Ultrasound examination of the joints.
- MRI of mobile connections.
- Arthroscopy is a minimally invasive diagnostic and treatment method that allows using an arthroscope to identify and treat orthopedic diseases.
- Joint puncture.
After carrying out all the necessary diagnostic measures, a diagnosis is made and treatment for arthropathic psoriasis is prescribed.
Therapeutic methods
The therapy is comprehensive and is aimed at reducing the inflammatory process, pain, eliminating the loss of joint functionality. The goal of treatment is to relieve the crisis, prevent the onset of symptoms, maintaining remission.
The main methods are: taking medications, physiotherapeutic procedures, following a set of rules for eating food.
Medicines:
- The main substances used to treat psoriatic arthritis are non-steroidal anti-inflammatory drugs: Indomethacin, Diclofenac, Ibuprofen, No-Shpa. In case of complications of the digestive system or individual intolerance, selective cyclooxygenase-2 inhibitors are prescribed: Celecoxib, Refocoxib, Nimesulide.
- Muscle relaxants are drugs that reduce muscle tone. These include: “Baclofen”, “Midokalm”, “Sirdalud”.
- Means for outdoor use. To remove puffiness, pain, and to combat mycelium, various ointments are used: Advantan, Nizoral, and Ultrafastin.
Physiotherapy is prescribed in the absence of contraindications and during the removal of attacks of the disease:
- PUVA therapy is a method combining UVA and photosensitizers.
- Magnetotherapy.
- Phonophoresis with glucocorticoids.
It is important to understand that only timely access to medical care guarantees the effectiveness of therapy. With self-treatment or advanced stages of arthropathic psoriasis, disability is guaranteed in most cases.
Diet for the disease
Any treatment has a greater effect, if you follow the daily routine and monitor nutrition. It is necessary to exclude certain foods from the diet that can provoke an ailment:
- Alcohol.
- Coffee and tea, the exception is green.
- Allergy-causing products: citrus fruits, honey, red fruits, eggs.
- Fried and smoked dishes.
- Spicy and salty foods.
- All fast food.
With arthropathic psoriasis, you need to eat often, but little by little. The emphasis should be on fermented milk products, raw and steamed vegetables. Eating meat should be limited, it is better to exclude pork.
Various specially designed exercises and gymnastics are very effective as therapy in combination with a diet.
Folk remedies for the treatment of psoriatic arthropathy
Alternative medicine can be a good addition to traditional. Before using a folk remedy, it is advisable to obtain the approval of a specialist.
Decoctions and herbal teas, celandine baths, compresses and lotions contribute to the reduction of inflammation.
Due to the poor knowledge of the etiology of arthropathic psoriasis, it is not possible to prevent the disease. But an appeal to the doctor in the early stages of the disease and well-chosen therapy can achieve a decrease in progression and stable remission.