Signs Your Psoriasis Could Actually Be Psoriatic Arthritis
Prevent permanent joint damage by catching—and treating—PsA early.
If you have psoriasis, you may already know that you’re at an increased risk of developing psoriatic arthritis (PsA), an inflammatory arthritis that causes joint pain, swelling, and stiffness. About 30 percent of people who have psoriasis eventually get PsA, according to the National Psoriasis Foundation (NPF).
Most people develop psoriatic arthritis about 5 to 12 years after psoriasis, although it can show up earlier. In fact, in 15 percent of cases, PsA is diagnosed at the same time as psoriasis.
“Psoriatic arthritis is an autoimmune disease, which means your body’s immune system attacks healthy tissue, such as the joints and the skin,” says Leah Elon, MD, a rheumatologist at Harlem Health Center and Queens Health Center in New York City.
If you have psoriasis, there’s no way to tell whether you’ll develop PsA, but knowing the signs can help you catch it early. “Starting treatment early can help prevent joint damage, and improve your symptoms and quality of life,” says Dr. Alon.
Symptoms of Psoriatic Arthritis
In most psoriatic arthritis cases, people tend get psoriasis symptoms, such as red or silvery patches on their skin, before arthritis-type symptoms, says Dr. Alon. “But there are some telltale signs that are unique to people with psoriatic arthritis.” Here are common PsA symptoms:
- Stiffness. People with PsA tend to be stiff first thing in the morning, or after they’ve been sitting for a long period of time.
- Sausage-like fingers. Some people with PsA have dactylitis, a sausage-like swelling in their fingers or toes.
- Pain in tendons or ligaments. People with PsA often develop tenderness or pain where tendons or ligaments attach to bones, called enthesitis. Common areas are at the heel (Achilles tendinitis), the bottom of the foot (plantar fasciitis), and in the elbow (tennis elbow), says Dr. Alon.
- Nail changes. If you notice that your nails are pulling away from the nail bed or develop pitting, ridges, or a yellowish-orange color, these could be signs of PsA.
- Eye inflammation. People with PsA may experience redness, irritation and disturbed vision (uveitis) or redness and pain in tissues surrounding the eyes (conjunctivitis, or "pink eye").
- Painful, swollen joints. PsA can cause swelling in the ankles, knees, fingers, toes, and lower back.
- Fatigue. People with PsA often feel general feelings of fatigue. This is caused by proteins called cytokines that are released during inflammatory reactions, according to NPF.
“If you are at all concerned that your skin issues, pain, or other symptoms could be psoriatic arthritis, please see a doctor,” says Dr. Alon. Early diagnosis and treatment will help prevent permanent joint damage and reduce the effect the PsA has on your life.
Dr. Alon is a board-certified rheumatologist in New York City.
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[MUSIC].
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Psoriatic arthritis is
an autoimmune disease, which means
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your body's immune system attacks healthy
tissue, such as the joints and the skin.
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[MUSIC]
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Psoriatic arthritis can have
a big range of symptoms and
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these can vary widely
from patient to patient.
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In most psoriatic arthritis cases,
people first get psoriasis symptoms,
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such as red or silvery patches on their
skin, before arthritis-type symptoms.
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But there are some telltale signs that are
unique to people with psoriatic arthritis.
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Skin lesions, nail problems, and
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specific patterns of joints affected let
us differentiate it from other conditions.
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Psoriatic arthritis can develop
over time with mild symptoms, or
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it can strike quickly and
be severe right away.
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For may patients,
it starts with a few swollen joints.
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A finger or toe may be visibly puffy.
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Some people may feel stiff in
the morning when they wake up.
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Other common symptoms include tenderness,
pain and swelling at your tendons.
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Common areas are the heel,
where it's called achilles tendinitis, or
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the bottom of the foot,
where it's called plantar fasciitis.
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It can also occur in the elbow,
where it's called tennis elbow.
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Fingers and toes with a sausage-like
appearance which is called dactylitis.
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Reduced range of motion,
nail changes such as becoming pitted or
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infected looking, fatigue and
exhaustion, lower back pain,
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skin issues such as the development of
thick red skin with flaky, silver white,
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scaly patches, overall redness and
pain of the eye, such as pink eye.
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If you are at all concerned
that your skin issues, pain or
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other symptoms could be psoriatic
arthritis, please see a doctor.
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Starting treatment early can help prevent
joint damage and improve your symptoms and
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quality of life.
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[MUSIC]
Psoriatic Arthritis (Beyond the Basics). Waltham, MA. UpToDate, 2020. (Accessed on May 30, 2021 at https://www.uptodate.com/contents/psoriatic-arthritis-beyond-the-basics)
Psoriatic Arthritis Symptoms. Chicago, IL. American Academy of Dermatology. (Accessed on May 30, 2021 at https://www.aad.org/public/diseases/painful-skin-joints/psoriatic-arthritis#symptoms)
Psoriatic Arthritis Symptoms. Atlanta, GA. Arthritis Foundation. (Accessed on May 30, 2021 at https://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/symptoms.php)
Fatigue and Psoriatic Arthritis. Portland, OR. National Psoriasis Foundation. (Accessed on May 30, 2021 at https://www.psoriasis.org/advance/fatigue-and-psoriatic-arthritis)
About Psoriasis. Portland, OR. National Psoriasis Foundation. (Accessed on May 30, 2021 at https://www.psoriasis.org/about-psoriasis)