Psoriatic Arthritis

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-08-25 11:04

The term refers to an inflammatory disease of the joints that occurs in around 20 percent of patients with psoriasis of the skin. More than 80 percent of those affected initially only have psoriasis of the skin for many years before psoriatic arthritis occurs.

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What are the symptoms?
How is the diagnosis made?
How is psoriatic arthritis treated?
Whom can I ask?
How are the costs going to be covered?

What are the symptoms?

A special feature of psoriatic arthritis compared to rheumatic diseases is their different characteristics. Psoriatic arthritis can manifest itself as an inflammation of the joint skin (synovitis), the bones (osteitis and osteomyelitis) and the periosteum (periostitis) as well as the attachment of joint capsules, tendons or ligaments (enthesitis) near the joint. There are different disease patterns. Depending on the severity, individual or a large number of joints can be affected and lead to very different complaints.

How is the diagnosis made?

In many cases, the diagnosis is only made when typical skin and nail changes are present and the so-called rheumatoid factor is absent. This factor can typically be detected in the blood of patients with rheumatoid arthritis. In the few people who develop psoriatic arthritis before (about ten percent) or without (less than ten percent) psoriasis of the skin, diagnosis can be very difficult.

Especially in patients with nail psoriasis, it is essential to look for psoriatic arthritis. Psoriatic arthritis is twice as common with nail involvement than without nail disease. The very detailed examination of the entire skin, including the navel, the anal folds and the hairy head, is important in order to identify individual, sometimes very small, psoriasis foci that have not yet been discovered.

How is psoriatic arthritis treated?

When selecting a suitable therapy, the extent, course, impairment, response and tolerability of previous therapies must be taken into account. The treatment should work on the inflammation in the skin and joints.

Non-steroidal anti-inflammatory drugs (NSAIDs) can help if you have mild psoriatic arthritis. Physiotherapeutic measures and orthopedic aids can also be useful when controlling the inflammation and pain. Cortisone injections can be considered if larger joints are affected.
As anti-rheumatic drug methotrexate (MTX) is used, which also has the psoriatic skin a beneficial effect. Leflunomide, sulfasalazine or cyclosporine A can also be used.
Significantly more effective than all previously used therapies are approved biologics for the treatment of psoriatic arthritis (e.g. adalimumab, etanercept, golimumab, infliximab). Biologics may be used if other measures are not sufficiently effective or cannot be tolerated. The advantage of these preparations is that they prevent psoriatic arthritis from progressing. There may even be a slight improvement in existing damage to bones.
Another therapy option is the phosphodiesterase inhibitor apremilast. This so-called small molecule in tablet form has the effect that fewer substances are formed in the inflammatory cells that stimulate or maintain inflammation.

Whom can I ask?

It is important to consult a general practitioner or a specialist in dermatology as early as possible in the event of persistent symptoms such as reddening of the skin, flaking and itching, etc. If joint problems occur and the diagnosis of psoriatic arthritis is confirmed, a coordinated diagnosis and treatment should be carried out by the specialist in internal medicine with a focus on rheumatology and by the dermatologist.

How are the costs going to be covered?

The e-card is your personal key to the benefits of the statutory health insurance. All necessary and appropriate diagnostic and therapeutic measures are taken over by your responsible social insurance agency. A deductible or contribution to costs may apply for certain services. You can obtain detailed information from your social security agency. Further information can also be found at: