2023-12-12 18:17:56
by Livia Gamondi
The diagnosis often comes late. If discovered promptly, however, it can be treated to stop the damage to the joints and often achieve remission of the disease
There are almost 300 thousand Italians affected by psoriatic arthritis. A chronic inflammatory autoimmune disease that can manifest itself with joint pain and psoriasis, more easily in the 30-50 year age group. It affects women and men equally and is more frequent in the Caucasian population. It can take up to 7 years to reach the diagnosis from the onset of symptoms, within the first two years almost 50 percent of patients develop joint complications. Early diagnosis and treatment are fundamental, in fact the control of the disease and the achievement of clinical remission depend on how early the diagnosis was. The screening test that helps identify signs and symptoms was recently presented in Milan on AbbVie’s Vicini di Pelle website.
Psoriatic arthritis is an inflammatory arthritis, characterized by joint inflammation, stiffness, fatigue and severe pain in people in the midst of their social and working life – explains Stefano Piaserico, Associate Professor of Dermatology, Department of Medicine-DIMED of the University of Padua —. It is an alteration of the immune response that causes a chronic inflammatory state such as that underlying psoriasis, but which can be very disabling due to joint pain. The onset could be cutaneous first and subsequently involve the joints, while in other cases the disease may manifest itself earlier at the joint level compared to the typical manifestations of psoriasis such as plaques. – And the expert continues – The patient suffering from psoriasis must recognize the possible onset of psoriatic arthritis early. He must listen to his body, feel the joint symptoms such as pain in the large joints, knee, shoulder or even small ones and in particular those of the hands, feet or even the insertion of the tendons: an annoying tendonitis that does not resolve itself in within a few days in a person with psoriasis it could be a sign of possible psoriatic arthritis.
People with psoriasis should never underestimate the appearance of joint or tendon pain of a certain duration, as psoriatic arthritis risks compromising the quality of life if not diagnosed and treated early. In fact, it can lead to bone damage at the joint level, in 47 percent of patients there is bone erosion within the first two years of the onset of symptoms. Dermatologist and rheumatologist have a key role in the patient’s diagnostic path and in the subsequent choice of treatment. Today, thanks to the available therapies it is possible not only to control symptoms and act quickly on pain and inflammation, but also to prevent irreparable damage to the joints.
The diagnosis of psoriatic arthritis is not always easy – points out Roberta Ramonda, Associate Professor of Rheumatology, Department of Medicine-DIMED of the University of Padua -. The disease has a slow onset and the clinical manifestations can be very different from person to person and easily confused with the symptoms of other forms of arthritis. Patients may have several manifestations in addition to pain and swelling of the peripheral joints and axial skeletal pain such as pain in the tendons and tendon insertion sites, swelling of an entire toe or hand (sausage toe), nail psoriasis or in other locations —. And, continues the expert, it is necessary to diagnose it early otherwise the joint damage becomes irreversible and even disabling. Today, effective therapies are available and capable of inducing control of the disease and eventual remission in a high percentage of cases provided that they are started promptly, making early diagnosis and contacting a rheumatologist specialist in good time.
Currently, there is no specific diagnostic test for psoriatic arthritis, but screening tools exist. On the Vicini di Pelle website there is a questionnaire, five simple questions, which can facilitate the diagnosis of psoriatic arthritis in patients with psoriasis. This disease compromises the quality of life due to severe pain, limitations in movement and the significant psychological involvement due above all to the fact that it “can be seen” on the skin. If left untreated it can produce devastating effects – states Antonella Celano, President of APMARR, National Association of People with Rheumatological and Rare Diseases -. Often people with psoriasis who begin to have pain, stiffness or swelling in the joints do not think that these could be the first signs of a chronic rheumatic disease. Instead, they should take the screening test and talk about it with their doctor, who will then liaise with the rheumatologist. Only with adequate information and rapid referral to a specialist, in a multidisciplinary approach where dermatologists and rheumatologists collaborate, will it be possible to achieve an early diagnosis and personalized treatment.
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December 12, 2023 (modified December 12, 2023 | 5:17 pm)
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