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Dallas, Texas 75231
Phone: (214) 363-2812
PLANO OFFICE
6020 West Parker Road, Suite 240
Plano, TX 75093
Phone: (214) 363-2812
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Arthritis Without Pain
Dr. Zashin's arthritis book is a comprehensive guide for patients considering or undergoing treatment with the TNF blockers Enbrel®, Remicade®, or Humira®.

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Psoriatic Arthritis
ARTHRITIS INVOLVING THE
JOINTS AND SKIN
Psoriatic arthritis is an
inflammatory condition that
is related to the skin
condition psoriasis. It is
often accompanied by
tell-tale skin patches of
raised red areas that have a
crusty, silvery scale. The
skin lesions usually appear
on the scalp, elbows, knees
or lower back, but they may
appear anywhere on the body.
About 10 percent of
Americans with psoriasis
also have the arthritic form
of the disease.
Abnormalities of the
fingernails and toenails in
patients with psoriasis
increase the likelihood that
they will develop the
arthritic form of the
disease. Psoriatic arthritis
strikes men and women
equally, and is usually
diagnosed between the ages
of 30 and 50. Among people
who have first-degree
relatives (parents and
siblings) with psoriatic
arthritis, there is an
increased risk of developing
the disease.
Psoriatic arthritis is a
seronegative
spondyloarthropathy. It is
diagnosed through physical
examination, x-rays and
laboratory tests. Lab test
abnormalities seen with
psoriatic arthritis often
mimic RA, except the
rheumatoid factor is usually
absent and HLA-B27 is
present. Psoriatic changes
in the skin and nails must
also be present before a
definitive diagnosis of
psoriatic arthritis is made.
Treatment focuses on
medications to relieve the
inflammation, including
NSAIDs, Azulfidine® (sulfasalazine),
methotrexate and TNF
blockers.
Five Patterns of
Psoriatic Arthritis
There are five types of
psoriatic arthritis. Each is
distinguished by the pattern
of the involved joints, but
all are associated with skin
psoriasis.
Symmetric psoriatic
arthritis.
Symmetric psoriatic
arthritis is the most common
form of psoriatic arthritis.
It involves pain and
swelling in many joints,
particularly the small
joints of the fingers and
toes. It is similar to
rheumatoid arthritis in that
it affects the same joints
on opposite sides of the
body.
Asymmetric psoriatic
arthritis.
Asymmetric psoriatic
arthritis involves a few
joints of the extremities,
but in a random pattern,
such as the fingers on the
left hand and toes on the
right foot.
Psoriatic
spondylitis.
Psoriatic spondylitis
affects specific joints of
the lower spine called the
sacroiliac joints.
Distal
interphalangeal predominant
psoriatic arthritis.
This form of psoriatic
arthritis primarily involves
the joints closest to the
nails of the fingers and
toes. It may also affect
other joints. This form of
the disease often involves
changes in the nails,
including pitting, splitting
or degeneration.
Arthritis mutilans.
The fifth type of psoriatic
arthritis is arthritis
mutilans. It is a very rare,
painful and destructive form
of psoriatic arthritis that
involves inflammation where
tendons and ligaments attach
to the bone (a condition
called enthesitis).
Scott Zashin, MD, PA is a
respected Texas psoriatic
arthritis Doctor/Specialist
with offices in Dallas &
Plano. The above information about
psoriatic arthritis is
from Dr. Zashin's
arthritis book:
Arthritis Without
Pain, a
comprehensive guide for
patients considering or
undergoing treatment with
the TNF blockers Enbrel®,
Remicade®, or Humira®. All
rights reserved.





Rheumatology Practice of
Scott Zashin, MD