Psoriatic Arthritis: More Than Skin Deep

By Bristol Health

January 14, 2019


Psoriasis is a skin condition characterized by plaques of red skin covered with silver colored scales, it affects between 2 percent and 4 percent of the general population

Usually patients are not aware that psoriasis can affect the joints.  Up to 30 percent of people with psoriasis can develop a form of inflammatory arthritis called as psoriatic arthritis (PsA), which causes pain, stiffness and swelling in and around the joints. Most people with PsA have skin symptoms before joint symptoms. However, sometimes the joint pain and stiffness strikes first. In some cases, people get psoriatic arthritis without any skin changes.

The exact cause of PsA is not known. However, a combination of genetic, immune system abnormalities and environmental factors are believed to play a role.

Types of Psoriatic Arthritis:

● Symmetric psoriatic arthritis. Affects joints on both sides of the body at the same time.

● Asymmetric psoriatic arthritis: doesn’t appear in the same joints on both sides of the body.

● Distal psoriatic arthritis:  Affects the ends of the fingers and toes, along with changes in nails such as pitting (as if pricked by a pin), white spots and lifting from the nail bed.

● Spondylitis: Pain and stiffness in the spine and neck

● Arthritis mutilans: considered the most severe form of PsA, deforms and destroys the joint.

In addition to joint symptoms, people sometimes have other symptoms which include:

● Swelling of a finger or toe called sausage finger or toe (dactylitis)

● Eye pain or redness

● Swelling in the areas where tendons attach to bones like back of the heel (enthesitis)

Moreover  patients with PsA have an increased risk for cardiovascular disease. PsA is usually diagnosed based on clinical history, family history of psoriasis, exam, Imaging tests.  Blood work is done to look for inflammation and rule out other conditions. 

While PsA can certainly affect an individual’s quality of life, the symptoms of the disease can be managed effectively. Paying attention to symptoms of the disease and addressing them as soon as they arise can, in fact, lead to positive outcomes.

Archana Sharma, MD, is a rheumatologist with the Bristol Hospital Multi-Specialty Group. Dr. Sharma’s office is located at 104 North St, Bristol. For more information or an appointment with Dr. Sharma, please call 1-833-4BHDOCS or visit