WHAT CAUSES PSORIATIC ARTHRITIS?

Psoriatic arthritis (PA)

is a form of inflammatory arthritis that usually occurs in people with skin disease called psoriasis. Between 10% and 30% of people with psoriasis will have PA, a condition that affects men and women as well and usually occurs between the ages of 20 and 50 years.

no cure for PA

There is no cure for PA, but early diagnosis and appropriate treatment can control the disease and prevent serious joint damage. Most people with PA can lead an active and productive life if they follow proper treatment that combines medication, surgery (in some cases), exercise, rest and joint protection techniques.

autoimmune disease

Psoriasis is an autoimmune disease that causes a disruption of the immune system. It attacks the skin and causes the appearance of inflamed red patches, or “closets”, covered with silvery white lamellae or “dander”. Psoriasis can be limited to a few small plaques or spread over much larger areas. The disease can also affect the fingers and nails. In most people, psoriasis is mild and may even go unnoticed.

inflammatory arthritis

PA is a type of inflammatory arthritis and autoimmune disease. In the case of PA, the immune system attacks the joints and causes inflammation (the joints become swollen, painful and warm to the touch). PA can also cause back and neck pain. In most cases, PA occurs after the onset of psoriasis. It should not be concluded, however, that psoriasis inevitably leads to PA; in fact, most people with psoriasis will never have PA. It should be noted, however, that nail psoriasis is associated with a higher risk of developing PA.

psoriatic arthritis

PA is usually slow onset and extends from one joint to another over a period of weeks to months. However, in some (less frequent) cases, a severe AF may occur suddenly. In short, PA is an atypical disease, the symptoms of which vary greatly from person to person.

The causes of psoriatic arthritis are unknown, but we know that heredity plays a very important role because there is a clear family predisposition: it is found in 30% of cases. If a family member has psoriasis (or psoriatic arthritis), the risk of psoriasis (or psoriatic arthritis) is higher for other members of the same family.

Several modified genes (“genetic variants”) have been identified in psoriasis. They are mostly located at the level of genes involved in immunity, coding for the HLA system, T lymphocytes or interleukins 17 and 22 involved in inflammation of the skin. These variants are numerous and only the combination of several of them is associated with psoriasis. No mutation can trigger the disease alone.

There is therefore a “genetic vulnerability” to psoriasis or psoriatic arthritis, but this will only occur if the vulnerable person is exposed to one or more environmental agents (who are not, at most often, not known). This exposure, however, triggers the autoimmune disease manifested by the activation of certain white cells that belong to the immune system (T lymphocytes) and these trigger inflammation in the skin and / or at the level of the skin. articulation and enthesis.

Triggers such as stress, skin injury, general infection, certain medications, smoking, and excessive alcohol consumption can cause psoriasis or psoriatic arthritis and even lead to development of the disease.

psoriatic arthritis

PA is usually slow onset and extends from one joint to another over a period of weeks to months. However, in some (less frequent) cases, a severe AF may occur suddenly. In short, PA is an atypical disease, the symptoms of which vary greatly from person to person.

The causes of psoriatic arthritis are unknown, but we know that heredity plays a very important role because there is a clear family predisposition: it is found in 30% of cases. If a family member has psoriasis (or psoriatic arthritis), the risk of psoriasis (or psoriatic arthritis) is higher for other members of the same family.

Several modified genes (“genetic variants”) have been identified in psoriasis. They are mostly located at the level of genes involved in immunity, coding for the HLA system, T lymphocytes or interleukins 17 and 22 involved in inflammation of the skin. These variants are numerous and only the combination of several of them is associated with psoriasis. No mutation can trigger the disease alone.

There is therefore a “genetic vulnerability” to psoriasis or psoriatic arthritis, but this will only occur if the vulnerable person is exposed to one or more environmental agents (who are not, at most often, not known). This exposure, however, triggers the autoimmune disease manifested by the activation of certain white cells that belong to the immune system (T lymphocytes) and these trigger inflammation in the skin and / or at the level of the skin. articulation and enthesis.

Triggers such as stress, skin injury, general infection, certain medications, smoking, and excessive alcohol consumption can cause psoriasis or psoriatic arthritis and even lead to development of the disease.

However, having a genetic predisposition does not necessarily mean that one day you will suffer from psoriasis or psoriatic arthritis.

The treatment is based on the prescription of drugs, but also on orthopedic appliances, functional rehabilitation, adapted physical activity and, possibly, surgical interventions.

The drugs prescribed in psoriatic arthritis aim to relieve pain and prevent joint damage by reducing local inflammation. They also help to limit the loss of joint mobility.

Background treatments are prescribed to prevent PSA outbreaks in people who suffer from it frequently, or when treatment for relapsing relief is not sufficient. These treatments are designed to partially inhibit the action of the immune system to reduce inflammation: they are called “immunosuppressive”. These treatments are reserved for severe or moderately severe forms but have a strong impact on the quality of life of the patient.

Outbreaks of psoriatic arthritis are usually relieved by taking nonsteroidal anti-inflammatory drugs (NSAIDs, eg ibuprofen or ketoprofen). In some cases, analgesics (for pain) may be prescribed for a limited time. Finally, it is possible to inject corticosteroids (drugs of the cortisone family) directly into the painful joint (s).

In addition to medications, other types of treatment exist to relieve the symptoms of psoriatic arthritis:

The use of orthotics, intended to limit the movements of the affected joints, helps relieve pain and prevent or limit joint deformities.

Functional rehabilitation, set up by a physiotherapist who carries out programs adapted to the affected joints. The sessions, performed alone or in groups, aim to preserve joint mobility and muscle strength, and to relieve pain.

Surgical procedures, performed in exceptional cases where the joints are very damaged.