While most of the people who develop psoriatic arthritis (PsA) already have psoriasis, it is possible to develop it without having psoriasis first. Psoriasis is an autoimmune condition that affects the skin.
A 2015 analysis found that estimates of the prevalence of PsA among people with psoriasis varied from 6% to 41%, depending on the definitions that the experts used.
In this article, learn about the possible complications of psoriatic arthritis.
Diabetes
Diabetes is a possible complication of PsA.
The findings of a 2018 study in Rheumatology suggest that PsA increases a person’s risk of type 2 diabetes.
Researchers compared people with PsA with those with psoriasis and those in the general population.
The risk of type 2 diabetes in people with PsA was about 40% higher than in those in the general population and more than 50% higher compared with those with psoriasis.
Eye health issues
According to the Arthritis Foundation, between 7% and 25% of people with PsA develop uveitis, which is inflammation of the uvea — the middle layer of the eye between the retina and the sclera. Uveitis is painful, and it can also threaten a person’s sight. PsA may also affect the skin around the eyes.
Steroids can help reduce inflammation and protect the eyes, but they also have side effects. It is important to discuss the risks and benefits with a doctor.
Some individuals also develop eye infections, such as conjunctivitis, which people often call pink eye.
Cardiovascular problems
Psoriasis causes chronic inflammation. Over time, this inflammation can damage blood vessels, increasing the risk of heart disease, stroke, and heart attacks.
People with PsA have an even higher heart disease risk than those with psoriasis alone, according to the authors of a 2018 review.
A healthful lifestyle may help reduce the risk of heart health problems. A heart-healthy lifestyle includes:
- maintaining a healthy weight
- being physically active
- eating a balanced and diverse diet
Depression
A person may find that symptoms of PsA affect their mental health.
Severe joint pain is a common symptom of PsA. For some people, joint pain can affect mobility and the ability to do daily tasks, such as typing, working, tending to children, or cooking. It can also affect a person’s mental health.
Some people with chronic pain develop depression or anxiety. Pain-induced depression may be more resistant to treatment than typical depression, according to a 2017 analysis.
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In another 2017 analysis, which involved 186,552 people with psoriatic arthritis, the prevalence of depression was 21.2%.
Lung health problems
Chronic inflammation can harm the lungs, which can lead to a lung health issue called interstitial lung disease (ILD).
ILD refers to a group of lung conditions that cause scarring of the lungs. Over time, this scarring leads to stiffness in these organs, which can make it more difficult to breathe.
Interstitial pneumonia is a potentially life threatening complication of ILD. A 2018 analysis found that 2% of 392 people with psoriasis had interstitial pneumonia. However, only one-fifth of the participants also had PsA.
Stomach and digestive issues
Chronic inflammation can make digestion more difficult, causing problems such as diarrhea and constipation. People with PsA are also more vulnerable to inflammatory bowel disease (IBD).
A 2013 study in women found that individuals with both psoriasis and PsA had a higher risk of Crohn’s disease than those with just psoriasis.
Liver and kidney issues
PsA also increases the risk of kidney disease and nonalcoholic fatty liver disease.
The risk of liver disease may be higher in people with other liver disease risk factors, such as obesity and metabolic syndrome.
As drinking alcohol can damage the liver, a doctor may recommend cutting back on alcohol.
Prevention
Regular exercise may help combat complications of PsA.
To prevent psoriatic arthritis complications, people with psoriasis should work with a doctor who specializes in their condition.
Psoriasis is a complicated illness. Many people with the disease notice that environmental factors, such as foods, seasonal changes, or infections, trigger symptoms. Controlling these factors may reduce the risk of psoriasis flares, as well as minimizing the symptoms of PsA.
Comprehensive treatment of psoriasis, including the use of psoriasis medications, may help. The authors of a 2019 study state that targeting specific inflammatory markers may improve psoriasis outcomes, though there is no evidence that this strategy reduces the overall risk of PsA.
It is not always possible to prevent PsA or its complications. For people who develop joint pain despite prevention strategies, treatment can minimize the risk of severe joint damage and other complications.
A doctor may recommend:
- anti-inflammatory medications
- corticosteroids
- light therapy
- drugs called disease-modifying antirheumatic drugs (DMARDs)
- biologic medicines that reduce inflammation
Some lifestyle strategies, such as exercising regularly, eating a nutritious diet, and maintaining a healthy body weight may reduce the risk of serious complications.
People who develop complications may need to adopt additional strategies to prevent those complications from causing serious health issues.
For example, a person with diabetes may need to eat a low glycemic index diet or use insulin to control their blood sugar. A person with heart disease may need to take blood pressure medication.
Summary
Psoriatic arthritis is a serious autoimmune disease that causes the body’s immune system to attack healthy tissue of the joints.
Comprehensive medical care can significantly reduce the risk of serious complications while making it easier to manage the symptoms.
Most people with psoriatic arthritis need to work with a rheumatologist or autoimmune disease specialist to get the best possible care.