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Pain Management in Painful Psoriasis and Psoriatic Arthropathy: Challenging and Intricately Intertwined Issues Involving Several Systems

Current Pain and Headache Reports volume 25, Article number: 36 (2021) Cite this article

Abstract

Purpose of Review

Psoriasis and psoriatic arthropathy are inflammatory autoimmune conditions that can lead to profound emotional distress, social stigmatization, isolation, disfigurement, pain, disability, unemployment, and decreased quality of life. Thus, this disease has immense psychological, social, and economic implications as the pain experienced is closely associated with the primary disease burden. This review focuses on discussing the primary disease burden of psoriasis and psoriatic arthropathy, as well as management of different types of pain in these patients.

Recent Findings

Pain affects over 40% of patients with psoriasis, ranging from neuropathic to nociceptive. Treatment of pain largely focuses on treating the underlying disease with mild topical steroids and non-steroidal medications including vitamin D analogs followed by systemic immunomodulatory agents for more severe disease. Interventional options such as corticosteroid injections are available for select cases (conditional recommendation).

Summary

Psoriasis and psoriatic arthropathy have been associated with underreporting and resultant undertreatment of pain. Pain control in these conditions is complex and requires a multidisciplinary approach. More research and guidelines are needed in the areas of reporting of psoriatic disease, associated pain, psoriatic nociception, and optimal clinical management.

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Authors and Affiliations

  1. Yale University School of Medicine, 333 Cedar St, TMP3, CT, 06510, New Haven, USA

    Vijay Kodumudi & Kanishka Rajput

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  1. Vijay Kodumudi
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  2. Kanishka Rajput
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Correspondence to Kanishka Rajput.

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Kodumudi, V., Rajput, K. Pain Management in Painful Psoriasis and Psoriatic Arthropathy: Challenging and Intricately Intertwined Issues Involving Several Systems. Curr Pain Headache Rep 25, 36 (2021). https://doi.org/10.1007/s11916-021-00952-5

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  • DOI: https://doi.org/10.1007/s11916-021-00952-5

Keywords

  • Pain
  • Psoriasis
  • Psoriatic arthropathy
  • Underreporting of pain
  • Disability
  • Pain management