People with psoriatic arthritis may have symptoms of both psoriasis and arthritis. The condition causes widespread inflammation and can affect the skin, musculoskeletal system, immune system, vision, and more.
Psoriatic arthritis (PsA) affects up to 30% of people who have the skin condition psoriasis.
Here, we describe eight effects of PsA, including the effects on vision, digestion, breathing, and movement. We also explore the treatment options.
Many people with PsA also have psoriasis. Possible symptoms of plaque psoriasis, the most common type, include:
- rough, scaly patches of skin
- a raised, silvery coating on some of these patches
- changes in skin color
- flakes on the scalp that may resemble dandruff
- thickened nails
- ridged, pitted, or crumbling nails
- separation of nails from the nail bed (onycholysis)
- itching and pain
Skin symptoms usually affect the elbows, knees, lower back, and scalp, but they can occur anywhere. Nail symptoms occur in
Psoriasis speeds up the life cycle of skin cells. New cells move to the outer layer of the skin in a few days rather than weeks. These new cells rapidly build up on the skin, forming the itchy, scaly patches that characterize psoriasis.
Around 68% of people who develop PsA already have skin symptoms of psoriasis, and about 15% of people with PsA develop symptoms of psoriasis at the same time.
In about 17% of cases, skin symptoms appear only after symptoms that affect the joints and other areas.
The immune reaction involved in psoriasis and PsA causes inflammation of the joints, which can affect the musculoskeletal system in several ways. Inflammation causes pain, stiffness, and swelling in one or more joints, making them difficult to move.
PsA symptoms usually affect
How does it affect cartilage?
In arthritis, the cartilage at the end of the bones becomes damaged and breaks down. In PsA, this damage results from persistent inflammation.
As the cartilage erodes, the bones rub together, causing further pain and joint damage. Inflammation can lead to bone erosion and extra bone growth.
Chronic inflammation can also affect the ligaments and tendons around the joint.
Can psoriatic arthritis make your whole body hurt?
According to the American Academy of Dermatology, early symptoms of PsA may include:
- swelling and tenderness in a joint, particularly a finger or toe
- heel pain
- swelling just above the heel
- stiffness that is worst when a person wakes up and improves throughout the day
Swelling often occurs throughout the fingers. The affected fingers and toes may develop a sausage-like appearance (dactylitis), which may be most prominent in the middle joints of the fingers.
The finger bone may change shape, which doctors can recognize using imaging technology. The middle bone in a finger joint becomes narrower, while the end joint becomes wider.
PsA may also cause inflammation in the back and pelvis, known as spondyloarthritis.
PsA is an autoimmune condition, which means it influences the way the immune system works. The immune system fights pathogens, such as bacteria and viruses. But in someone with an autoimmune condition, the immune system mistakenly attacks healthy cells.
In a person with PsA, the immune system attacks the joints, the tendons, and the insertion points of tendons and ligaments. If a person also has psoriasis, this immune system reaction also affects the skin.
Researchers do not fully understand why this happens. They think some bacterial infections, including strep throat, may trigger PsA. In addition, if a person has a genetic susceptibility, they may develop PsA as a result of severe stress, a physical injury, or an event that causes the immune system to react strongly.
Learn more about the relationship between psoriasis and the immune system.
Inflammation in and around the eyes can affect vision. Some
Uveitis is a group of diseases related to eye inflammation. Without treatment, it can lead to vision loss. People with PsA should have regular eye exams for this reason.
There is a link between inflammatory bowel disease (IBD), such as Crohn’s disease, and PsA because inflammation underlies both conditions. IBD causes diarrhea and other gastrointestinal symptoms.
People with PsA have a significantly increased risk of developing IBD, according to a 2017 study. And some research suggests that psoriasis is eight times more common in people with Crohn’s disease.
PsA may affect the body in other ways, including the following.
Effects on the respiratory system
People with PsA appear to have a higher chance of developing chronic obstructive pulmonary disease (COPD), according to a
A
How can psoriasis affect the lungs?
Effects on the cardiovascular system
People with PsA have a
Among people with PsA, there are also higher rates of metabolic syndrome. This includes conditions such as obesity, high blood pressure, diabetes, and high cholesterol. These, too, can put added stress on the blood vessels and the cardiovascular system.
Effects on mental health
PsA
Psoriasis and PsA may also reduce self-esteem and cause feelings of embarrassment, especially when treatments do not adequately manage symptoms.
Treatments for PsA aim to:
- manage symptoms
- reduce the frequency and severity of symptoms
- slow the progression of the disease
- prevent permanent damage
Some
A doctor may recommend:
- nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil), and other medications to manage pain and inflammation
- steroid injections to ease inflammation
- joint replacement surgery when damage to a joint is severe
The following strategies may also help:
- participating in physical and occupational therapy
- making efforts to maintain a moderate weight
- engaging in low impact exercise such as yoga or tai chi
- undergoing massage therapy
- undergoing acupuncture
- avoiding or quitting smoking
- seeking support from others, such as family, friends, or a therapist
Living with a chronic inflammatory condition such as PsA can be difficult. The symptoms may come and go, worsening during flares and disappearing during periods of remission. Over time, they may become more severe.
If skin symptoms occur, they can cause physical discomfort. These physical manifestations of PsA can also have a detrimental effect on relationships, both personally and professionally, and increase a person’s chances of developing mood disorders such as anxiety and depression.
However, a person’s individual experience with PsA will depend on how severe their symptoms are, which parts of the body the condition affects, and whether any comorbidities, such as heart disease, emerge.
In addition to medical treatment, there are a few things a person can do to find relief and manage the condition:
- Engage in arthritis-friendly forms of exercise such as yoga and walking.
- Rest as needed.
- Avoid any known triggers, such as certain foods or habits.
- Eat a balanced diet and make efforts to maintain a healthy weight.
PsA causes inflammation in the joints, which leads to swelling, pain, and stiffness. It can also cause fatigue, nail changes, and other symptoms. People with PsA have a
There is no cure for PsA, but medication can help manage it and prevent progressive joint damage. Alternative therapies and lifestyle strategies, such as engaging in low impact exercise and avoiding smoking, may also help.