15 Things to Know About Psoriatic Arthritis

Psoriatic arthritis is considered an immune-mediated disease with autoimmune features.

If you have this condition, your immune system mistakenly attacks your own body tissues. This causes inflammation in the affected tissues, which can become painful and damaged over time.

With psoriatic arthritis, your immune system attacks your skin (through psoriasis) and joints. This can cause rashes, joint swelling and pain, and pitted nails.

In more severe psoriatic arthritis, the immune system may attack internal organs, such as your heart and lungs.

Unlike other autoimmune-type conditions, psoriatic arthritis can develop at any age. Most people are diagnosed between the ages of 30 and 50, but this condition can develop as early as childhood.

Also, while most autoimmune diseases tend to have a higher prevalence in women, psoriatic arthritis affects both women and men equally.

There’s no single cause of psoriatic arthritis, and the triggers are highly individual. Psoriasis and psoriatic arthritis may be hereditary, and conditions with autoimmune features may run in families.

Aside from a possible genetic component, psoriatic arthritis may be triggered by stress, physical trauma, or infection.

While psoriatic arthritis can develop after psoriasis, not everyone who has psoriasis will develop this type of arthritis. It’s estimated that about 20% of people with psoriasis will eventually develop psoriatic arthritis.

On the other hand, while uncommon, a small number of people may develop joint pain in psoriatic arthritis before symptoms of psoriasis.

When people with psoriasis develop psoriatic arthritis, they may first notice symptoms in their fingers. You might experience swelling, pain, and warmth, especially in the joints closest to your fingernails.

It’s possible to experience significant swelling in the fingers and toes, also called dactylitis.

Early symptoms of psoriatic arthritis may also develop in your wrists, knees, and ankles. As the condition progresses, it may affect the spine and hips in some people.

With psoriatic arthritis, joint pain tends to develop asymmetrically. This means you may experience symptoms within different joints on different sides of your body.

For example, psoriatic arthritis may develop in your left hand and right ankle.

Due to high levels of inflammation, fatigue is a common symptom in diseases with autoimmune features, such as psoriatic arthritis. The fatigue may come and go, and it may be severe enough to limit your everyday activities, such as work.

It’s also possible for a low grade fever to accompany fatigue.

Eye changes may occur in some people. This includes physical symptoms, such as redness, irritation, and pain — all of which can feel similar to pink eye.

Persistent eye inflammation may also cause vision changes, such as blurry vision.

Skin plaques, joint pain, and eye changes are all common in psoriatic arthritis.

However, this condition may lead to other chronic health problems if left untreated. These may include gastrointestinal problems, breathing difficulties, and heart issues.

Psoriatic arthritis may also increase your risk of osteoporosis and metabolic syndrome.

Metabolic syndrome is an umbrella term that includes a group of related conditions, such as high cholesterol, high blood pressure, type 2 diabetes, and obesity.

There’s no single test available to diagnose psoriatic arthritis. Instead, your doctor will first look for signs of psoriasis and joint problems and also ask you about skin and joint symptoms.

A skin biopsy may be ordered to confirm psoriasis if you’re not currently diagnosed with the skin condition.

A doctor will then order a series of blood tests that may indicate inflammation in the body, such as rheumatoid factor (RF) C-reactive protein.

Imaging tests — such as an ultrasound, MRI, or X-ray — can also help your doctor identify specific joints that may be affected by psoriatic arthritis.

Since it’s possible to develop multiple types of autoimmune diseases, a doctor may also check for these. Examples include inflammatory bowel disease (IBD), autoimmune thyroid diseases, and type 1 diabetes.

An RF blood test is essential in differentiating psoriatic arthritis from other rheumatic diseases. People who have psoriatic arthritis are often RF-negative.

If your results come back positive, this could indicate rheumatoid arthritis instead. But your doctor will likely order further testing.

There’s no cure for psoriatic arthritis. Instead, the goal of treatment is to control flares or periods of worsening symptoms.

Getting the right treatment can result in less inflammation and fewer flares. This can also help reduce your risk of further health complications from psoriatic arthritis.

Treatment for psoriatic arthritis focuses on reducing joint damage and pain caused by underlying inflammation. This involves a combination of medications, such as disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs).

Additionally, you may still need to work with a dermatologist to help treat your psoriasis symptoms. This may involve some of the same medications used for psoriatic arthritis, as well as topical medications, such as corticosteroids or salicylic acid.

Psoriatic arthritis can cause worsening joint issues and also lead to other health problems if left untreated. While there’s no cure yet, multiple types of therapies can help control your symptoms, reduce the number of flares, and prevent related complications.

If you have psoriasis and are experiencing joint pain and inflammation, talk with your dermatologist or primary care doctor. They may refer you to a rheumatologist who can help diagnose and treat psoriatic arthritis.