I have psoriasis. What changes if I get psoriatic arthritis, too?
Psoriasis is more than skin deep. When you're not looking, inflammation related to the disease may be slowly damaging your joints. About three out of 10 people with psoriasis will get psoriatic arthritis.
Questions about psoriasis and psoriatic arthritis might leave you scratching your head — and your elbows and knees and perhaps other places, too. How do you know if achy joints mean you have psoriatic arthritis or if they're simply a sign of everyday aging and wear and tear? Only a doctor can tell you for sure.
Knowing the answers to some common questions can help you better manage your condition and prevent complications.
How will I know I have psoriatic arthritis?
If you've got psoriasis and the joints in your fingers, hands, feet or other parts of your body start to hurt, don't shrug it off to growing older. Joint pain and damage are serious complications of psoriasis.
Your dermatologist should talk to you about and screen you for psoriatic arthritis at each and every checkup. In most adults with psoriasis, skin symptoms occur years before psoriatic joint pain sets in.
Psoriasis experts recommend watching for the following signs and symptoms of psoriatic arthritis. Tell your doctor right away if you develop more than one:
- Pain or swelling in one joint or more
- Swelling that makes a finger or toe appear sausage-like
- Red, warm joints that are hot to the touch
- Frequent joint tenderness or stiffness
- Pain in and around the feet and ankles
- Nail changes, including small indentations in the nails (pitting) or lifting from the nail bed
- Pain in the lower back, above your tailbone
Usually, psoriatic arthritis affects the small joints of the hands, feet, knees, wrists and elbows, but it may also strike the spine. You're more likely to get psoriatic arthritis if someone in your family has it.
Will I need a new doctor?
If you have psoriasis, you should be seeing a skin and nail specialist (dermatologist). Your dermatologist plays an important role in screening and informing you about psoriatic arthritis.
If you develop psoriatic arthritis, you'll be referred to a doctor who specializes in autoimmune and musculoskeletal diseases (rheumatologist). Ideally, you and your doctors will all communicate with each other to come up with a personalized treatment plan that best fits your specific health needs.
How will my treatment change?
Your medications may not change. Medications such as biologics and DMARDs, used to treat moderate to severe psoriasis, are also prescribed for psoriatic arthritis. Your doctor may need to tweak your dosage. Or, you may be given other medications to add to your existing treatment plan.
Be sure to stick with your prescribed treatment plan. Without proper treatment, psoriatic arthritis can cause significant complications and irreversible joint damage, greatly disrupting your quality of life.
Will I need checkups more often?
You'll need regular health screenings to prevent complications. People who have psoriasis and psoriatic arthritis have a higher risk of other serious health conditions, including heart disease, obesity and depression. It's also a good idea to see a primary care doctor for recommended wellness exams.
July 02, 2019
See more Expert Answers
- Elmets CA, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. Journal of the American Academy of Dermatology. 2019;80:1073.
- AskMayoExpert. Psoriasis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2019.
- Psoriasis: Diagnosis, treatment, and outcome. American Academy of Dermatology. https://www.aad.org/public/diseases/scaly-skin/psoriasis/diagnosis-and-treatment-of-psoriasis. Accessed May 21, 2019.
- Could you have psoriatic arthritis? Know the signs. National Psoriasis Foundation. https://www.psoriasis.org/psoriatic-arthritis/know-the-signs. Accessed June 1, 2019.
- Bolognia JL, et al., eds. Psoriasis. In: Dermatology. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2018. https://www.clinicalkey.com. Accessed June 1, 2019.