Psoriasis is a chronic skin condition that’s known to be related to several other diseases through inflammation. Psoriatic arthritis (PsA) is a joint condition seen in a portion of people who have psoriasis. Now researchers are investigating how psoriasis and PsA are related to another form of inflammatory arthritis known as gout.
MyPsoriasisTeam members have shared their experiences of living with psoriasis, PsA, and gout. “Anyone suffer from gout? Lately I’ve been having pain in my big toe and upper arm with no injuries. I have psoriasis and psoriatic arthritis,” wrote one member.
In this article, we’ll discuss what gout is and how it’s related to psoriasis and psoriatic arthritis. By better understanding your risk and the associated symptoms, you can seek treatment as quickly as possible to better manage your condition.
Gout is a type of inflammatory arthritis that affects more than 9 million adults in the United States, according to JAMA Network. This condition is caused by hyperuricemia — high levels of uric acid, a substance produced during digestion. It’s important to note that just because you have hyperuricemia doesn’t mean you’ll go on to develop gout.
Your body creates uric acid when it breaks down purines, which are building blocks of DNA. Purines are found in certain types of seafood (e.g., scallops, tuna, and anchovies) and red meat. Drinking alcohol can also raise your uric acid levels.
A high level of uric acid causes crystals to form in the fluid and tissues surrounding your joints. These uric acid crystals cause inflammation leading to swollen, hot, painful joints. Gout typically affects just one joint at a time, most often the big toe. Other large joints that may be affected include the knee, ankle, and other toe joints.
MyPsoriasisTeam members have shared their gout symptoms: “I am in the middle of a really painful episode of gout in my foot. I can barely put it on the floor, and it’s so painful.”
Gout is a chronic disease that comes and goes, with periods of flares and remission. During a flare, your symptoms will get worse, lasting for several days to weeks. Then you’ll go into remission — a period of symptom relief — for several weeks to years, depending on your case. The duration of each flare and remission can vary based on how well you’re controlling the condition. Without treatment, the average gout flare lasts around two weeks.
If left untreated, repeated gout flares can eventually cause permanent joint damage, leading to a condition known as chronic gouty arthritis. You may also notice hard lumps known as tophi underneath the skin near affected joints. Tophi are caused by the buildup of uric acid crystals.
Certain groups of people are more likely than others to be affected by gout. For example, men tend to have higher uric acid levels and develop gout more often than women, according to Mayo Clinic. Men also tend to develop gout at a younger age (30 to 50 years old) compared with women, who are more at risk after menopause because their uric acid levels rise with age.
Other factors that increase the risk of developing gout include:
Psoriasis is a chronic skin condition that leads to thick, scaly patches of skin. Specifically, your immune system triggers your skin cells to generate faster than they’re shed, causing the buildup of thick plaques or lesions. Around 30 percent of people with psoriasis will also develop psoriatic arthritis, according to the National Psoriasis Foundation. PsA is associated with joint pain, swelling, and stiffness.
Doctors and researchers have looked into the connection between psoriasis, psoriatic arthritis, and gout. Studies show that the link between the three conditions is uric acid. Specifically, they’ve found that inflammation and rapidly growing and dividing skin cells in psoriasis and PsA produce uric acid as a byproduct.
One large study in Taiwan looked at 7,833 people with psoriasis and 7,833 without the condition to determine their risk of developing gout. Researchers found that people with psoriasis were 1.38 times more likely to develop gout compared with the others. Age was also found to play a large role in risk — people older than 65 were more likely to develop gout than people under 40.
The researchers also looked at factors that lowered the risk of developing gout. They found that people who took nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil or Motrin) and naproxen (Aleve) were less likely to develop gout.
Another large study performed in the U.S. on people with both psoriasis and PsA found similar results — both men and women with psoriasis were more likely to develop gout than those without it. People with both psoriasis and PsA were at a much higher risk of gout than those who had only psoriasis.
The authors of this study, published in the Annals of the Rheumatic Diseases, also noted that the risk of gout is much lower in other types of arthritis, including rheumatoid arthritis and osteoarthritis.
Although you can’t control the fact that your psoriasis or that PsA may increase uric acid levels, you can control other factors. Your diet is a major source of purines, which contribute to uric acid production in your body. By watching what you eat, you can help control your risk of gout.
Cleveland Clinic suggests following a gout diet, which emphasizes eating low-purine foods while limiting high-purine choices. Try replacing red meat with other sources of protein, and eat plenty of vegetables. The diet also involves drinking water, coffee, or low-fat milk to help your body clear out extra uric acid. It’s also best to watch your high-fructose corn syrup intake — try to limit sodas, sweets, and other foods that may have this ingredient hidden in them.
Weight loss can also help control gout symptoms. Having a higher body weight or obesity is associated with increased risks of both psoriasis and gout. By watching what you eat and getting more exercise, you can lower your risk of gout while also better controlling your psoriasis.
If you’re living with psoriasis or psoriatic arthritis and you’ve started to notice new gout symptoms, talk to your doctor. They can help guide you on what lifestyle changes to make, and they may offer treatment options to help control flares. According to the Arthritis Foundation, treating psoriasis or PsA may also help treat or prevent gout, much like making diet changes helps.
Many treatments that help control inflammation in psoriasis and PsA are also used to treat gout flares. NSAIDs are commonly prescribed medications for reducing pain and swelling. You can find them over the counter, or your doctor may give you a prescription. One member shared, “I have gout along with psoriasis. The pain from gout is terrible. I have meds for it, but I found ibuprofen helps more.”
Corticosteroids are also used to control inflammation associated with psoriasis, PsA, and gout. Your doctor may prescribe a pill or injection into an affected joint to help. One commonly used corticosteroid is prednisone.
Working together, you and your health care team can get your symptoms under the best control possible, whether you’re living with psoriasis, psoriatic arthritis, or gout — or a combination of these conditions.
MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 116,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.
Do you have gout and psoriasis or psoriatic arthritis? How have you managed your symptoms? Share your experiences in the comments below, or start a conversation by posting on your Activities page.
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