Psoriatic Arthritis

What Is Psoriatic Arthritis?

Psoriatic arthritis (PsA) is an inflammatory arthritis associated with the skin condition psoriasis. About 30% of people with psoriasis develop PsA. It can affect the joints, spine, and sites where tendons attach to bone (entheses).¹

Types of PsA²

Asymmetric oligoarthritis - Few joints, not matching sides
Symmetric polyarthritis - Similar to rheumatoid arthritis
Distal arthritis - Fingers and toes near nails
Spondylitis - Spine involvement
Arthritis mutilans - Severe, destructive (rare)

Symptoms

Joint pain and swelling
Morning stiffness
Sausage-like swelling of fingers/toes (dactylitis)
Heel or foot pain (enthesitis)
Nail changes (pitting, separation)
Back pain and stiffness
Fatigue

Diagnosis

Presence of psoriasis (current or past/family)
Characteristic pattern of arthritis
Imaging (X-rays, MRI)
Blood tests (usually RF negative)

Treatment³

Medications

NSAIDs (mild disease)
DMARDs (methotrexate, sulfasalazine)
Biologics (TNF inhibitors, IL-17/IL-23 inhibitors)
JAK inhibitors

Other Treatments

Physical therapy
Exercise
Joint protection
Weight management

Early Treatment Important

Early diagnosis and treatment help prevent joint damage. Without treatment, PsA can be destructive.

References

Ritchlin CT, Colbert RA, Gladman DD. Psoriatic arthritis. N Engl J Med. 2017;376(10):957-970.
Coates LC, Helliwell PS. Psoriatic arthritis: state of the art review. Clin Med. 2017;17(1):65-70.
Singh JA, Guyatt G, Ogdie A, et al. 2018 American College of Rheumatology/National Psoriasis Foundation guideline for the treatment of psoriatic arthritis. Arthritis Rheumatol. 2019;71(1):5-32.