Psoriasis is a chronic skin disease that is very common. There are various types of this pathological process. Scale lichen (another name for the disease) is classified depending on medical specifics, localization, and severity. Arthropathic psoriasis (psoriatic arthritis) is a form of skin psoriasis, accompanied by an inflammatory lesion of the connective tissue and the movable connection of the bones (joint). This type of skin lesion affects 15% of the total number of cases of scaly lichen.
Description of pathology
Arthropathic form of psoriasis is characterized by pain in the joints and spine, the presence of skin plaques, painful sensations in the muscles due to hypertonicity of muscle cells. The disease can affect any abdominal connections, but is most often localized on the distal phalanges of the fingers of the upper and lower extremities.
The disease can affect the process that connects the scapula and collarbone (acromion), the sternoclavicular joint. Severe forms of psoriatic arthritis includeserious damage to the skin, spine and nervous system, extreme exhaustion of the body.
Therapy is carried out for a long time and systematically, allowing to achieve temporary relief and reduce the rate of increase in the disease.
Types of arthropathic psoriasis
The disease is classified according to the location 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 joints. Due to the fact that the inflammatory process affects several joints at once, it is not possible to cope with the disease immediately. The difficulty also lies in the fact that there are no characteristic symptoms of the disease; it is possible to determine the onset of oligoarthritis only with the help of X-rays.
- Interphalangeal deforming osteoarthritis is a pathology affecting the maculophalangeal joints, distal joints of the fingers and toes. Joint dystrophy is more prone to women after menopause.
- Psoriatic symmetrical polyarthritis is a disease that develops against the background of aggressive psoriasis. The disease is characterized by bilateral lesions of the mobile joints of the hands and feet.
- Amityl arthritis is a devastating irreversible inflammatory process characterized by absolute destruction of bone heads, bone tissue, destruction and truncation of fingers.
- Psoriatic spondylitis is the destruction of the vertebral bodies, leading to a curvature of the spine. The disease occurs in patients with psoriasis for more than 5 years. Source -vesicular formations on the skin.
There are malignant forms of articular pathologies, but they appear quite rarely.
Articular changes, in addition to forms, are classified into stages: progressive, stationary, regressing. On the bottom photo - arthropathic psoriasis (exacerbation stage).
Reasons for formation
The factors without which the pathology will never develop are unknown. Consider the causes that can provoke the onset of psoriatic arthritis.
- Genetic predisposition. In 40% of patients with this disease, the next of kin suffer from psoriatic inflammation of the joints.
- Uncontrolled use of drugs for the treatment of dermatosis affecting the skin. Indiscriminate drug 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 excess body weight and standing work, arthropathic psoriasis quickly becomes progressive.
- Neurological diseases.
- Emotional overstrain, stress.
- Diabetes mellitus.
- Viral and bacterial infections.
- Inadvertent use of corticosteroids, drugs that block beta-adrenergic receptors.
How to recognize symptoms
In most cases, articularthe syndrome is formed following the dermatological manifestations of a disease that affects the skin. Symptoms of arthropathic psoriasis may appear sequentially or suddenly.
- Stiffness in the morning. Sometimes full recovery comes in the late afternoon.
- Pain in the joints, worse at night. Unpleasant sensations first appear sporadically, gradually increasing in duration and strength.
- Swollen and sausage-shaped fingers.
- The skin over the joints turns pink first and then purplish blue.
- Disorder of the joints and multidirectional axes of the fingers.
- Pain in the muscles and adjacent fascia.
Which specialist should I contact?
If you have the above symptoms (one or more), you should consult a dermatovenereologist, arthrologist or rheumatologist. An experienced specialist, after a visual examination and anamnesis, will give a presumptive 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 prescribed therapeutic procedures.
According to ICD-10, this disease is distinguished as a separate species. The doctor in the history of the disease designates arthropathic psoriasis with a special code - L40.5.
Diagnosis
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. On thethe images show defects in the cartilaginous and bone structure of the bone, axial displacement of damaged bones. In addition to non-invasive study of the structure of the joints using x-rays, the patient is prescribed a number of additional procedures:
- Complete blood count.
- Rheumatoid factor test.
- Examination of synovial fluid.
- Determination of the circulating immune complex - quantitative analysis for antigens and immunoglobulins.
- Ultrasound examination of the joints.
- MRI of moving joints.
- 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 of arthropathic psoriasis is prescribed.
Therapeutic Methods
Therapy is complex and is aimed at reducing the inflammatory process, pain, eliminating the loss of joint functionality. The task of treatment is to relieve the crisis, prevent the increase in symptoms, and maintain remission.
The main methods are: taking medicines, physiotherapy, following a set of rules for eating food.
Medications:
- The main substances used to treat psoriatic arthritis are non-steroidal anti-inflammatory drugs: "Indomethacin","Diclofenac", "Ibuprofen", "No-Shpa". In case of complications from the digestive system or individual intolerance, selective cyclooxygenase-2 inhibitors are prescribed: Celecoxib, Refocoxib, Nimesulide.
- Miorelaxants - drugs that reduce muscle tone. These include: Baclofen, Mydocalm, Sirdalud.
- Products for external use. To relieve swelling, pain syndrome, various ointments are used to combat mycelium: "Advantan", "Nizoral", "Ultrafastin".
Physiotherapy is prescribed in the absence of contraindications and during the period of withdrawal of disease attacks:
- PUVA Therapy is a method that combines UVA and photosynthetic agents.
- Magnetotherapy.
- Phonophoresis with glucocorticoids.
It is important to understand that only timely seeking medical help guarantees the effectiveness of therapy. With self-treatment or advanced stages of arthropathic psoriasis, disability is guaranteed in most cases.
Diet for sickness
Any treatment gives a greater effect if you follow the daily routine and follow the diet. From the diet, it is necessary to exclude certain foods that can provoke an illness:
- Alcoholic drinks.
- Coffee and tea, except green.
- Foods that cause allergies: citrus fruits, honey, red fruits, eggs.
- Fried and smoked dishes.
- Spicy and s alty food.
- All fast food.
With arthropathic psoriasis, you need to eatoften, but little by little. The emphasis should be on dairy products, raw and steamed vegetables. The consumption of meat should be limited, it is better to exclude pork.
Very effective as a therapy in combination with a diet are various specially designed exercises and gymnastics.
Folk remedies for the treatment of psoriatic arthropathy
Alternative medicine can be a good addition to traditional medicine. Before using a folk remedy, it is advisable to obtain the approval of a specialist.
Decoctions and teas from medicinal herbs, baths with celandine, 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 contacting a doctor in the early stages of the disease and well-chosen therapy can achieve a decrease in progression and a stable remission.
