Is there a connection between psoriatic arthritis and Raynaud's syndrome?

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The National Psoriasis Foundation (NPF) does not list Raynaud’s syndrome as a comorbidity of PsA.

A 2020 article reports Raynaud’s phenomenon occurring in relation to secukinumab (Cosentyx), a type of biologic therapy that can be effective in treating PsA.

Another older 2015 study examines the prevalence of autoimmune conditions, including Raynaud’s phenomenon. The study’s authors suggest that the frequency of overlap between psoriasis and autoimmune conditions is low.

Although Raynaud’s phenomenon and PsA can occur independently in the same person, they are distinct conditions with different underlying causes. More research is necessary to determine whether there is any direct link between them.

Raynaud’s syndrome and other types of arthritis

While there is little evidence of a link between Raynaud’s syndrome and PsA, the phenomenon can occur alongside another autoimmune condition, rheumatoid arthritis (RA).

There are two types of Raynaud’s phenomenon:

• Primary type: This type has no known cause, although there may be a genetic link. It typically occurs before age 30.
• Secondary type: This type occurs alongside or due to another condition, such as RA. It is less common but is typically more severe.

PsA and Raynaud’s phenomenon cause different symptoms and signs, including the following.

Symptoms of psoriatic arthritis

During a flare, someone with PsA may experience the following symptoms:

• joint pain, stiffness, tenderness, and swelling
• reduced range of motion in affected joints
• eye inflammation
• swelling of fingers or toes, known as dactylitis or “sausage digit”
• nail changes, such as pitting or separation

Unlike RA pain, which is usually symmetrical, PsA pain is often asymmetrical, occurring on only one side of the body. The frequency and duration of PsA flares vary from person to person.

Symptoms of Raynaud’s phenomenon

Raynaud’s syndrome is a vascular disorder that typically affects the fingers and toes but can affect other body parts, such as the ears and nose.

When someone experiences an episode of Raynaud’s phenomenon, the affected body part undergoes a series of changes, including:

• turning white, blue, or purple in response to cold or stress
• numbness, tingling, or pain
• skin color returning to typical appearance when warming up or relieving stress

Exposure to cold temperatures, stress, and smoking can trigger a Raynaud’s syndrome flare-up. Raynaud’s phenomenon attacks can last anywhere from minutes to hours.

Treatment options for both PsA and Raynaud’s phenomenon aim to:

• reduce the number and frequency of flares or attacks
• alleviate symptoms
• protect affected areas from damage

For PsA, treatment can include medications such as nonsteroidal anti-inflammatory drugs, biologics, and disease-modifying antirheumatic drugs, along with physical therapy and exercise.

Likewise, Raynaud’s syndrome treatment options include medications that manipulate the blood vessels and blood flow. Additionally, chemical injections, such as Botox, block sympathetic nerve fibers.

Doctors may recommend that people learn and avoid triggers for both conditions. In severe cases, surgery might be an option for both conditions.

The NPF recommends consulting a rheumatologist as soon as possible after noticing signs of PsA. PsA can increase the risk of comorbidities that affect other body parts and organs, so people should also inform their doctor about nonjoint symptoms.

For the most part, Raynaud’s phenomenon stays within the affected areas. However, people can develop ulcers and gangrene in those areas.

Older adults with Raynaud’s syndrome may also be at a higher risk for adverse cardiac events than those of the same age without the syndrome.

Anyone with Raynaud’s phenomenon who notices sores or infections in the affected areas or who has any reason to believe they have a higher risk of heart disease should contact their doctor.

Psoriatic arthritis causes joint pain, swelling, and stiffness, often coexisting with psoriasis, while Raynaud’s syndrome involves atypical blood vessel spasms in response to cold temperatures or stress.

Although an individual can simultaneously experience both conditions, current research has not found a link between PsA and Raynaud’s phenomenon.

It is important for someone who has or suspects they have PsA or Raynaud’s syndrome to contact their doctor. Without treatment, these conditions and their symptoms can lead to permanent damage to the affected areas and beyond.