World arthritis day is on the 12th October
Arthritis is a debilitating condition. It can come in many varieties. But why would arthritis be of interest to a dermatologist? Good question!
There is often an interplay between skin and joints. So many arthritic conditions have skin manifestations. And in many instances, the skin shows signs of the underlying joint issue well before the patient has realized they have joint issues! For example. Psoriasis is a common scaly skin condition that common affects the elbows knees and scalp. But it can also affect the nails, and in 30% of skin cases, the joints. This is called psoriatic arthritis. And you don’t even have to have severe skin involvement to have underlying joint involvement. This arthritis tends to affect the joints of the hands, the lower back, the Achilles' tendon, and can affect just one joint, or many joints. It can be quite painful and swollen, particularly in the morning,and cause problems with doing daily activities. It can affect very young people and if left untreated can cause joint deformity.
On the flip side, sometimes patients present first with joint pains or arthritis and the rheumatologist may be unsure if the joints are due to psoriasis or some other type of psoriasis. Dermatologists are trained to spot very subtle features of psoriasis the skin and nail that majority of patients may not have even know they had! It's why I love dermatology, the skin often lets you know what's going on a deeper level.
The treatments for psoriasis can often also help psoriatic arthritis, but i always recommend my patient see a rheumatologist to co -care. Commonly patients would be prescribed disease modifying agents such as methotrexate. The most recent medicines on the market are biologics, and they are great as they treat both the skin and the joints, with minimal side effects and a great improvement in the quality of life.
There are many other types of arthritis conditions that can affect the skin such as lupus, and other autoimmune disorders. lupus again has sometimes very subtle skin signs, like changes around the nail folds, hair loss, mouth ulcers and a sun sensitive butterfly rash. It may also be small scaly patches on the arms or limbs, Carefully clinical correlation is required,as red rashes on the face can be due to other more common condition such as rosacea and seborrheic dermatitis.
On world arthritis day I'll be thinking of all my patients who suffer with joint and skin disease, and hoping they have an ache-free day! And I'll keep waiting for a World Skin Day!!