Tag Archives: condition

Understanding the links between psoriasis and psoriatic arthritis – The Irish Times

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Most people are familiar with the common skin condition, psoriasis, which causes a scaly, lumpy rash on the backs of elbows, front of knees, the scalp and other parts of the body. But, the autoimmune disease, psoriatic arthritis, which about a third of people with psoriasis also suffer from, is much less well known.

There is currently no diagnostic blood test for psoriatic arthritis.

A group undertaking an international study is seeking to better understand the links between the two conditions, with the aim to find out why some people with psoriasis go on to develop psoriatic arthritis and what treatment would work best to halt its development.

Prof Oliver Fitzgerald, research professor in rheumatology at the Conway Institute at University College Dublin and Prof Steve Pennington, professor of proteomics at UCD, are leading the Irish arm of the Hippocrates consortium study. We have about 350 patients so far, but we are keen to have 2,000, so we are interested in anyone aged 18 or over diagnosed with psoriasis to join the study, says Prof Fitzgerald.

Prof Oliver Fitzgerald.

Those who choose to partake in the study will be required to fill out a questionnaire every six months over three years. Details required are the extent of their psoriasis, current treatments and if they have noted any emerging symptoms of arthritis.

Prof Fitzgerald says that, ultimately, the identification of distinct biomarkers for psoriatic arthritis could lead to earlier treatment and possibly even prevention of the condition. The researchers also hope to identify a potential blood test which would diagnose psoriatic arthritis. It shares some symptoms of joint pain, swelling and loss of function with rheumatoid arthritis but it has some features which are different, says Prof Fitzgerald.

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These distinguishing features include how the toes and fingers swell to look like little sausages, pain and stiffness in the spine that gets worse with rest yet improves with exercise. And pain and inflammation in the tendon and ligaments attached to the bone, for example, in the Achilles tendon attached to the heel.

I always tell my students that you have to be hunting for psoriatic arthritis to find it and the psoriasis doesnt always have to be very severe to have it. It could be between the buttocks, under the arm pits or under the breasts in women, he explains.

Some studies have found that scalp psoriasis may be a risk factor for psoriatic arthritis. And both conditions also have a genetic component as they tend to run in families. A delayed diagnosis can result in treatments starting later, allowing the joints to deteriorate further in the intervening time.

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Some of the newer biologic treatments seen as a game changer in the treatment of rheumatoid arthritis work very well in clearing the psoriasis but dont improve the condition of the joints. The problem is that we dont know which patients suit which treatment. We also want to find this out in the study, says Prof Fitzgerald.

The information submitted by those who join the study will be reviewed every six months and individuals will be given feedback on their submissions.

We will advise those who we identify with symptoms of psoriatic arthritis to seek medical assessment, but we also advise people with psoriatic to remain as active as they can to prevent further loss of function of their joints, he adds.

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Understanding the links between psoriasis and psoriatic arthritis - The Irish Times

How COVID and steroids are affecting the hips in young adults – IndiaTimes

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In a surprising turn of events post-COVID-19, doctors are noticing a rise in cases of Avascular Necrosis (AVN), a condition causing the death of bone tissue, particularly in the hips. What's more surprising is that this is happening to a much younger crowd, people between 20 to 40 years old, whereas it used to be more common in people in their forties or fifties. If you have been treated for COVID-19 in the past and are now experiencing hip joint pain- early detection could help you! This is not only a red flag for old people but also younger demographic. Why is this occurring? Steroids were used even earlier for the treatment of conditions like asthma, arthritis, certain malignancies, and various other inflammatory conditions. It was an important risk factor for the development of AVN even then, albeit the incidence was lesser and the condition was much slower in disease progression. On the contrary, we are observing that patients who were affected with COVID and received steroid treatment, even for a short duration and with a lower dose are presenting with a much rapid destruction of the joint. This implies that its not just the steroid therapy but also the hypercoagulability and other vascular-related pathologies associated with COVID-19 that are contributing to the musculoskeletal damage. It is unpredictable as to which patient can develop this dreaded complication.

So what are the tell-tale signs to watch out for? It is predominantly pain in the hips, worsening on weight bearing and sometimes occurring even at rest. In the initial stages, it could be asymptomatic. Early detection, helps us identify this condition sooner and take measures to slow down the progression. AVN progresses through multiple stages and may not be detected on X-rays in the initial grade. It can be identified on the x-ray, usually in stage 2 or 3 when there is already a collapse of the femoral head (the ball in the hip joint). MRI is the only diagnostic tool that helps us pick up the disease in the initial stages of the pathology. When identified early, patients could benefit from joint preservation procedures like decompression surgery combined with stem cell therapy that can salvage the hip joint. Total hip replacement is recommended for those with collapse of the joint and irreversible damage as in stage 3.

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How COVID and steroids are affecting the hips in young adults - IndiaTimes