What are the 5 types of psoriatic arthritis?


Psoriatic arthritis (RP) is linked to psoriasis, but it’s not the same thing. Psoriasis is a chronic skin condition that causes red, scaly skin. PsA, on the other hand, usually manifests as joint pain. It is possible to have both conditions, or to have one without the other.

If you have PsA, it helps to know what type you have so that you can get the right treatment. Here’s how to recognize the top five types of PsA, and treatment tips for each.

Asymmetric PsA is the most common type of PsA. It accounts for at least 60 percent of cases. It affects your joints individually rather than in pairs. This means that you might feel pain in the joints of your right hand without affecting your left.

But your symptoms won’t necessarily stay on one side. For example, your left knee and right foot may show symptoms at the same time, even though you have asymmetric PA. According to a 2019 study, this type of PsA is more common in men.

How to spot it

Common symptoms of asymmetric RP include:

How it’s treated

PsA currently has no cure. But there are ways to show your symptoms who’s boss. Your doctor can help you decide which one (or a combination or treatments) is right for you.

Potential treatments include:

  • physical therapy
  • occupational therapy
  • oral corticosteroids (such as prednisone)
  • biological drugs (such as adalimumab or etanercept)
  • nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen
  • intra-articular joint injections (such as hyaluronic acid or cortisone)

With symmetrical PsA, symptoms tend to appear on both sides of your body at the same time. This type of PsA accounts for 15 to 61 percent of cases. It is more common in women.

How to spot it

The symmetrical symptoms of RP closely resemble the asymmetric symptoms of RP. Symmetric PsA tends to affect the small joints of the feet or hands, rather than larger joints like the knees or elbows.

for your information: Symmetric RP is sometimes confused with rheumatoid arthritis (RA). A simple blood test can help you tell if you have RA instead.

How it’s treated

Treatments for symmetric PsA are often similar to asymmetric PsA. The exact ideal treatment plan may depend on your:

  • age
  • weight
  • mobility
  • pain level
  • overall health

PSA PSA: Studies show that smoking cigarettes can worsen symptoms of RP. It could also reduce some of the positive results of the treatment.

It is estimated that 10% of peeps with RP have predominantly distal interphalangeal RP (PID). It targets the DIP joints which are located near the tips of your toes and fingers, so you may notice changes in your fingernails. It can appear in a single joint or affect several.

How to spot it

Common predominantly distal interphalangeal (PID) symptoms include:

  • swollen fingers or toes
  • ligament or tendon pain
  • reduced range of motion
  • joint stiffness in the fingers or toes

Nail problems are also very common in PsA PID. You may notice:

  • sting
  • crumbling
  • White dots
  • discoloration
  • cracking nails
  • detachment

How it’s treated

Your doctor may suggest nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections to help treat mild inflammation and discomfort. For more severe cases, you may be given tumor necrosis factor (TNF) inhibitors. Those strength slow progression of the disease.

For temporary relief, you can try a DIY treatment. Here are some possible options:

  • Cold therapy. Place an ice pack on the affected area for up to 10 minutes to calm the inflammation.
  • Manicure. Avoid trimming your cuticles and applying nail polish to reduce your risk of irritation. You can also keep your nails hydrated with oils and cuticle creams.
  • Soak up it. Give your hands or feet a relaxing bath. Just keep your soak relatively short to avoid drying out your skin. You should also follow with a top notch moisturizer.
  • Keep your hands and feet dry. Gently pat your skin dry after each shower. You should also opt for sweat-wicking socks that wick moisture away from the skin.

Remember to talk to your doctor before trying any PsA home remedy. It is important to check that it is not interfering with your prescription treatments or worsening your unique symptoms.

About 7-32% of people with PsA have PsA spondylitis (aka axial arthritis). This type of PsA tends to target the joints between your spinal vertebrae.

How to spot it

PsA spondylitis can cause pain, stiffness, and swelling in the neck and back. But these symptoms can also affect your:

How it’s treated

According to the Spondylitis Association of America, treatments for spondylitis can include:

  • NSAIDs
  • physical therapy
  • occupational therapy
  • immunosuppressants
  • sulfasalazine (Azulfidine)
  • biological drugs (such as TNF inhibitors)
  • disease-modifying anti-rheumatic drugs (DMARDs)

PsA mutilans is a rare but severe form of PsA. It only affects about 5% of people with PsA. It usually causes severe pain – usually in the hands, feet, or wrists.

How to spot it

PsA mutilans can cause extreme inflammation which can lead to joint damage. You can also have:

  • deformities of the affected joints
  • bone loss in the affected joints
  • loss of motion or reduced range of motion
  • pain that radiates to other parts of the body

How it’s treated

Psoriatic arthritis mutilans is a progressive disease. It can get worse over time, so it’s important that you manage the symptoms as soon as they appear.

Treatments may include anti-TNF inhibitors, DMARDs, or biologic drugs. A 2011 study also found that a drug called etanercept (Enbrel) can help restore joint function. But we need more research to prove if this is legitimate.

Psoriatic arthritis (PsA) is a type of arthritis that affects up to 30% of people with psoriasis. It is not a universal condition and can affect everyone differently.

Treatment plans depend on your unique symptoms and other lifestyle factors. Your doctor may suggest medications that can help reduce inflammation and pain while slowing the progression of the disease.


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