Psoriatic Arthritis

Reviewed by: HU Medical Review Board | Last reviewed: June 2022

Similar to rheumatoid arthritis (RA), psoriatic arthritis (PsA) is an inflammatory condition. PsA affects the joints and tendons. It often occurs in people who have psoriasis, which is an inflammatory disease of the skin. Psoriasis causes red, scaly patches that are itchy and painful.1

Symptoms and signs of psoriatic arthritis

The symptoms and signs of PsA vary for each person. There may be times when symptoms get worse, known as flares-ups. But there may be times when symptoms go away, known as remission.1

Some of the most common symptoms of PsA include:1

  • Swelling, stiffness, redness, and heat at the joints
  • Inflammation and pain where ligaments and tendons come together
  • Joint pain
  • Tiredness
  • Changes to nails, like discoloration or tiny holes on the surface of nails

These common symptoms often lead to:1

  • Swollen fingers and toes – This is often the first noticeable sign of PsA
  • Foot pain – This can make it hard to walk and get around
  • Lower back pain – This can lead to arthritis in the back (spondylitis) in some people
  • Eye inflammation (uveitis) – This can cause eye pain, redness, blurry vision, and even vision loss if left untreated

Types and patterns of psoriatic arthritis

PsA is defined by 5 clinical patterns:2

  • Distal interphalangeal predominant pattern – Mainly affects the joints closest to the nails in the fingers and toes
  • Oligoarticular asymmetrical – Only a few joints are affected and do not match on both sides of the body
  • Polyarticular RA-like – Multiple joints are affected on both sides of the body in a symmetric pattern, similar to RA
  • Spondylitis – Joints in the spine are affected
  • Arthritis mutilans – Severe form of the disease that causes deformity of the hands, fingers, or toes

What causes psoriatic arthritis?

The exact cause of PsA is unknown. Experts believe it is likely a combination of genetic and environmental factors.1,2

PsA occurs when the body’s immune system mistakenly attacks healthy cells and tissue. This causes inflammation in the joints, along with an overproduction of skin cells.1

External factors can sometimes trigger PsA in people who have a family history of the condition. For example, something in the environment, an infection, or trauma to an area of the body might trigger PsA symptoms.1,2

Who gets psoriatic arthritis?

Anyone can get PsA. The condition affects men and women equally. However, PsA is more common in people with certain risk factors, including:1,3

  • Psoriasis – About 1 in 3 people with psoriasis will go on to develop PsA
  • Family history – People with PsA often have a parent or sibling with the condition
  • Age – PsA can occur at any age, but it is more common in people ages 30 to 55
  • Obesity – More weight on the joints and ligaments may be a trigger for PsA

Treatment for psoriatic arthritis

Similar to RA, treatment for PsA depends on the severity and the type of PsA a person has. The goal is to reduce pain and reach remission of the disease. Treatment options for PsA include:4

  • Anti-inflammatory medicines – These are usually the first course of treatment and are used for people with mild PsA.
  • Disease-modifying drugs (DMDs) – These types of prescription drugs are for people with more active or severe PsA. These drugs work with the immune system to help reduce swelling, pain, and inflammation.
  • Physical therapy (PT) – Working with a physical therapist can help strengthen the muscles and joints while improving stability.
  • Weight management – Losing weight can help with joint pain. Weight loss may also make medicines for PsA more effective.

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