Psoriatic arthritis is a disease that combines skin irritation associated with psoriasis with joint inflammation. The disease generally develops in adults between ages 30 and 50, who already have psoriasis.
However, the condition can also occur in children. An estimated 1 to 10 of every 33,000 children are diagnosed with juvenile psoriatic arthritis, typically when they are from the ages of 6 to 10. The disease is more prevalent in girls than boys. Unlike the adult form, juvenile psoriatic arthritis more often presents itself as the simultaneous onset of psoriasis and psoriatic arthritis.
The cause of psoriatic arthritis is not fully understood, but it is thought to be triggered by a combination of genetic and environmental factors, and an immune system disorder in both children and adults. Children with juvenile psoriatic arthritis typically have a parent or close relative with arthritis or psoriasis.
How does juvenile psoriatic arthritis affect the body?
The symptoms of the disease vary between children and can be confused with other conditions, making it difficult for physicians to correctly diagnose the patient. Psoriasis is typically characterized by scaly and itchy rashes on the knees, elbows, face, scalp, and backside. A common secondary indicator is the pitting of the finger and toenails.
In addition to symptoms of psoriasis, patients with juvenile psoriatic arthritis may also develop joint swelling, pain, and stiffness, normally in fingers and toes. Swelling of the fingers and toes, called dactylitis (or “sausage” fingers or toes), is particularly common and more pronounced in girls ages 1 to 6.
Without treatment, the joints can become permanently deformed due to chronic inflammation. Children may also display unusual levels of fatigue and are at a high risk of developing eye inflammation, or uveitis, which if untreated, can result in reduced vision and possibly blindness. Long-term disabilities associated with juvenile psoriatic arthritis occur in fewer than 10 percent of patients.
How is juvenile psoriatic arthritis diagnosed?
The child’s physician will typically begin with a physical examination and a complete review of the medical history. If a child does not show symptoms indicative of psoriasis and arthritis, a correct diagnosis will be more difficult.
There are several blood tests that may help to guide identification of the disease. High levels of uric acid are linked to juvenile psoriatic arthritis. Anemia, high levels of antinuclear antibody (ANA), and clumping of red blood cells are all used as indications of inflammation. Physicians may also recommend eye examinations to look for signs of uveitis, or an X-ray of inflamed joints to evaluate the degree of arthritis.
How is juvenile psoriatic arthritis treated?
Effective treatment can result in the remission of the disease. Generally, physicians will begin treatment with nonsteroidal anti-inflammatory drugs (NSAIDs). If NSAIDs do not relieve symptoms, treatment may be modified to include immunosuppressive therapies (treatment that dampens the immune response) and corticosteroids. Corticosteroids can have negative side effects, such as growth delays and severe osteoporosis. Biologic therapies that directly target cell signaling proteins such as tumor necrosis factor (TNF) alpha), thought to play a role in juvenile psoriatic arthritis, are also being included in treatment regimens. Ultraviolet light treatments and topical skin creams may also be recommended to further reduce the symptoms of psoriasis.
Juvenile Arthritis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.