Psoriasis in Italy affects 3% of the population: over the years of this disease the level of knowledge has increased and with it the therapeutic possibilities. “However, even today we tend to overlook the presence of joint pain, which frequently signals the onset of psoriatic arthritis in psoriatic patients, inflammatory and joint disease that it is important to treat in time to avoid consequences, even serious, to the joints “. Like this Niccolò Possemato, rheumatologist at the Rheumatology Unit, S. Maria Nuova hospital in Reggio Emiliain an interview published on Allies for Healththe portal dedicated to medical-scientific information created by Novartis, takes stock of how to recognize joint pain typical of psoriatic arthritis.
“It is – explains Possemato – of an inflammatory pain, which differs from mechanical pain and which has a subtle onset, for this reason we will hardly be able to identify the moment in which this symptom appears. It is a predominantly nocturnal and morning pain that is associated with a stiffness at the beginning of the movement, responds well to inflammatory diseases and above all improves with movement. “Unlike mechanical pain, which worsens by stressing the joint, inflammatory pain, in fact, it improves over the course of the day.
According to Possemato, among people with cutaneous psoriasis “about 1 in 3 will develop psoriatic arthritis and up to 85% of cases psoriasis precedes psoriatic arthritis“. The appearance of joint pain must therefore be considered a wake-up call and above all” a patient with psoriasis, if he begins to develop a joint symptom, should contact his doctor “, warns the rheumatologist. Psoriatic arthritis is a disease complex and determines a symptomatology that can affect different sites of the body. In fact, it causes “very different clinical manifestations – underlines the expert – because it can affect the joints, tendons, back, but sometimes also organs such as the intestine or the ‘eye, in addition of course to the skin “.
The joints can become inflamed (knee, hand, wrist or fingers). When the inflammation affects the fingers this causes the appearance of dactylitis, or the so-called “sausage finger”. “Particular attention must be paid to this phenomenon because – warns Possemato – a dactylitis in a patient suffering from psoriasis is a highly suggestive manifestation of psoriatic arthritis and deserves a specialist visit”.
In 15% of patients psoriatic arthritis appears without psoriasis or in a contextual way, but in most cases, cutaneous psoriasis precedes psoriatic arthritis. For this reason, patients with psoriasis must be carefully followed by the general practitioner and dermatologist, making them aware of any joint symptoms, in order to understand if the involvement of the rheumatologist is necessary. The latter can proceed according to different diagnostic methods, depending on the area affected by the joint pain: joint ultrasound (to highlight peripheral arthritis, which therefore affects the hands, feet, ankles and wrists, and for tendonitis), magnetic resonance ( if the pain is in the back).
Thanks to the “new therapies that we have available today, we are able to cure not only arthritis but also psoriasis. These diseases can be treated effectively with drugs that act on the immune systemwhich slow down the immune system and allow you to heal both the skin and the joints “, concludes Possemato.
The full article is available on https://www.alleatiperlasalute.it/whatsapp-con-il-medico/psoriasi-attention-al-dolore-articolo
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