Psoriatic Arthritis: What Your Dermatologist May Not Tell You

Psoriasis might prompt a visit to a dermatologist, but your doctor may not tell you that your skin condition could result in psoriatic arthritis, a condition that also affects your joints.

Psoriasis is caused by the body’s immune system going into overdrive and attacking the skin causing red patches, rash, and scales, says the American College of Rheumatology. In about 15 percent of people with psoriasis, the immune system response can begin to also attack the joints and cause chronic inflammation, or psoriatic arthritis.

According to Mayo Clinic, the primary symptoms of psoriatic arthritis mimic those of rheumatoid arthritis, another condition characterized by chronic inflammation. Symptoms include joint stiffness, heat in the joints, and swelling.

Pain can also occur, especially in the soles of the feet or at the back of the heel.

Psoriatic arthritis can affect any part of the body, and symptoms can range from mild to severe. Patients often experience intermittent flare-ups of the disease followed by periods of remission.

There are five types of psoriatic arthritis, says the Arthritis Foundation:

• Symmetric psoriatic arthritis is similar to rheumatoid arthritis and affects joints on both sides of the body.
• Asymmetric psoriatic arthritis often has milder symptoms that only affect one side of the body.
• Digital psoriatic arthritis is characterized by stiffness and inflammation in the toes and fingernails. Patients can also experience pitting and white spots on fingernail and toenail beds.
• Spondylitis occurs in some patients with psoriatic arthritis and is marked by stiffness in the spine and neck.
• Arthritis mutilans is the most severe form of psoriatic arthritis. It is a rare condition that causes deformities that can destroy the joints of the fingers and toes.

According to the American College of Rheumatology, treatment of psoriatic arthritis depends on the severity of the symptoms. For some patients, treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen or injections of corticosteroids is helpful for reducing inflammation. For others, chemotherapy drugs used to treat arthritis may be appropriate.

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