Is psoriatic arthritis an autoimmune disease?

What is Autoimmune Disease?


The primary function of the immune system is to keep the body healthy by fighting off foreign invaders (pathogens) that cause infection and illness. When the immune system does not function properly, it goes into action without the presence of any pathogen and automatically launches an inflammatory response against the body. Autoimmune diseases are a result of an overactive immune system.


So, is psoriasis an autoimmune disease? In a nutshell, yes, and so is psoriatic arthritis. While researchers continue to search for answers in what triggers the immune system to attack the body’s own tissues, psoriasis and psoriatic arthritis treatments are available to help manage the symptoms of the disease. Unfortunately, there is no known cure, but the prognosis is good with effective methods in managing the symptoms.

In psoriatic disease, the immune system wages war with the skin and joints causing mild to severe symptoms. With common psoriasis, different layers of the skin are affected, and abnormalities (flaky pink plaques) appear on the skin’s surface around the elbows, knees, scalp or under the breasts. However, psoriatic arthritis is different as it comes with skin disfigurements as well as joint pain.


Conditions Associated with Psoriasis


What is psoriatic arthritis? It is a type of arthritis and autoimmune disease affecting the joints in people who have existing psoriasis. However, it is possible for psoriasis to occur after the joint problems start. Psoriatic arthritis is not to be confused with rheumatoid arthritis where inflammation occurs symmetrically involving multiple joints in one area, like several knuckles on the hand. Psoriatic arthritis gradually affects one or two random joints such as the knee or toe with swelling and pain.


People with preexisting psoriatic arthritis are susceptible to getting Enthesitis. The tendons are tissues attaching the muscles to the bones, and ligaments attach the bones to each other. Where the tendon or ligament meets the bone is called an enthesis. Inflammation of the enthesis causes Enthesitis that can cause new bone tissue to form, leading to pain and stiffness, particularly when moving. Symptoms usually occur around the Achilles tendon (heel), knee, hip, elbow, or backbone.

Is psoriatic arthritis an autoimmune disease?

Another condition affecting people with psoriasis is Dactylitis. This is inflammation of a whole digit of a finger or a toe. When caused by psoriatic arthritis, it does not present symmetrical joint involvement so individual digits are affected differently. The tendons against the finger or toe become inflamed causing swollen and painful joints.


Living with psoriasis increases the risk of other complications and conditions. Several comorbidities like metabolic syndrome, cancer, heart or lung disease, inflammatory bowel disease, and diabetes have been linked to psoriasis. People with psoriatic disease need to consult with a medical practitioner to discuss regular screenings, and diet and lifestyle guidelines to mitigate the associated health risks.


Diagnosing and managing psoriatic arthritis disease


Psoriasis and psoriatic arthritis are more than skin deep as they are complex and chronic diseases. Typically, people will experience relapses over a long-term period with symptoms that may come and go. A doctor or dermatologist can diagnose psoriasis through understanding the person’s medical history and physically examining the skin, scalp, and nails. In some cases, a skin biopsy might be done.


When people experience symptoms like psoriasis and fatigue together with swollen and painful joints, a medical examination should be done sooner rather than later to avoid permanent joint damage. A psoriatic arthritis diagnosis can include a range of different tests such as blood tests, X-rays, an MRI, or ultrasound as other types of arthritis need to be ruled out.


There is no one test to confirm a diagnosis, so depending on the symptoms, people may be referred to a rheumatologist who specializes in arthritis. Generally, the diagnosis is made through medical observations and eliminations. Joints are closely examined for signs of swelling or tenderness, fingernails are checked for flaking and abnormalities, as well as other areas of the body.


When it comes to treatment, psoriatic arthritis medication helps to control the inflammation of the affected joints and relieve pain. These include nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and immunosuppressants. Medications do have side effects, but this must be discussed in-depth with the doctor. Other procedures can be considered for extreme cases, such as steroid injections and joint replacement surgery.


As a first step, people should make the necessary diet and lifestyle changes to improve their general health. Protect the joints by not straining, have a healthy weight, and wholesome diet, partake in regular and gentle exercise, quit smoking, and limit the intake of alcohol are all steps that can be taken to minimize risks and consequences of psoriatic disease and the effects of medication.


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