Beyond Joints: How PsA Affects The Body
Joint pain is a big part of living with psoriatic arthritis (PsA). But the inflammation that affects your joints can cause problems for other organs and tissues too. You’ll probably think of skin issues first, but your eyes, heart, lungs, gastrointestinal (GI) tract (stomach and intestines), liver and kidneys may also be affected.
Skin. Psoriasis appears first in 60 to 80 percent of patients, usually followed within 10 years by arthritis. However, the arthritis may not develop for up to 20 years after psoriasis develops. Some patients are diagnosed with both diseases at the same time, and up to 20 percent have psoriatic arthritis symptoms before psoriasis. Psoriasis causes patches of skin to become thick, reddish and inflamed, often with silvery-white scales. These patches – which sometimes itch and burn – may appear anywhere on the body, but are most common on the elbows, knees, scalp, back, face, palms and feet. More than 10 percent coverage is considered severe.
Eyes. If you have PsA or psoriasis, it may affect your eyes in different ways. You may get pink eye (conjunctivitis), dry eye syndrome which causes dry, burning, gritty-feeling eyes or swelling in the white part of the eye. About 7 to 25 percent of people with PsA develop eye inflammation, called “uveitis.” The condition can affect one or both eyes. It can cause pain, redness, irritation and disturbed vision, which may lead to permanent vision loss.
GI Tract. Having psoriatic arthritis may make you more likely to have inflammatory bowel disease, especially the form called Crohn’s disease, which causes diarrhea and other gastrointestinal issues. A 2013 study in Annals of the Rheumatic Diseases found that women in the U.S. who had psoriasis were four times more likely than others to develop Crohn’s disease; those who had both psoriasis and psoriatic arthritis had a nearly 6.5 times increased risk.
Heart. Studies have shown that psoriasis, PsA and cardiovascular disease are linked. Chronic inflammation can damage blood vessels, increasing the risk for heart attacks and strokes. A 2013 study in the Journal of the European Academy of Dermatology and Venereology found that having psoriasis raises the risk of developing cardiovascular disease by 25 percent, while PsA increases the chances even more – by 57 percent.
Lungs. The inflammation that causes PsA may also harm your lungs, causing a condition known as interstitial lung disease that leads to shortness of breath, coughing and fatigue. This condition tends to also affect people with other rheumatic diseases, such as rheumatoid arthritis and ankylosing spondylitis.
Liver and Kidneys. Since so many people with psoriatic arthritis have psoriasis, your doctor will also pay attention to how your liver and kidneys work. Having psoriasis increases your risk of having chronic kidney disease and a type of nonalcoholic fatty liver disease. Your PsA increases these risk even more.
Caring for your joints is important. But make sure to talk to your doctor about your non-joint symptoms. Coping with PsA’s health effects may sound like a full-time job, but open communication with your doctor will help you develop an effective treatment plan that cares for your whole health.