If you're a rheumatologist or dermatologist, there's a good chance you're familiar with psoriatic arthritis (PsA), a type of inflammatory arthritis associated with psoriasis that affects nearly 2.1 million people in the US alone.

National Psoriasis Foundation.  https://www.psoriasis.org/for-medical-professionals/.

Psoriatic Arthritis. Cleveland Clinic. November 29, 2019.

 

 

With five distinct types and a wide range of symptoms, PsA can be challenging to treat. Individual cases may present differently, sometimes affecting only four joints in the body, other times affecting far more than four—along with possible nail and eye involvement. PsA can require a variety of interventions, and often involves multidisciplinary teams.   

 

The NPF's pocket guide for physicians 

 

A must-have resource for any physician treating PsA, The Psoriasis and Psoriatic Arthritis Pocket Guide: Treatment Algorithms and Management Options is a comprehensive guide published by the National Psoriasis Foundation (NPF).

The Psoriasis and Psoriatic Arthritis Pocket Guide. National Psoriasis Foundation.

 

Authored by some of the nation's leading dermatologists and rheumatologists, the pocket guide provides extensive information about PsA and up-to-date guidance for managing patients with both PsA and psoriasis. 

Now in its 8th edition, the guide boasts seven chapters of treatment algorithms and management options, with an introductory section that covers just about every angle of PsA you can imagine. Topics include:

• Epidemiology 

• How to effectively assess patients

• Treatment selection (NSAIDs; methotrexate; biologics; physical therapy) 

• Algorithms for patient-specific situations—such as individuals with HIV infection and psoriasis, or women of childbearing potential with psoriasis—to give a holistic understanding of how PsA may operate alongside other conditions 

• Side effect profiles of the numerous treatments used in psoriasis and PsA 

• Infection risk assessment for patients who are pursuing therapies 

• Insurance advocacy, which may help patients to better access quality care

• And more

 

ACR's Fast Facts sheet

 

The American College of Rheumatology (ACR) offers physicians a succinct and convenient article to answer some of the most common questions asked by patients.   

This Fast Facts sheet defines PsA, discusses who gets it, and provides detailed responses to questions pertaining to diagnostics, treatment, broader health impact, and the rheumatologist’s role in helping patients manage their symptoms.

Psoriatic Arthritis. Fast Facts. American College of Rheumatology. December 2021.

 

 

One observation, under the section titled “Living with Psoriatic Arthritis,” addresses the value of exercise and movement in keeping joints flexible and healthy.

"Many people with psoriatic arthritis also benefit from physical and occupational therapy,” the authors wrote, “to strengthen muscles, protect joints from further damage, and increase flexibility.”

Aqua therapy can be beneficial, as some people with arthritis find it easier to move in water.  

 

AAD diagnosis and treatment sheet

The American Academy of Dermatology Association’s (AAD's) article on diagnosis and treatment related to PsA, is another helpful resource that can be shared with patients.

Psoriatic Arthritis: Diagnosis and Treatment. American Academy of Dermatology Association. 2023.

 

This article dives into how PsA is diagnosed, which may require a close look at their medical records, extensive questioning about family history, an examination of the joints, and, potentially, x-rays and blood tests.

This educational material about PsA can provide patients with a solid background on the disease and help them understand the rationale for your treatment plan.

The use of disease-modifying, anti-rheumatic drugs (DMARDs) to treat PsA is explained. DMARDs mitigate pain and swelling. Methotrexate and injectable biologics are two DMARDs used to manage PsA symptoms.

 

NPF's Screen for PsA test

The NPF has created the Screen for PsA test, an easy, free, at-home screening tool that patients can complete at any time.

Screen for PsA. National Psoriasis Foundation. 2022.

 

Designed to help patients identify possible symptoms of PsA, the Screen for PsA consists of five questions:

• Have you ever had a swollen joint (or joints)?

• Has a doctor ever told you that you have arthritis?

• Do your fingernails or toenails have holes or pits?

• Have you had pain in your heel?

• Have you had a finger or toe that was completely swollen and painful for no apparent reason?

Based on the number of “yes” answers, the test will let the patient know whether they are likely to be struggling with PsA.

This is a resource that patients (especially those with psoriasis) can return to every 6 months to check in about the progression of their symptoms—and one that they can use to gauge when it’s time to set up an appointment with you for further testing.