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Psoriatic arthritis is a form of arthritis associated with psoriasis. Psoriasis is a chronic skin and nail disease. It causes red, scaly rashes and thick, pitted fingernails. Psoriatic arthritis is similar to rheumatoid arthritis (RA) in symptoms and joint inflammation. But it tends to affect fewer joints than RA. And it does not produce the typical RA antibodies. The arthritis of psoriatic arthritis comes in 5 forms:
Psoriatic arthritis is one of 4 disorders which are classified as spondyloarthropathies. The other disorders are:
These disorders have similar features such as:
The cause of psoriatic arthritis is unknown. But factors such as immunity, genes, and the environment may play a role.
Symptoms can occur a bit differently in each child. The skin condition psoriasis may start before or after the arthritis. Psoriasis causes scaly, pinkish-red, itchy rash on the knees, elbows, scalp, face, and folds of the buttocks. It can also cause pitting of fingernails or toenails. Symptoms of psoriatic arthritis may include:
The symptoms of psoriatic arthritis can be like other health conditions. Make sure to see your healthcare provider for a diagnosis.
Psoriatic arthritis is easier to confirm if your child already has psoriasis. If the skin symptoms have not yet occurred, diagnosis is more difficult. The process starts with a medical history and a physical exam. Your healthcare provider will ask about your child's symptoms. Your child may have blood tests to check:
These tests can be positive for many kinds of rheumatic diseases. But younger children are more likely to have a positive ANA test.
Other tests may include:
Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is. The treatment team will include your child's primary healthcare provider. It will also include a pediatric rheumatologist, and an ophthalmologist.
Treatment is done for both the skin condition and the joint inflammation. Some medications used to treat psoriatic arthritis include:
Other treatment may include:
Children with psoriatic arthritis may go into remission. This means that their symptoms may go away fully. This is more likely with early diagnosis and treatment. When treatment is delayed, remission is less likely. In these cases, the condition may lead to long-term disability.
Help your child manage his or her symptoms by sticking to the treatment plan. This includes getting enough sleep. Encourage exercise and physical therapy and find ways to make it fun. Work with your child's school to make sure your child has help as needed. Work with other caregivers to help your child take part as much possible in school, social, and physical activities. Your child may also qualify for special help under Section 504 of the Rehabilitation Act of 1973. You can also help your child find a support group to be around with other children with pediatric arthritis.
Tips to help you get the most from a visit to your child’s healthcare provider:
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