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I have the kind of psoriasis that comes with arthritis. I've been taking a simple over-the-counter antiinflammatory to control my joint symptoms. But what can I do for the skin problems? They don't seem to go away with the pills.
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Psoriatic arthritis is an inflammatory joint disease. It affects a small percentage of people who have psoriasis. Psoriasis is a chronic, inherited, skin disease. It is inflammatory but not infectious. There are well-defined patches of red skin called plaques that are covered with a silvery scale. Some patients are especially bothered by itching and, occasionally, pain from dry, cracked, encrusted lesions.
Psoriasis usually starts in adults between the ages of 20 and 30. The arthritis may not occur for up to 20 years after the first signs of psoriasis. The disease can occur in children, usually between the ages of 9 and 12 years.
About 20 per cent of the patients with psoriasis also develop arthritis of the joints. Psoriatic arthritis occurs more often in those with severe psoriasis. It tends to progress slowly. For most of those affected, it is more of a nuisance than a disabling condition.
Standard treatment of mild psoriatic arthritis starts with antiinflammatory drugs and topical skin creams. There are several commercially available skin creams that seem to give short-term relief of itchy, scaly skin. Lotions or sprays containing zinc pyrithione may be helpful. Zinc pyrithione is a zinc compound, (a metal, not an herbal treatment).
To relieve the itching, some patients use vaseline, salicylic acid preparations, urea-containing topical ointments, oatmeal baths, and emollients. Topical agents with corticosteroids should be used sparingly because of the incidence of side effects that have increased with the use of the superpotent fluorinated preparations. Only weak preparations, such as 0.5 per cent or 1.0 per cent hydrocortisone, should be used on the face, groin, or other sensitive areas (e.g., underarms, front of forearms, belly).
When looking for an effective topical cream for psoriasis, don't be swayed by advertising. Check with your physician first. He or she will be able to recommend one that has the most evidence to support its use.
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