Psoriasis is an inflammatory autoimmune condition that can manifest as a variety of skin symptoms, the most common being raised, red, silvery plaques on the skin, called plaque psoriasis. Up to 30 percent of people who have moderate-to-severe psoriasis develop a form of arthritis called psoriatic arthritis (sometimes abbreviated as PsA).
The majority of patients who have psoriatic arthritis first experience skin psoriasis symptoms; however, roughly 15 percent of patients develop psoriatic arthritis without a skin rash.
Like psoriasis, psoriatic arthritis is an autoimmune disorder. When a person has psoriatic arthritis, an abnormal immune response attacks tissues inside the joints, causing inflammation, joint pain and stiffness. Over time, this can cause permanent damage to the joints, which is why it is important to recognize the signs and symptoms of psoriatic arthritis and work with a healthcare provider. Getting an early and accurate diagnosis, and starting treatment as soon as possible, can help prevent long-term or permanent damage to your joints.
As with psoriasis, psoriatic arthritis symptoms tend to flare at times, and subside during others. The following are common symptoms of psoriatic arthritis.
Nail changes
Nail thickening and pitting, and separation of fingernails or toenails from the nail bed, can be a symptom of psoriasis. Research has shown that psoriatic arthritis is more common in people who have nail psoriasis. For some, nail psoriasis is the first symptom of psoriatic arthritis.
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Joint pain, stiffness and swelling
Psoriatic arthritis can affect any joint in the body—the small joints in the fingers and toes, the knees, even the spine (called psoriatic spondylitis or spondyloarthritis). Indicators of psoriatic arthritis include:
- Painful and stiff joints
- Ligament and tendon pain
- Reduced of range of motion
- Swollen fingers and toes (this is called dactylitis, and the affected digits are often described as looking “sausage-like”)
- Inflammation of the tendons and ligaments where they connect to the bone (called enthesitis)
- Inflammation in they eyes
- Foot pain
- Lower back pain
If you experience these symptoms, see your healthcare provider. Joints that are chronically inflamed can become weakened, damaged and deformed. Early diagnosis and treatment can help prevent or delay this damage.
Fatigue
As with other forms of arthritis, such as rheumatoid arthritis, patients with psoriatic arthritis often report feeling fatigued.
Family history
In addition to your own symptoms, is also important to pay attention to your family’s medical history. While the exact cause of these conditions is not known, genetics and family history are known to be a risk factor of both psoriasis and psoriatic arthritis. If you have a family history of psoriasis and/or psoriatic arthritis, you may be at a higher risk of developing this condition.
Medically reviewed in January 2020.