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Psoriatic Arthritis

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An inflammatory arthritis linked to psoriasis — sausage digits, nail changes and end-joint involvement — and why early treatment protects the joints.

Isang kamay na may namamagang mga kasukasuan ng daliri at isang buong daliring mukhang 'sausage'.
Ang psoriatic arthritis ay maaaring magdulot ng pamamaga ng mga kasukasuan, pamamaga ng buong daliri (dactylitis) at mga pagbabago sa kuko. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ang iyong nararamdaman

Ang psoriatic arthritis ay may tendensiyang dahan-dahang lumitaw sa halip na biglaang magparamdam. Maaaring mapansin mo na ang isa o higit pang mga kasukasuan (madalas sa mga daliri, ngunit maaari ring sa pulso o siko) ay naging matigas at masakit, at ang paninigas ay pinakamalala sa unang bahagi ng umaga o pagkatapos ng matagal na pag-upo, at nababawasan kapag nagsimula ka nang gumalaw. Ang pattern na ito, ng paninigas na lumuluwag kapag ginagamit, ay isang pahiwatig na ang problema ay inflammatory sa halip na simpleng pagkapudpod (wear and tear).

May ilang mga katangian na espesyal na karakteristiko. Ang isang buong daliri (o daliri sa paa) ay maaaring mamaga na parang maliit na sausage, at ito ay tinatawag na dactylitis; maaari itong maging maselan at gawing mahirap itukod ang daliri. Maaari kang makakita ng mga pagbabago sa iyong mga kuko: maliliit na butas o uka, mga guhit (ridging), paninilaw at pag-angat ng kuko mula sa nail bed nito, o pagkadurog sa gilid. Ang mga dulo ng kasukasuan ng mga daliri, yaong mga pinakamalapit sa kuko, ay madalas na apektado, na medyo hindi karaniwan para sa inflammatory arthritis at isang kapaki-pakinabang na palatandaan para sa iyong doktor. Ang ilang mga tao ay nakakaranas din ng sakit mismo kung saan ang tendon ay nakakabit sa buto, gaya ng sa siko o sa likod ng sakong.

Maraming tao na may psoriatic arthritis ang namumuhay din na may kondisyon sa balat na psoriasis, na may mga patch ng pula at kaliskis na balat, madalas sa mga siko, tuhod o anit. Ang problema sa kasukasuan ay maaaring magsimula bago ang mga pagbabago sa balat, pagkatapos nito, o nang walang anumang malinaw na pagkakasangkot ng balat. Kasabay ng mga kasukasuan, karaniwan ang matinding pagkapagod (deep fatigue) at maaaring isa ito sa pinakamahirap na bahagi ng kondisyon.

(Kung ang iyong pangunahing alalahanin ay rheumatoid arthritis o isang mas pangkalahatang problema sa inflammatory joint, tingnan ang aming hiwalay na pahina tungkol sa inflammatory and rheumatoid arthritis; ang psoriatic arthritis ay isang natatanging kondisyon, kahit na maaari silang magmukhang magkatulad.)

Ano ang aktwal na nangyayari

Ang psoriatic arthritis ay isang kondisyong dulot ng immune system. Sa halip na depensahan ang katawan, nagkakamali ang immune system sa pag-atake sa sarili mong mga tissue at nagiging sanhi ng pamamaga (inflammation). Ang parehong maling proseso na nagdudulot ng makaliskis na balat ng psoriasis ay maaari ring tumarget sa mga kasukasuan at, sa natatanging paraan, sa mga entheses, ang maliliit na zona kung saan ang mga tendon at ligament ay nakakabit sa buto.

Ang pamamagang iyon ang nararamdaman mo bilang pagmanas, paninigas, at sakit. Ang pagmanas na parang sausage ng buong daliri ay nagmumula sa pamamaga sa mga kasukasuan at sa mga tendon sheath sa kahabaan ng daliri nang sabay-sabay. Ang mga pagbabago sa kuko at ang pagkakasangkot ng mga dulo ng kasukasuan ng daliri ay nagpapakita kung gaano kalapit ang koneksyon ng kuko, ng balat, at ng huling kasukasuang iyon.

Hindi ito osteoarthritis, ang "wear-and-tear" arthritis na dumarating kasabay ng edad at sobrang paggamit; hindi rin ito katulad ng rheumatoid arthritis, bagaman ang dalawang inflammatory condition na ito ay maaaring magmukhang magkatulad. Ang mahalagang punto ay ang psoriatic arthritis ay aktibo at patuloy: kung ang pamamaga ay hahayaang hindi magamot sa loob ng maraming taon, maaari nitong unti-unting sirain at maaari pang i-deform ang mga kasukasuan. Ang mabuting balita ay ang prosesong ito ay maaaring gamutin, at ang pagkontrol sa aktibidad ng immune system ay nagpoprotekta sa mga kasukasuan mula sa pinsalang iyon.

