Psoriasis & psoriatic arthritis
Psoriasis is a chronic, immune-related skin condition that causes the body to produce new skin cells faster than normal. This leads to thick, red, scaly patches, often on the scalp, elbows, knees and torso. Psoriatic arthritis is an inflammatory condition that develops in some people with psoriasis and affects the joints, areas where tendons and ligaments attach to bone and sometimes the spine.
Common symptoms
- Skin: Well-defined red plaques with silvery scale, itching, burning or pain. Nail changes may include pitting, ridging, discoloration or separation from the nail bed.
- Joints: Pain, swelling and stiffness, often worse in the morning, reduced range of motion and fatigue. Symptoms may affect one or multiple joints and can occur on one or both sides of the body.
Causes and triggers
Psoriasis and psoriatic arthritis occur when the immune system becomes overactive in people with a genetic tendency for these conditions. Triggers that may start or worsen symptoms include infections, skin injury, stress, certain medications, heavy alcohol use and smoking.
Risk factors
- Family history of psoriasis or psoriatic arthritis
- Personal history of psoriasis, especially longer duration
- Obesity and metabolic syndrome
- Smoking and heavy alcohol use
- Certain infections and medication exposures
How it is diagnosed
Diagnosis is mainly clinical. Our team of specialists evaluates the skin and nails, while rheumatology specialists assess joint symptoms. Imaging such as X-rays, ultrasound or MRI may be used to look for joint inflammation or damage. Blood tests can show inflammation, but there is no single test that confirms psoriasis or psoriatic arthritis. In some cases, a skin biopsy may be needed. Early recognition and referral to rheumatology are important to help prevent joint damage.
Outlook and management approach
Both conditions are long-term but manageable. Treatment focuses on controlling inflammation, relieving symptoms, improving daily function and preventing joint damage. Care may include topical treatments, light therapy, oral or injectable medications that target the immune system, physical therapy and healthy lifestyle choices. Care is often coordinated among primary care, dermatology and rheumatology, with treatment plans tailored to each person.
What is the difference between psoriasis and psoriatic arthritis?
Psoriasis mainly affects the skin and sometimes the nails. Psoriatic arthritis is an inflammatory joint condition that develops in some people with psoriasis and can lead to joint damage if untreated.
Is psoriasis or psoriatic arthritis contagious?
No. Neither condition is contagious. Both are related to immune system changes and influenced by genetics and environmental triggers.
How common is psoriatic arthritis in people with psoriasis?
About 10 to 30% of people with psoriasis develop psoriatic arthritis. Risk increases with longer or more severe skin disease and a family history.
What tests will my doctor order to diagnose psoriatic arthritis?
Diagnosis is mostly clinical. Imaging such as X-rays, ultrasound or MRI may be used to look for inflammation or joint damage. Blood tests like ESR or CRP can show inflammation and help rule out similar conditions, but no single test confirms psoriatic arthritis.
What are the treatment options?
Treatment depends on symptom severity. Options may include topical therapies and light therapy for skin disease, NSAIDs for pain and medications such as methotrexate, sulfasalazine, biologics targeting TNF or IL-17/IL-23 and JAK inhibitors to control inflammation. Care is individualized by dermatology and rheumatology teams.
Can lifestyle changes help?
Yes. Maintaining a healthy weight, exercising regularly, quitting smoking, limiting alcohol and managing stress can reduce symptoms and improve treatment response. Physical therapy and joint protection strategies can help preserve movement.
When should I see a specialist?
See a specialist for new or worsening skin symptoms. Joint pain, swelling, morning stiffness or reduced movement should prompt a visit to a rheumatologist. Early referral helps lower the risk of joint damage.
Are there complications I should be aware of?
Untreated psoriatic arthritis can cause permanent joint damage. People with psoriasis or psoriatic arthritis also have a higher risk of heart disease, diabetes, obesity and depression, making regular monitoring important.
Can psoriasis or psoriatic arthritis go into remission?
Many people achieve periods of minimal or no symptoms with treatment, especially with newer immune-targeted therapies. Ongoing care helps maintain control and monitor for side effects.
Is it safe to take biologic medications?
Biologic medicines are effective for many patients. They can increase infection risk and have other side effects, so regular monitoring is required. Your healthcare practitioner will discuss risks and benefits to help choose the best option.
