Psoriasis Isn’t Always Just a Skin Condition: Signs of Psoriatic Arthritis to Watch For

Many people have grown up hearing older relatives complain about their arthritis, and are well aware that aching joints go along with it. And, while not as common as arthritis, most people have heard of psoriasis. Far fewer know about a related condition called psoriatic arthritis. 

Unfortunately, the lack of awareness surrounding psoriatic arthritis and the way some symptoms mimic normal aches and pains, overuse, or aging often leads to underdiagnosis of the condition. In fact, one study found that around 15.5% of patients with psoriatic arthritis go undiagnosed or experience delayed diagnosis with negative outcomes. 

Knowing what psoriatic arthritis symptoms look like, how they differ from other forms of arthritis, and understanding who is most at risk can help patients and doctors alike catch this condition before it causes too much damage.

The link between psoriasis and joint pain

Psoriasis and many forms of arthritis are caused by rampant inflammation. The inflammation related to these conditions is due to the immune system mistakenly attacking healthy tissues. Normally, the immune system fights invaders in the body, like bacteria, but in these conditions, it attacks healthy skin or joints. This kind of confusion within the immune system is referred to as an autoimmune disorder. 

Psoriatic arthritis is a chronic autoimmune disorder that affects the joints, tendons, ligaments and their attachment sites, called the entheses. Surprisingly, some people with psoriatic arthritis don’t have psoriasis skin symptoms, although around 84% do experience psoriasis long before psoriatic arthritis symptoms show up. It is estimated that around a third of psoriasis sufferers also get psoriatic arthritis. People with psoriatic arthritis also have a higher risk of developing other autoimmune disorders and systemic inflammatory diseases.

Signs of psoriatic arthritis

The most common signs and symptoms of psoriatic arthritis include:

• Tender, painful, swollen joints (this may occur on only one side of the body)

• Swelling of fingers and toes (a symptom referred to as dactylitis) which is often associated with more severe psoriatic arthritis

• Fatigue

• Lower back pain

• Tiny pits or dents in the nails

• Lifting of the nail beds

• Morning stiffness

• Poor range of motion in the joints

Since other forms of arthritis also feature tender joints, loss of range of motion, and fatigue, it’s sometimes difficult to differentiate psoriatic arthritis from them. However, symptoms like dactylitis and nail issues can help doctors differentiate psoriatic arthritis. Patients with psoriatic arthritis also may get uveitis, which is a condition where the eyes become inflamed, red, and painful with blurry vision.

Who gets psoriatic arthritis?

Doctors aren’t exactly sure why people get psoriatic arthritis, but it is more likely to occur in some people. As mentioned earlier, around a third of people with psoriasis end up getting psoriatic arthritis, so this is the main risk factor. Usually, psoriatic arthritis develops between the ages of 30-40, but some people get it a little later. Generally, psoriatic arthritis develops 10-20 years after psoriasis is diagnosed, and it occurs nearly equally in both men and women. 

Other risk factors include:

• Obesity

• A family history of one or more first-degree relatives with psoriatic arthritis or psoriasis

• Having had certain infections that required antibiotics

• Smoking

• Previous joint trauma

• Being caucasian

What to do when you see early symptoms of psoriatic arthritis

If you already have psoriasis, it’s good to be on the lookout for early symptoms of psoriatic arthritis, like those listed above, especially if you experience more than one. If you are already working with a dermatologist for psoriasis treatment, be sure to let them know about your risk factors for psoriatic arthritis and any new symptoms you experience. 

Early psoriatic arthritis treatment can help prevent permanent damage in the joints, reduce inflammation that can cause other problems, and lessen pain. Some research even suggests that certain treatments for psoriasis can help prevent the development of psoriatic arthritis, so working with a dermatologist for psoriasis is also important even if you don’t yet have psoriatic arthritis. Not everyone who experiences psoriasis and joint pain at the same time has psoriatic arthritis, but it’s important to stay a step ahead of potential joint damage.

If your dermatologist thinks you might have psoriatic arthritis, they might work with a rheumatologist to reduce symptoms of both conditions and control flare-ups. Along with prescription medications, stress reduction, exercise, and a healthy diet can help to reduce systemic inflammation and flare-ups.

At Forefront, we take psoriasis and joint pain seriously and work with you to reduce worsening symptoms and disease progression. Find one of our offices to make an appointment and talk to one of our board-certified dermatologists.