Ano ang maaari nating gawin tungkol dito

Ang diagnosis ay karaniwang ginagawa ng isang rheumatologist, isang espesyalista sa inflammatory joint disease. Walang iisang blood test na nakakapagkumpirma ng psoriatic arthritis, kaya ang diagnosis ay binubuo mula sa iyong kasaysayan, isang pagsusuri ng mga kasukasuan, kuko at balat, at imaging tulad ng X-ray o ultrasound. Mahalagang maiba ito sa ibang uri ng arthritis, dahil binabago nito ang paggamot.

Ang pangunahing pundasyon ng paggamot ay medikal, pinamumunuan ng rheumatology, at naglalayong patahimikin ang immune process mismo:

  • Disease-modifying drugs (DMARDs) tulad ng methotrexate ay madalas na unang hakbang. Pinapahina ng mga ito ang overactive immune response at pinoprotektahan ang mga kasukasuan sa pangmatagalan.
  • Biologic and targeted medicines ay ginagamit kapag hindi sapat ang DMARDs, o para sa mas agresibong sakit. Ang mga ito ay precision drugs na humaharang sa mga partikular na immune signals na nagtutulak ng pamamaga, at maaari itong maging napaka-epektibo para sa mga kasukasuan, ang mga entheses at ang balat nang magkakasama.
  • Paggamot sa balat ang psoriasis ay kasabay ng paggamot sa mga kasukasuan, at madalas na nakikipag-ugnayan sa isang dermatologist.
  • Hand therapy at ehersisyo upang mapanatiling gumagalaw ang mga kasukasuan, mapanatili ang grip at function, at makatulong sa paninigas at pagkapagod.

May papel ang operasyon, ngunit limitado lamang, pangunahin na para sa mga kasukasuan na nasira na o nadeporma na ng maraming taon ng pamamaga, kung saan ang layunin ay ibalik ang function o bawasan ang sakit. Kahit sa pagkakataong iyon, ang medikal na paggamot upang kontrolin ang sakit ay nagpapatuloy. Ang pinakamahalagang mensahe ay pinoprotektahan ng maagang paggamot ang mga kasukasuan: habang mas maagang nakokontrol ang pamamaga, mas kaunti ang permanenteng pinsalang nagagawa.

Ano ang dapat asahan

Ang psoriatic arthritis ay isang long-term condition sa halip na isang bagay na nagagamot nang isang beses at nakakalimutan na, ngunit ito ay napaka-treatable, at karamihan sa mga taong nagsisimula ng gamutan nang maaga ay nagiging maayos. Ang layunin ng modernong pangangalaga ay patahimikin ang sakit nang lubos upang ang mga kasukasuan ay maramdaman at gumana nang malapit sa normal, at para sa maraming tao, ito ay nakakamit.

Dahil ito ay itinutulak ng immune system, ang gamutan ay karaniwang tuloy-tuloy, at maaaring mangailangan ng ilang pagsasaayos upang mahanap ang gamot, o kombinasyon, na pinakaangkop para sa iyo. Ang kondisyon ay maaaring lumala at humupa, na may mga panahong tahimik at paminsan-minsang flares. Mahalaga ang pananatili sa regular na pakikipag-ugnayan sa iyong rheumatologist, kapwa upang mapanatiling suppressed ang inflammation at upang mabantayan ang mga gamot. Ang kapalit ng long-term commitment na iyon ay tunay na proteksyon: ang pagpapanatiling mababa ng inflammation ay nagpapanatili sa iyong grip, sa function ng iyong kamay at sa iyong mga kasukasuan para sa mga darating na taon.

Kailan dapat magpatingin

  • Sakit o pamamaga ng kasukasuan na may paninigas sa umaga, lalo na kung ang buong daliri ay namamagâ o ang paninigas ay nababawasan habang gumagalaw: nararapat itong masuri, mainam na ng isang rheumatologist.
  • Psoriasis kasama ang mga bagong sintomas sa kasukasuan. Kung mayroon ka nang psoriasis at ang iyong mga kasukasuan ay nagsimulang sumakit, mamagâ o manigas, banggitin ito sa iyong doktor; ang ugnayan nito ay mahalaga at madaling makaligtaan.
  • Mga pagbabago sa kuko gaya ng pitting, ridging, pagkadurog o ang pag-angat ng kuko mula sa nail bed, lalo na kasabay ng sakit sa kasukasuan o sa dulo ng kasukasuan ng daliri.
  • Sakit kung saan ang tendon ay nakakabit sa buto (halimbawa sa siko o sakong) na hindi gumagaling.
  • Mga kasukasuan na nagiging matigas, deformado o mas mahirap gamitin sa paglipas ng panahon: isang palatandaan na ang sakit ay maaaring hindi lubos na kontrolado, at nararapat na suriin upang ang gamutan ay mapataas bago pa magkaroon ng higit pang pinsala.

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