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People with psoriasis can also get joint disease: The connection explained

People with psoriasis can also get joint disease: The connection explained
Psoriasis appear commonly on the scalp, elbows, knees, and lower back. © Shutterstock

Researchers have found that a protein is responsible for both skin inflammation and arthritis-like damage in psoriasis patients.

Written by Longjam Dineshwori |Updated : July 9, 2020 8:54 PM IST

People suffering from psoriasis often experience diverse comorbid conditions, such as psoriatic arthritis (PsA, which can cause severe, disabling joint disease. It is estimated that one-third of patients with psoriasis develop psoriatic arthritis, but the reason behind it hasn't been clear yet. Since PsA can cause irreversible damage, it is important to identify the condition early, before too much damage is done to bones, tendons, and joints.

A new study published in The Journal of Clinical Investigation has now revealed the connection between psoriasis and joint disease. The research team, led by Case Western Reserve University School of Medicine researchers, found that the protein KLK6 that causes skin inflammation in psoriasis patients also plays a key role in damaging joints and bones in them.

Turning down KLK6 eliminated the skin inflammation and even improved the arthritis-like damage, said Nicole Ward, PhD, the study's principal investigator and a professor of nutrition and dermatology at the medical school.

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How can joint and bone damage beprevented?

In their previous study, the researchers found that the skin of psoriasis patients had 6 times more KLK6 than normal. These patients' skin and immune cells also had a higher number of PAR1 receptor protein, which causes cellular/tissue responses like inflammation when activated. Thus they came to know that KLK6 triggers inflammation through signaling of PAR1.

In their latest study, the researchers developed psoriasis-like skin disease by overproducing KLK6 through genetic engineering. Then when they deleted PAR1 receptor protein, they found a reduction in skin inflammation, as well as an improvement in bone and joint problems.

Based on these findings, the researchers concluded that chronic inflammation originating in the skin can also cause distant joint and bone destruction seen in arthritis. They suggested that clinicians need to aggressively treat patients with psoriasis to prevent arthritis changes.

Know more about this skin disorder

In people suffering from psoriasis, their skin cells multiply up to 10 times faster than normal. This leads to the appearance of red, scaly patches on the skin. Such patches appear commonly on the scalp, elbows, knees, and lower back. Psoriasis is not contagious, meaning you cannot catch the disease by touching someone who has it.

Usually, this skin disorder occurs in early adulthood and affects only a few areas. However, in severe cases, it can spread to larger parts of the body. Psoriasis can heal and then come back.

Plaque psoriasis is the most common type of psoriasis. A person suffering from plaque psoriasis may have:

  • Itchy and painful plaques of red skin that are often covered with silver-colored scales. Sometimes these plaques may crack and bleed.
  • Discoloration and pitting of the fingernails and toenails. Sometimes, the nails may crumble or detach from the nail bed.
  • Plaques of scales or crust on the scalp.

The exact cause of psoriasis is not clear, but experts believe that a malfunction in the immune system causes inflammation, which in turn triggers new skin cells to form too quickly. Normally, skin cells are replaced every 10 to 30 days, but in psoriasis patients, new cells grow every 3 to 4 days. Those silver scales are the result of buildup of old cells.

Psoriasis tends to run in families, but certain things can also trigger its outbreak such as cuts, scrapes, or surgery, emotional stress, strep infections, blood pressure medications (like beta-blockers), antimalarial medication, etc.