Psoriatic Arthritis

Psoriatic arthritis is a chronic disease in which inflammation affects the joints, spine and skin. Inflammation happens when the body’s immune system mistakenly attacks healthy parts of the body. Many people later diagnosed with psoriatic arthritis have previously been diagnosed with psoriasis. Once it begins, it is a life-long condition, although symptoms can come and go.

PsA in the joints: Psoriatic arthritis causes pain and swelling in the membranes that hold together and protect the bones in your joints. This can bend and stretch the tendons and ligaments and eventually harm the bone and cartilage in your joints as well. Unlike other joint diseases like rheumatoid arthritis, PsA may be asymmetrical, meaning it could affect only one side of your body or some joints and not others. You could experience pain, swelling and stiffness in the small joints of the fingers and toes. PsA can also affect other body organs and tissues.

PsA in the skin: psoriatic arthritis causes skin lesions or plaques—patches of dead skin—that can appear to be rough, dry and thick as dead skin builds up, red and irritated with silvery scales and a distinct border between the plaque and normal skin. Sometimes the lesions itch, burn or bleed. Patches are most often seen on the elbows, knees and torso, but can appear anywhere, including the scalp. Fingernails and toenails can also be affected, with the nails becoming thickened, lifting up from the skin or becoming pitted with small holes.⁵

Psoriatic arthritis is caused by a malfunction of the immune system, in which your immune system mistakenly attacks healthy cells in your own body. Scientists are not sure why this happens. However, there may be both genetic and environmental factors that help cause PsA. For instance, certain genes are associated with psoriatic arthritis, although carrying those genes is not enough to develop the disease (and some people can develop the disease without carrying these genes). You may also experience a “triggering event,” in which a period of stress, infection or injury sets off the condition for the first time.

The biggest risk factor for psoriatic arthritis is having psoriasis. Up to 30% of people with psoriasis may ultimately develop PsA.^{2 4} Having a family history of psoriatic arthritis or carrying certain genes also increase your chances of developing PsA. While PsA symptoms can begin at any age, it often develops after the age of 30.

Research suggests that psoriatic arthritis affects up to 1% of the population. However, it is much more common (20-30%) among people with psoriasis.² PsA appears to affect men and women equally.

A number of conditions often coincide with PsA. These include obesity, diabetes, cardiovascular disease, inflammatory bowel disease and eye diseases like uveitis and conjunctivitis. There may be some connection between these conditions and persistent inflammation caused by PsA.²

There is no single test of psoriatic arthritis. Instead, diagnosis is based on a number of factors. Your healthcare provider may ask you about your symptoms and medical history and conduct a physical exam. They may also order blood tests or X-rays to check for signs of inflammation and bone or joint damage.

If inflammation from psoriatic arthritis is left untreated, it can eventually lead to joint deformities and severe stiffness that make daily activities difficult. There are ways to treat psoriatic arthritis and prevent damage before it happens. Timely diagnosis is important for receiving effective PsA treatment. In some cases, pain or anti-inflammatory medications and steroids can help reduce inflammation. If you have a more serious form of PsA, anti-rheumatic drugs (called DMARDs) and biologic therapies can be used.¹ However, current medications may not work equally well for everyone. You can talk with your health care professional about what course of treatments is right for you, and whether you might be a good candidate for a clinical trial.

There is no cure for psoriatic arthritis, although symptoms may vary. Treatment focuses on mitigating its impacts on your daily life. Early diagnosis and effective treatment are key to reducing the risk of long-term joint damage and maintaining quality of life. Other conditions associated with PsA, such as cardiovascular issues, can cause risks if not treated properly.

Living with any chronic disease can make you feel isolated—especially when you have to adapt or change your daily routine. When you have PsA, it's invaluable to keep the lines of communication open with your family, friends and coworkers: they can't understand what it's like to live with PsA if you don't talk openly about it.

Psoriatic arthritis is different for every patient, and treatment must be tailored for each individual case. The key is to communicate regularly with your doctor. This can help them monitor your progress and the effects of your treatment, as well as identify any other conditions associated with PsA you may be experiencing. It is important to follow your treatment instructions every day, as medication can take time to work. If you feel there's a problem with your regimen, or are experiencing any side effects, talk to your doctor right away about alternatives.

Researchers are continuously investigating potential new and more effective treatments. For guidance on the best treatment options for you—and to determine if you may qualify for a clinical trial—please speak with your healthcare provider.