Psoriatic ArthritisSymptoms, Doctors, Treatments, Advances & More
Learn About Psoriatic Arthritis
View Main Condition: Arthritis
Psoriatic arthritis is a joint problem (arthritis) that often occurs with a skin condition called psoriasis.
Arthritis - psoriatic; Psoriasis - psoriatic arthritis; Spondyloarthritis - psoriatic arthritis; PsA
Psoriasis is a common skin problem that causes red patches on the skin. It is an ongoing (chronic) inflammatory condition. Psoriatic arthritis occurs in 7% to 42% of people with psoriasis. Nail psoriasis is linked to psoriatic arthritis.
In most cases, psoriasis comes before the arthritis. In a few people, the arthritis comes before the skin disease. However, having severe, wide-spread psoriasis appears to increase the chance of getting psoriatic arthritis.
The cause of psoriatic arthritis is not known. Genes, immune system, and environmental factors may play a role. It is likely that the skin and joint diseases have similar causes. However, they may not occur together.
The arthritis may be mild and involve only a few joints. The joints at the end of the fingers or toes may be more affected. Psoriatic arthritis can cause arthritis only on one side of the body or both sides of the body.
In some people, the disease may be severe and affect many joints, including the spine. Symptoms in the spine include stiffness and pain. They most often occur in the lower spine and sacrum.
Some people with psoriatic arthritis may have inflammation of the eyes.
Most of the time, people with psoriatic arthritis have the skin and nail changes of psoriasis. Often, the skin gets worse at the same time as the arthritis.
Tendons may become inflamed with psoriatic arthritis. Examples include the Achilles tendon, the plantar fascia, and the tendon sheath in the hand.
Your provider may suggest nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling of the joints.
Arthritis that does not improve with NSAIDs may need to be treated with medicines called disease-modifying antirheumatic drugs (DMARDs). These include:
- Methotrexate
- Leflunomide
- Sulfasalazine
Apremilast is another medicine used for the treatment of psoriatic arthritis.
Multiple injectable biologic medicines are effective for progressive psoriatic arthritis that is not controlled with DMARDs. These medicines block proteins involved in the inflammation process. They are often helpful for both the skin disease and the joint disease of psoriatic arthritis.
Additionally, there are two JAK-inhibitors that are approved for psoriatic arthritis: Tofacitinib and Upadacitinib. These medications are given orally.
Very painful joints may be treated with steroid injections. These are used when only one or a few joints are involved. Most experts do not recommend oral corticosteroids for psoriatic arthritis. Their use may worsen psoriasis and interfere with the effect of other medicines.
In rare cases, surgery may be needed to repair or replace damaged joints.
People with inflammation of the eye should see an ophthalmologist.
Your provider may suggest a mix of rest and exercise. Physical therapy may help increase joint movement. You may also use heat and cold therapy.
Reading Hospital
. Dr. Chakravarty is rated as an Elite provider by MediFind in the treatment of Psoriatic Arthritis. He is also highly rated in 4 other conditions, according to our data. His clinical expertise encompasses Psoriatic Arthritis, Psoriasis, Arthritis, and Ankylosing Spondylitis. Dr. Chakravarty is board certified in American Board Of Internal Medicine.
Seattle Rheumatology Associates
Dr. Mease graduated from Stanford University receiving his Medical Doctorate. He specializes in internal medicine and rheumatology. Dr. Mease is a practicing physician at Seattle Rheumatology Associates, Swedish Cherry Hill, and Swedish First Hill. Dr. Mease is rated as an Elite provider by MediFind in the treatment of Psoriatic Arthritis. He is also highly rated in 10 other conditions, according to our data. His clinical expertise encompasses Psoriatic Arthritis, Arthritis, Psoriasis, and Axial Spondyloarthritis (AxSpA). Dr. Mease is board certified in American Board Of Internal Medicine. Dr. Mease is currently accepting new patients.
Johns Hopkins Bayview Medical Center
Dr. Ana-Maria Orbai is an Associate Professor of Medicine in the Division of Rheumatology at the Johns Hopkins University School of Medicine. Her areas of clinical expertise include rheumatology and psoriatic arthritis. Dr. Orbai earned her M.D. from the Iuliu Hatieganu School of Medicine and Pharmacy, Cluj-Napoca, in Romania. She completed internship and residency training in internal medicine at the Johns Hopkins University-Sinai Hospital program. Subsequently, Dr. Orbai completed her post-doctoral fellowship training in rheumatology at Johns Hopkins. During her fellowship she earned her Master in Health Sciences degree in Clinical Investigation at the Johns Hopkins Bloomberg School of Public Health. Dr. Orbai directs the Psoriatic Arthritis Program in the Johns Hopkins Arthritis Center. Her clinical focus is psoriatic arthritis and spodyloarthritis. Dr. Orbai's research aims to understand psoriatic disease subtypes and improve treatment strategies for people with psoriatic arthritis. Dr. Orbai was awarded a Rheumatology Research Foundation Scientist Development award in 2014 and a Jerome L Greene Foundation Scholar award in 2018. Dr. Orbai is rated as an Elite provider by MediFind in the treatment of Psoriatic Arthritis. She is also highly rated in 6 other conditions, according to our data. Her clinical expertise encompasses Psoriatic Arthritis, Psoriasis, Arthritis, and Rheumatoid Arthritis (RA). Dr. Orbai is board certified in American Board Of Internal Medicine.
The disease is sometimes mild and affects only a few joints. However, in many people with psoriatic arthritis damage to joints occurs within the first several years. In some people, very bad arthritis may cause deformities in the hands, feet, and spine.
Most people with psoriatic arthritis who do not improve with NSAIDs should see a rheumatologist, a specialist in arthritis, along with a dermatologist for the psoriasis.
Early treatment can ease pain and prevent joint damage, even in very bad cases.
Contact your provider if you develop symptoms of arthritis along with psoriasis.
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Published Date: January 28, 2025
Published By: Diane M. Horowitz, MD, Rheumatology and Internal Medicine, Northwell Health, Great Neck, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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