Have Psoriasis? Make the Connection Between Skin & Bones

Milk and cookies. Bacon and eggs. Some connections are obvious. But what about skin and bones? For the one million Canadians who live with psoriasis, including Toronto-based advocate and psoriasis warrior Reena Ruparelia, this link is critical. “For a long time, I thought that it was just about my skin,” says Reena. “Now I know that it’s deeper and I make sure to have those conversations, including the link between psoriasis and psoriatic arthritis.”

Photo, Gareth Dix

What is the connection?

Both psoriasis and psoriatic arthritis are part of a family of conditions called psoriatic disease, and both cause inflammation. The difference is that while the former is highly noticeable (think red, itchy and scaly patches on the skin), the latter is essentially invisible to the naked eye and manifests through swollen and painful joints and tendons.

“There are several types of arthritis, most of them very common and caused by simple wear and tear,” explains Dr. Joseph Doumit, dermatologist at Montreal’s Clini-Derma clinic. “However, many of the patients that I see are unaware that their psoriasis may be linked to their joint issues.”

About 30% of Canadians who live with psoriasis will develop psoriatic arthritis, but a recent survey showed most are not aware of the link between joint pain and psoriasis. In fact, one of the risk factors for developing psoriatic arthritis is having psoriasis, followed by a family history of either condition. And while diagnosing psoriatic arthritis can be tricky—there is no test to definitively diagnose the condition—early detection and effective management is critical to avoid permanent joint damage.

“Detecting it early makes for a better prognosis,” notes Dr. Doumit. “Without treatment, it can become disabling, which is why it’s so important to be informed.”

If you have psoriasis, or if it runs in your family it’s important to not forget about your joints. Keep an eye out for symptoms including swollen, tender or painful joints or tendons and changes in the appearance of your nails.

“Through my advocacy work, I’ve done lots of research and learned about the risk of developing psoriatic arthritis,” says Reena. “It is in my family so it’s something I look out for and routinely talk to my doctor about.”

More than her skin
As someone who was diagnosed with psoriasis at age 14, talking to doctors is something Reena does more than most. While the highly visible physical symptoms have had a major impact on her life, there have been invisible psychological and emotional repercussions to manage as well.

“For the most part, I lived in a shell and had a lot of social anxiety. I was obsessed with covering my psoriasis. Then, in my late 20s, I couldn’t hide it anymore,” explains Reena.

In 2016, she experienced the most debilitating flare-up of her life. She couldn’t move her hands or walk, but she did something radical: She turned to Instagram as a way of getting support. “I came out of the skin closet, if you will,” she laughs. “The more I put myself out there, the more support I got.”

Quickly, others began to respond to her and her account, which became a safe space for the psoriasis community to connect, get support, and have important conversations. As her self-acceptance and confidence grew, so did the power of her voice: she has been featured in television, billboard and online ads and was recently named to the Canadian Association of Psoriasis Patients @canadapsoriasis Board of Directors.

Photo, Gareth Dix

This year Reena finds herself and her psoriasis at the centre of a national campaign urging Canadians to make the connection between their skin and joints as the ‘woman behind the hand’.

Are you a psoriasis warrior? If so, be sure to ask your doctor about your skin and your joints. Make the connection at mySKINandBONES.ca.