Psoriatic Arthritis Signs and Symptoms | Johns Hopkins Medicine

(gentle music) – 30 to 40 years is the peak age where people develop psoriatic arthritis, which is about a decade later than the peak age for
psoriasis, for the skin disease. People usually take 10 to 20 years to develop psoriatic arthritis. In terms of the disease course,
it’s rather unpredictable. People will experience
episodes of worsening of the psoriatic arthritis and
then episodes of improvement. Early symptoms with psoriatic
arthritis are important. For example, in the Toronto cohort, it was shown that people who
developed psoriatic arthritis the year before they were diagnosed had reported joint pain,
fatigue, and stiffness. So, again, the symptoms, although they may seem
non-specific, are very important and maybe the initial steps
that patients experience even before they are diagnosed. Psoriasis is a relatively
common skin disease. It affects about 4% of Americans. And the form that is most associated with psoriatic arthritis is psoriasis that’s located on the scalp. Having psoriasis behind the ear or inside the ear also counts. Perianal psoriasis. And then of course there’s
the more frequent form where classic psoriasis
is localized on the knees and on the elbows. It’s very bothersome for patients, and there’s degrees of this. And then the most classic form is what we call plaque psoriasis where people will develop these raised lesions. There’s a rash that’s
called guttate psoriasis, which looks like little drops of rain. That’s how it got its name. It’s just very little patches of rash, but it’s spread over
almost the entire body, so if you add these patches together, it’s a lot. It’s just that they are spread all over. People tend to get this more often after strep throat. It’s most common in young people. That’s one form, in addition to the classic plaque psoriasis. There’s one that’s
called inverse psoriasis, where people tend to develop
the rash in the skin folds. It tends to look different just because the skin in those areas has a different quality. It’s not going to scale as much, but it’s going to be red, and it’s going to hurt, and it’s going to ooze fluid, and it’s very uncomfortable. Then there are more rare forms. About two to four percent
of people with psoriasis will have a rash that’s
called pustular psoriasis. It looks like little pimples on the hands or on the soles of the feet. Of course, these are,
again, itchy and tender. These pimples are sterile. There’s no bacteria in it, so it’s not a real pimple. It’s just an inflammation, but it looks like that. We see this in people with
psoriatic arthritis as well. Then, of course, there’s
more severe systemic forms where most of the skin, 80% to 90% of the skin is
affected with red rash. We call that erythroderma. When that is severe, that
sometimes needs hospitalization and treatment with health and drugs to try and get the skin under control. Because if you think the
skin is our largest organ, and it’s essential for the
body to function properly and to be protected from
everything else around you. Nail psoriasis can look
in many different ways. The most common form is
what we call nail pitting. There are small pits on
the surface of the nail and, again, that can have
different degrees of severity, from just a few pits on several nails to really, all the entire nail surface being changed by that. Then, the extreme form of pitting would be nail plate crumbling, where the nail can turn into a powder and then it’s basically
just disintegrating. Another form is what we call onycholysis, when the nail lifts off the nail bed. The nails grow slowly, so even with treatment, it takes months for the
nail to fully recover. But it’s definitely reversible
with effective treatment. (gentle music)

7 thoughts on “Psoriatic Arthritis Signs and Symptoms | Johns Hopkins Medicine

  1. Your wrong about the pimple like things being on the feet and hands well at least my case they are everywhere on me but those areas and if u scratch they open. Mine look like they are forming in the spots where the hair grows that is missing

  2. Weird that scalp psoriasis is most connected with psoriatic arthritis. I wonder why that is, but it explains why every time my scalp flares I get pain in my shoulder!

  3. I have psoriatic arthritis I'm 33 , I've had two lower back surgeries I have back issues but I developed PA after my surgeries, and not to mention that when it gets rainy and gets cold my hips ache I'll get sharp shooting pains that goes back and forth from my hip to my knee mostly on my right side.

  4. Thank you so mich forvthis video. I have suffered with pustular psoroasis on my hands and feet for over a decade, and now have arthritis. It's just bice to finally have a dignosis and learn about what's going on with my body.

  5. She just described everything I have for psoriatic arthritis. It hit me all at once; can't hold a glass of water or walk without a limp. I'm shedding my scalp like a lizard. Helped me narrow down what kind of Doctor I should see,

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