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Psoriatic arthritis

Medically reviewed by Drugs.com. Last updated on Sep 22, 2023.

Overview

Psoriatic arthritis is a form of arthritis that affects some people who have psoriasis — a disease that causes red patches of skin topped with silvery scales. Most people develop psoriasis years before being diagnosed with psoriatic arthritis. But for some, the joint problems begin before skin patches appear or at the same time.

Joint pain, stiffness and swelling are the main signs and symptoms of psoriatic arthritis. They can affect any part of the body, including your fingertips and spine, and can range from relatively mild to severe. In both psoriasis and psoriatic arthritis, disease flares can alternate with periods of remission.

There's no cure for psoriatic arthritis. Treatment is aimed at controlling symptoms and preventing joint damage. Without treatment, psoriatic arthritis can be disabling.

Plaque psoriasis

Plaque psoriasis is the most common type of psoriasis. It usually causes dry, red skin lesions (plaques) covered with silvery scales.

Symptoms

Both psoriatic arthritis and psoriasis are chronic diseases that worsen over time. However, you might have periods when your symptoms improve or go away temporarily.

Psoriatic arthritis can affect joints on one or both sides of your body. The signs and symptoms of psoriatic arthritis often resemble those of rheumatoid arthritis. Both diseases cause joints to become painful, swollen and warm to the touch.

However, psoriatic arthritis is more likely to also cause:

When to see a doctor

If you have psoriasis, tell your doctor if you develop joint pain. Psoriatic arthritis can severely damage your joints if left untreated.

Causes

Psoriatic arthritis occurs when your body's immune system attacks healthy cells and tissue. The immune response causes inflammation in your joints as well as overproduction of skin cells.

It seems likely that both genetic and environmental factors play a role in this immune system response. Many people with psoriatic arthritis have a family history of either psoriasis or psoriatic arthritis. Researchers have discovered certain genetic markers that appear to be associated with psoriatic arthritis.

Physical trauma or something in the environment — such as a viral or bacterial infection — might trigger psoriatic arthritis in people with an inherited tendency.

Risk factors

Several factors can increase your risk of psoriatic arthritis, including:

Psoriasis on the nails

In some cases, psoriasis can cause pitted and deformed nails that are thickened and discolored. Nails may also separate from the nail bed.

Complications

A small percentage of people with psoriatic arthritis develop arthritis mutilans — a severe, painful and disabling form of psoriatic arthritis. Over time, arthritis mutilans destroys the small bones in the hands, especially the fingers, leading to permanent deformity and disability.

Psoriatic arthritis also puts some people at higher risk of developing hypertension, metabolic syndrome, diabetes and cardiovascular disease

Diagnosis

During the exam, your doctor might:

No single test can confirm a diagnosis of psoriatic arthritis. But some types of tests can rule out other causes of joint pain, such as rheumatoid arthritis or gout.

Imaging tests

Laboratory tests

Treatment

No cure exists for psoriatic arthritis. Treatment focuses on controlling inflammation in your affected joints to prevent joint pain and disability and controlling skin involvement. One of the most common treatments are prescription medications called disease-modifying antirheumatic drugs (DMARDs).

Treatment will depend on how severe your disease is and what joints are affected. You might have to try different treatments before you find one that brings you relief.

Medications

Drugs used to treat psoriatic arthritis include:

Therapies

Physical and occupational therapies might ease pain and make it easier to do everyday tasks. Ask your doctor for referrals. Massage therapy might also offer relief.

Surgical and other procedures

Self care

Coping and support

The support of friends and family can make a tremendous difference when you're facing the challenges of psoriatic arthritis. For some people, support groups can offer the same benefits. A counselor or therapist can help you devise coping strategies to reduce your stress levels.

Preparing for your appointment

You're likely to first discuss your signs and symptoms with your family doctor. He or she may refer you to a doctor specializing in the treatment of arthritis and related disorders (rheumatologist).

What you can do

If possible, bring a friend or a family member with you to your appointment to help you remember the information you get.

Make a list of:

Basic questions about psoriatic arthritis might include:

Don't hesitate to ask other questions you have.

What to expect from your doctor

Your doctor might ask some of the following questions:

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