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Psoriatic arthritis is a rare form of arthritis or joint inflammation that affects both skin and joints. It can occur in people who have psoriasis, a skin and nail disease. Psoriasis is an ongoing (chronic) condition that causes a red, scaly, itchy rash. It also causes nails to become thick and pitted with tiny holes.
Psoriatic arthritis causes painful joint pain and swelling, along with skin rashes. It most often affects finger and toe joints. But it can also affect wrists, knees, ankles, and the lower back.
This condition is most common in adults ages 30 to 50. But it can begin in childhood. In many cases, the skin disease starts before the arthritis.
Early diagnosis and treatment helps to ease pain and prevent joint damage from getting worse.
The cause of psoriatic arthritis isn’t known. But things such as a child’s immune system, genes, and the environment may play a role. Children with this condition often have a family member with arthritis or psoriasis.
The skin condition psoriasis may start before or after the arthritis. Psoriasis causes a scaly, red, itchy rash on the knees, elbows, scalp, face, and the folds of the buttocks. It can also cause pitting of fingernails or toenails.
Each child’s symptoms may vary. Symptoms of psoriatic arthritis may include:
Psoriatic arthritis is easier to confirm if your child already has psoriasis. If the skin symptoms have not yet occurred, diagnosis is more difficult. Your child’s healthcare provider will take your child’s medical history and do a physical exam. The provider will ask about your child's symptoms. Your child may have blood tests such as:
Other tests may include:
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 medicines used to treat psoriatic arthritis include:
Other treatment may include:
Children with psoriatic arthritis are at risk of having an eye condition called uveitis. This is an inflammation of the eye’s middle layer.
With early diagnosis and treatment, children can go into remission. This means that symptoms go away. But when treatment is delayed, remission is less likely. Then 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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