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How to Spot the Early Signs of Psoriasis Becoming Psoriatic Arthritis

Learn what to look for, and when to seek help.

经过Tracy Davenport, Ph.D. Health Writer

2023年1月9日

GettyImages/Charday Penn

2023年1月9日

看起来似乎like a big leap to go from skin issues related to psoriasis (PsO) to joint pain that can accompany psoriatic arthritis (PsA). We get it. But when you’re living with psoriasis, it’s really important to understand that both conditions are related to the same overactive immune system, and their close relationship means if you have one, you are more vulnerable to developing the other. Here, experts explain exactly how the diseases are linked, some common early signs of psoriatic arthritis that people with psoriasis should be aware of, and what you should do if you suspect you may be developing PsA.

牛皮癣如何成为牛皮癣关节炎

“在牛皮癣中，炎症会导致皮肤细胞过量生产，从而产生红色，鳞状皮疹，”纽约市Lenox Hill医院皮肤科医生Michele Green说。“在PSA中，在这种情况下也存在炎症，在这种情况下影响关节并导致关节疼痛，僵硬和肿胀。”好消息是，并非每个患有牛皮癣的人都会患上银屑病关节炎。格林博士说：“但是，由于PSA呈现了30％的牛皮癣患者，因此牛皮癣被认为是发展牛皮癣关节炎的危险因素。”没有人知道谁会得到这两个条件，但似乎确实是一个遗传危险因素。某些基因使个体易患牛皮癣，银屑病关节炎和其他炎症性疾病。知道PSA的迹象很重要，因为根据最近studies, early detection of PsA is key. We now understand that delaying a diagnosis of PsA can lead to permanent joint damage and disability.

With Psoriasis, Watch for These Early Signs of Psoriatic Disease

No two people experience psoriatic arthritis the same way—it’s a disease whose features vary from person to person. What can be even more confusing is that some of the early symptoms of PsA may be similar to other conditions such as rheumatoid arthritis and osteoarthritis. Even with these uncertainties, there are common early signs to be on the lookout for that can help distinguish PsA from other diseases when you’re living with psoriasis.

Joint Pain

皮肤科医师认为，皮肤科医生在患者发现PSA的前线是皮肤病学副教授，在北卡罗来纳大学教堂山的实践。他说：“如果患者注意到关节症状，那么如果他们知道询问皮肤科医生是否可以与皮肤病有关，那就太好了。”PSA可能会感到的关节疼痛范围从轻度到重度，并且可能影响身体的任何部位。疼痛可能是波浪，称为疾病耀斑和缓解。

背痛

对于许多牛皮癣的人来说，由PSA引起的背痛是这种疾病的常见迹象，大约25％至70％轴向脊柱受累的银屑病关节炎患者（当脊柱受影响时，称为轴向关节炎或脊柱炎。）关节炎基础，研究表明，大多数患有脊柱炎的患者可以在进行诊断之前长达10年的后退症状。

While everyone is different, if you have psoriasis, specifically look out for back pain lasting for more than three months, a gradual onset of back pain before 40 years old, improvement of back pain with exercise, no improvement in pain with rest, and back pain at night (with improvement upon getting up). All these can signal PsA according to the journalRheumatology and Therapy。

关节肿胀

手指或脚趾的肿胀，称为腺炎，是PSA的标志性特征。当发生双乳扰炎时，关节之间存在太多的炎症，以至于实际的关节肿胀无法再识别出来，看来整个数字肿胀。腺炎发生16% to 49%of patients with PsA, and often occurs early in the disease as one of the first symptoms. Unlike other types of inflammatory arthritis, in PsA, dactylitis is usually asymmetrical, affects the right side more than the left side, involves feet more than hands, and often happens to multiple fingers or toes simultaneously.

Eye Inflammation

The same inflammation that can impact your skin with psoriasis can also impact your eyes when the condition evolves into psoriatic arthritis. When it comes to PsA, about7%of those with the condition will develop uveitis, or inflammation of the eye. This can be caused by several different diseases, so it’s important to maintain regular eye exams if you already have psoriasis, to make sure you any changes can be monitored closely. Making sure your eye doctor has it on record that you live with PsO (even if you are in remission) can allow your provider to also be on the lookout for PsA.

Nail Changes

牛皮癣全都与您的皮肤有关，但指甲的改变是您未来的银屑病关节炎的重要线索。专家说，指甲牛皮癣是PSA的预测因素。up to 80%由指甲变化影响的银屑病关节炎的人。与PSA指甲有关的最常见症状是指甲凹痕 - 指甲床内的表面凹陷。但是其他变化也可能发生。除了指甲凹痕之外，您可能会注意到指甲与指甲床分开，指甲上的斑点或其他异常变色。您的指甲突然看起来更易碎甚至更厚。这些更改中的任何一个都可能表明PSA。

如果您患有牛皮癣，该怎么办？

根据纽约Lenox Hill医院皮肤科医生乔治·汉（George Han）的说法，诊断PSA可能会在周围挑战。但是，如果您已经患有牛皮癣，在某些方面，您可以尽早抓住PSA。他说：“我们遇到的最令人沮丧的情况通常是开始出现PSA症状的患者，没有任何明显的牛皮癣迹象。”

Han博士补充说：“如果您怀疑PSA，但没有接近诊断，您可以做的一件事就是寻找任何可能暗示皮肤牛皮癣演变的东西，包括严重的头皮屑。”他说，在某些情况下，推动更敏感的成像（例如MRI）提供更详细的信息可能会有所帮助。

Most importantly, don’t give up if you are worried about your psoriasis becoming psoriatic arthritis and you aren’t getting the answers you need. “Seeking specialist care early on can be helpful,” says Dr. Han. “Make that first step and call for an appointment.”

认识我们的作家

Tracy Davenport, Ph.D.

Davenport是TracyShealthyliving.com的创始人。使用最新的科学研究，她通过一对一的教练，公司谈判并分享了1000多个与健康有关的人，帮助人们过着最健康的生活更多的

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