Complications of Psoriatic Arthritis a Rheumatologist Wants You to Know

In a way, psoriatic arthritis (PsA) is already a complication in itself. For many people, PsA is something that develops from psoriasis, a skin condition.

“Not all people with psoriasis get psoriatic arthritis,” says Nicola Kim Berman, MD, a rheumatologist based in New York. “But there is definitely a clear association with the skin condition and the arthritis condition.” About 30 percent of people with psoriasis go on to develop PsA, according to the Arthritis Foundation.

Like psoriasis itself, PsA is an autoimmune disease that causes chronic inflammation. When someone has any type of inflammatory condition, their risk for other inflammatory problems increases.

Thus, there are a number of complications that can arise from PsA, especially if the inflammation is not managed. “It’s essentially just an inflammatory process occurring in different parts of your body,” says Dr. Berman.

Metabolic Syndrome

“A big complication of psoriatic arthritis is metabolic syndrome,” says Dr. Berman. “That’s a combination of high blood pressure, [high blood sugar], abdominal obesity, [and] high blood pressure.” Statistically, having psoriasis or PsA doubles the risk of having metabolic syndrome, according to the Arthritis Foundation.

Metabolic syndrome is not a disease in itself, but it’s a cluster of conditions that increases the risk of several diseases, especially heart disease and type 2 diabetes. As a result, regular visits to your primary care doctor to keep tabs on your blood pressure and blood sugar is essential.

Inflammatory Bowel Diseases

Another common complication of PsA is inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis. The relationship goes both ways: Having inflammatory bowel disease can also increase the risk of developing psoriasis and PsA.

These conditions cause inflammatory attacks on parts of the digestive tract and lead to symptoms like diarrhea, bloody stools, and abdominal pain. Learn more about the symptoms of ulcerative colitis here.

Inflammatory Eye Diseases

A common complication associated with many autoimmune conditions is inflammation in the eyes. This condition is known as uveitis, or inflammation of the middle layer of the eye. Uveitis can lead to damage in the eye tissue and even compromise vision, according to the U.S. National Eye Institute.

“Things to look out for would be painful, hot, red eyes or blurred vision. It usually will present in one eye, and rarely in both,” says Dr. Berman.

Additionally, people with PsA are more likely to develop conjunctivitis—better known as “pink eye”—and dry eye syndrome.

Skin Problems

Since PsA and psoriasis are closely linked, you might expect to experience skin issues with PsA. However, it’s not just the thick, scaly plaques associated with psoriasis that people with PsA should look out for; rashes and skin ulcers are also common complications.

Mental Health

“Another thing that [patients with PsA] should also be screened for by their primary care doctor would be depression,” says Dr. Berman. “There’s a really high incidence of depression amongst these populations, and it’s something to be aware of with your patients.”

Mental illness and psoriatic diseases are a two-way street: Having one increases the risk of having the other. Specifically, people with psoriasis have a 39 percent higher risk of being diagnosed with depression than people without psoriasis, according to the National Psoriasis Foundation. That number is believed to be higher for people with PsA.

One explanation is that dealing with chronic diseases is inherently stressful and can cause feelings of hopelessness. However, there’s also evidence that chronic inflammation actually alters brain functioning.

The best way to prevent complications of PsA is to stick to your prescribed treatment regimen and keep inflammation at bay. Learn more about treatments for psoriatic arthritis here.