Juvenile psoriatic arthritis (JPA) is a chronic inflammatory condition that affects children under the age of 16. It is a form of juvenile idiopathic arthritis (JIA) that occurs with psoriasis, a skin disorder characterized by red, scaly rashes. The condition accounts for approximately 6 per cent of all cases of juvenile arthritis. A considerable number of people in India suffer from psoriatic arthritis, with prevalence rates ranging from 0.5 per cent to 2.5 per cent among the population.

However, despite its prevalence, psoriatic arthritis remains underrecognized and undertreated. Dr Rajiva Gupta, Vice Chairman, Rheumatology and Immunology, Medanta, Gurugram shares that it is imperative to raise awareness to ensure early diagnosis, appropriate management, and improved quality of life for those affected.

Dr Rajiva Gupta explains that the symptoms of psoriatic arthritis vary from child to child and range from mild to severe. Psoriasis is just one symptom of psoriatic arthritis, and not all children have psoriasis skin rash. The symptoms of JPA can vary but commonly include joint pain, swelling, and stiffness, particularly in the fingers and toes. These symptoms are often accompanied by a red, scaly rash typical of psoriasis, which can appear on the scalp, elbows, or knees.

Inflammation can also affect other parts of the body, such as the eyes, leading to conditions like uveitis. Unfortunately, the symptoms of JPA are frequently overlooked or mistaken for growing pains, leading to delayed diagnosis and treatment. This delay can result in more severe joint damage and reduced quality of life for affected children.

Dr Rajiva Gupta shares the exact cause of juvenile psoriatic arthritis remains unknown, but it is believed to result from a combination of genetic and environmental factors. Genetics also appear to be involved: 40-80 per cent of children with psoriatic arthritis have an affected first- or second-degree family member, such as a sibling, parent, grandparent or aunt/uncle. Children with a family history of psoriasis or arthritis are at higher risk of developing JPA.

Environmental triggers, such as infections or physical trauma, can also play a role in the onset of the disease. Additionally, certain genetic markers have been identified that may increase susceptibility to JPA, further highlighting the importance of genetic factors in the disease's development. Risk groups primarily include children with a family history of psoriasis or psoriatic arthritis. Recent advancements in genetic research and biological treatments have significantly enhanced our understanding and management of this condition.

Diagnosing juvenile psoriatic arthritis involves a thorough clinical evaluation, including a detailed medical history and physical examination. Doctors may also use imaging techniques like X-rays or MRI scans to assess joint damage and inflammation. Laboratory tests, including blood tests for inflammatory markers and genetic testing, can aid in confirming the diagnosis. Early diagnosis is crucial in managing JPA effectively, as it allows for timely intervention that can prevent joint damage and improve long-term outcomes. Conversely, late diagnosis can lead to severe complications, including permanent joint deformities and functional impairment.

The treatment of juvenile psoriatic arthritis aims to reduce inflammation, relieve pain, and prevent joint damage. Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologics are commonly used to manage symptoms and control disease progression. Physical therapy plays a vital role in maintaining joint flexibility and strength, while lifestyle changes, including a balanced diet and regular exercise, can enhance overall well-being. Recent advancements in biological therapies have revolutionized JPA treatment, offering more targeted and effective options for managing the condition.

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