Rheumatoid arthritis (RA), an autoimmune disease in which the body immune system acts abnormally and mistakenly attacks its own healthy tissue, is a chronic long-term disease that can lead to a number of serious complications if it’s poorly controlled. As the name suggests, it mainly affects the joints. But it also can affect other parts of the body, including skin. Can it cause itching, too?
RA mainly affects the joints, causing classic symptoms of arthritis such as swollen, pain, and stiffness in the affected joints. Interestingly, many times it affects the joint symmetrically (though not always). For example, if you have it in your left knee, your right knee is usually affected too.
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It’s estimated that about 4 out of 10 people with the disease experience related problems in other parts of the body.
Still, again the joints are mainly affected. Painful and swollen joints are impossible to ignore in people with RA, that’s why it’s categorized into arthritis (a group of diseases where the joints are affected /damaged).
Typically, the disease starts in the small joints of the feet and hands. As the disease progresses, then it can affect other larger joints of the body. See also the differences between RA and OA (osteoarthritis, the most common form of arthritis) in here!
Inflammation of blood vessels
Systemic inflammation of RA may affect blood vessels. As a result, blood vessels can get narrowed and blood doesn’t flow as well as usual.
Inflammation of the blood vessels due to systemic inflammation of RA is medically called ‘vasculitis’. It can lead to a number of complications, depending on where the inflammation occurs. For example, if it occurs in the blood vessels close to the heart, you can have coronary artery disease.
The risk of heart disease
People with RA are two times more likely to develop heart disease. The disease can cause chronic inflammation that hurts your arteries. Over time, this increases your risk of heart attack, coronary heart disease, heart failure, or stroke.
In some cases, systemic inflammation of the disease can also make the sac-like structure around the heart (called the ‘pericardium’) to get inflamed. In time, this can lead to thickened and scarred pericardium if left untreated.
About 10 percent of people with RA experience lung problems. The systemic inflammation of the disease can cause a number of lung diseases. The common ones include pulmonary fibrosis, pleurisy, and emphysema. See more this issue in this section!
RA can affect nerves
Some people with the disease develop nerve damage such as peripheral neuropathy. This can lead to a number of symptoms such as extreme sensitivity to touch, numbness /burning in the hand or feet, or poor coordination – depending on what kind of nerve in your peripheral system that is affected.
Also, the nerve damage due to systemic inflammation of RA can get worse when you have vasculitis. Vasculitis can interfere with the blood supply to the nerves. As a result, the damage is more difficult to heal.
The disease may cause inflammation in various parts of the eye, causing a number of eye problems such as blurred vision, eye redness, more sensitive to light, cataract, and glaucoma. In worst scenario, the damage may lead to permanent blindness.
For in-depth information about how RA affects the eyes, see this previous post!
Carpal tunnel syndrome
Inflammation may also occur in the joints between the bones of the wrist and forearm. This can cause extra pressure that pushes on the median nerve in the wrist. As a result, you may have carpal tunnel syndrome, a condition that causes numbness, tingling sensation, weakness, pain, and other discomfort symptoms in your hand.
In rare cases, RA may lead to a condition called Felty’s syndrome, enlarged spleen which is usually followed with low white blood cell count. People with Felty’s syndrome are more vulnerable to infection. It only affects about 1 percent of RA patients.
What actually is itching? It is an unpleasant, irritating sensation that compels you to scratch the affected area. Its medical name is ‘pruritus’.
Depending on the cause of your itching, it could be localized (when it only occurs in a particular area) or generalized (when it occurs in many areas of the body). It may also be associated with:
- Spots, bums, or blisters.
- Skin redness.
- Cracked, dry skin.
- Scaly texture on the affected skin (leathery).
There are a number of different conditions that cause itchy skin. One of them is autoimmune condition such as RA. But even in people with RA, sometimes their itching could be caused by something else. Again, the problem can be attributed by many factors.
For examples, the following are some common causes of itching:
- Skin conditions such as eczema, contact dermatitis, psoriasis, and dandruff.
- Insects and parasites such as insect bites and threadworms.
- Skin infections such as athlete’s foot, chickenpox, or fungal infection (like ringworm).
- Skin allergies due to irritant, environmental factor, or an allergen.
- Other health conditions such as anemia, liver-related conditions, kidney problem, thyroid disorder, or even certain cancers (in rare cases).
RA can affect your skin and cause itching. The bad news, some treatments of the disease can also contribute to worsen your skin problem and make it itch even more.
It seems that RA can cause itchy skin in several ways. The main ones are outlined below: