Could your skin be causing your joint pain?

It’s your body’s largest organ, but how many of you stop and consider your skin when it comes to your overall health and wellbeing? Your skin is often the first to reveal you could be suffering a disease or an ailment.

One such indicator is psoriasis.

“Psoriasis is a genetic condition and currently there are 20 different genes currently identified that are involved in psoriasis,” clinical associate professor Saxon Smith says.

“Psoriasis is characterised by raised red areas of skin — called plaques — with fine or thick scale over the surface. Classically it is seen on elbows and knees but can range from a single patch of affected skin to covering the whole body.”

Affecting more than 450,000 Australians, many people don’t realise that psoriasis can lead to a much more severe health condition — psoriatic arthritis.

Understanding psoriasis

Smith says there are five main ways psoriasis presents in patients: large plaque psoriasis (large areas of raised red flakey skin); guttate psoriasis (small areas of raised red flakey skin); palmoplantar psoriasis (psoriasis of palms of the hands and soles of thee feet); psoriasis inversus (red well demarcated patched under the arms, in the groin, in the genital area and under the breasts in women); scalp psoriasis (red raised areas with thick flakey scale in and around the scalp).

“It can also affect the whole body — called erythrodermic — and can also have lots of pustules/pimples — pustular psoriasis.”

The skin condition affects around 1 million Australians.

There are a range of treatment options available to help you with your psoriasis, but Smith says the severity and the area of the body affected plays a part in the treatment available.

“Mild psoriasis often is well controlled with topical creams and ointments. Phototherapy, which is anti-inflammatory and anti-itch, is highly effective for many people suffering from mild, and moderate to severe psoriasis. For those that don’t respond to these there are further options to get control including medication,” Smith says.

Being able to recognise, diagnose and treat psoriasis is one way of ensuring any changes to the condition, including the development of psoriatic arthritis, are identified early.

About psoriatic arthitis

Around 30 per cent of those with psoriasis will develop psoriatic arthritis. This can cause pain, stiffness and swelling in and around your joints.

Early diagnosis of psoriatic arthritis is critical to ensure you get effective treatment that is able to relieve pain and inflammation and that joint damage is prevented.

The development of symptoms can vary from patient to patient, but you should be on the lookout for:

• tenderness, pain and swelling in your tendons
• swollen fingers and toes that look like sausages
• a general feeling of fatigue
• stiffness, pain, throbbing, swelling and tenderness in one or more joints
• a reduce range of motion
• stiffness and tiredness in the morning
• changes in your nails, such as separation from the nail bed
• redness and pain of your eye, like conjunctivitis.

The condition usually affects the joints closest to the nail, so be alert to changes around your fingers and toes.

However, you could also experience any of the above symptoms with your lower back, wrists, knees or ankles.

Because psoriasis usually always occurs before the joint disease, Smith recommends you regularly see your health care professional for a whole health assessment.

“If you have psoriasis that does not seem to respond to your current treatment, if your psoriasis has changed or is getting worse over time, or if you haven’t seen a doctor about your condition for a significant period of time it is worth seeing your doctor,” Smith says.

Working with your doctor and/or a dermatologist is often one of the first steps in diagnosing psoriatic arthritis. It is also recommended you see a rheumatologist who specialises in the condition.

Dr Irwin Lim, a rheumatologist and director at BJC Health, says psoriatic arthritis is a surprisingly common type of arthritis.

While there are no cures for psoriatic arthritis there is treatment available and Lim says the treatment you receive is often targeted towards the specific type of arthritis.

“There are medications to help reduce the discomfort and improve quality of life, and there are medications to prevent progressive damage for some types of arthritis,” he says.

However, Lim points out that lifestyle plays an important part in the management of psoriatic arthritis and it is worth considering the effect your weight, nutrition, regular exercise and smoker status could have.

Do you have psoriasis or another skin condition? Have you noticed any changes to the condition? Had you heard of psoriatic arthritis?