Psoriatic Arthritis – Symptoms and Causes

Understanding Psoriatic Disease

Plaque psoriasis represents the most common form of psoriasis among affected individuals. It typically appears as dry, reddened patches of skin (plaques) with a distinctive silvery-white scale covering.

These plaques often develop on the elbows, knees, scalp, and lower back, though they can appear anywhere on the body. The patches may itch, burn, or feel painful, and in some cases might crack and bleed.

Plaque size varies from small spots to large patches, and the severity ranges from mild to severe. Many people with plaque psoriasis later develop joint problems associated with psoriatic arthritis.

Treatment Options

Several approaches exist for managing psoriatic disease:

• Topical treatments – Creams, ointments, and lotions applied directly to affected skin.
• Light therapy – Controlled exposure to natural or artificial ultraviolet light.
• Oral medications – Pills that work throughout the body to reduce inflammation.
• Biologic injections – Targeted treatments that block specific immune pathways.
• Lifestyle modifications – Stress management, gentle exercise, and proper skin care.

Most effective treatment plans combine multiple approaches tailored to the individual’s symptoms and disease severity.

Symptoms

Psoriatic arthritis and psoriasis both have a chronic nature that typically worsens with time. Many patients experience periods of remission where symptoms lessen or disappear temporarily.

Psoriatic arthritis can affect joints on either one or both sides of the body. Psoriatic arthritis shares symptoms with rheumatoid arthritis, such as painful, swollen, and warm joints, but has distinct characteristics.

• Sausage-like digits – Fingers and toes can become painfully swollen
• Tendon and ligament pain – Particularly common in the feet, including:
  • Pain at the back of the heel (Achilles tendinitis)
  • Pain in the sole of the foot (plantar fasciitis)
• Spinal inflammation – Some people develop spondylitis, causing:
  • Inflammation between spinal vertebrae
  • Inflammation where the spine meets the pelvis (sacroiliitis)
• Nail problems including:
  • Small pits or dents
  • Crumbling nails
  • Nails separating from the nail bed
• Eye issues – Uveitis may cause:
  • Eye pain and redness
  • Blurry vision
  • Potential vision loss if not treated

Joint pain can move between different areas of the body and vary in severity from mild discomfort to severe pain that hampers daily activities.

When to See a Doctor

If you have psoriasis and start feeling pain in your joints, contact your doctor right away. Without proper treatment, psoriatic arthritis can cause serious damage to your joints. Early medical attention is essential.

Causes

Psoriatic arthritis develops when the immune system mistakenly attacks healthy cells in the body. This abnormal immune response leads to joint inflammation and causes skin cells to grow too quickly.

Both genetics and environmental factors likely contribute to psoriatic arthritis. Many patients have family members with psoriasis or psoriatic arthritis. Scientists have identified specific genetic markers linked to this condition.

For people with a genetic predisposition, certain triggers may start the disease process:

• Physical injuries
• Viral infections
• Bacterial infections

These triggers can activate the immune system incorrectly in people who are already genetically susceptible to developing psoriatic arthritis.

Risk Factors

Nail Psoriasis

People with psoriasis may develop nail changes that signal a higher risk for psoriatic arthritis. Affected nails often become:

• Pitted with small dents or holes
• Thicker and harder than normal
• Discolored, often yellowish or brownish
• Deformed in shape or texture

In some cases, the nail might lift away from the nail bed, creating gaps underneath. These nail symptoms can appear before joint pain begins, making them an important warning sign.

If you have psoriasis and notice these nail changes, talk with your healthcare provider about monitoring for psoriatic arthritis.

Other important risk factors include:

• Having psoriasis (biggest risk factor)
• Family history of the condition
• Age between 30 and 55 years

Health Problems

Psoriatic arthritis can lead to several serious health issues. Some people develop more severe complications over time.

Additional Health Concerns

A small number of people with psoriatic arthritis may develop arthritis mutilans. This rare but severe form gradually destroys the small bones in the hands, particularly the fingers.

This can cause permanent deformity and make daily activities difficult. People with psoriatic arthritis also face higher risks for other health conditions. These include high blood pressure, metabolic syndrome, diabetes, and heart disease.

Healthcare providers need to carefully monitor these conditions. It is essential to manage overall health in conjunction with arthritis symptoms.