Are people with psoriasis more likely to develop psoriatic arthritis?

Joint pain

Synopsis

Yes. About one psoriasis patient out of three will develop psoriatic arthritis at one point in his or her life. Psoriatic arthritis manifest in the joints, not in the skin, and some people suffering from psoriasis can experience the symptoms of psoriatic arthritis for a while before they establish a connection between the stiffness or pain in the joints and their psoriasis. It is important to report those symptoms to a doctor in order to get treated rapidly and avoid permanent damage to the joints.

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Expert Answers

Dr. Ron Vender:

The answer is yes: they are more likely. The more complete answer is that there is an association between psoriasis and psoriatic arthritis. About 30% of people who have skin psoriasis may develop psoriatic arthritis. Most of the time, the psoriasis is diagnosed before psoriatic arthritis. The reverse is rare but less likely.

There is no relationship between where psoriasis is and where psoriatic arthritis will manifest in the body. For example, if someone has psoriasis on the elbows, it does not mean that arthritis will manifest in the elbows. Also, if someone has scalp psoriasis for example, there is no way to predict where the psoriatic arthritis will manifest.

There is an important genetic component to this. When someone has psoriasis or psoriatic arthritis in the family, they have a 35% probability of developing psoriasis as well.

The psoriatic arthritis symptoms are painful, swollen joints, nail changes and morning joint stiffness. Psoriatic arthritis can sometimes be symmetrical (i.e. affecting the same parts of the body on both sides) or asymmetrical. For example, some people will have both knees affected by it, while other will have the right wrist and left ankle.

Psoriatic arthritis manifests most commonly in ankles, knees and the lower back. There are no blood tests that can positively identify psoriatic arthritis. 

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Sandra Walsh:

Yes, it is thought that about one in every three people with psoriasis will also develop an inflammatory arthritis called psoriatic arthritis.  While most people will have psoriasis about 10 years before developing psoriatic arthritis, a few people will develop psoriatic arthritis before psoriasis or the arthritis and psoriasis will first occur together.

 While the cause of psoriatic arthritis is unknown, we do know that the body’s own immune system triggers the excessive inflammation in the joints.  It can develop slowly or quickly and the symptoms may be mild or severe and one or more joints may be involved.  Like psoriasis, the joints may flare, get better and flare again.  Inflammation leads to pain, stiffness and swelling of the involved joints.

If you have psoriasis and any of the following symptoms, you may have psoriatic arthritis:

Stiffness, pain, swelling or tenderness in one or more joints

Swollen fingers or toes

Lower back or neck pain, associated with stiffness, that worsens with rest and improves with activity

Reduction in a normal range of movement of joints and/or spine

Tendonitis

Stiffness lasting at least 30 minutes after waking up or inactivity

Unexplained Fatigue

 

 If you have psoriasis and you are experiencing any of the above symptoms, it is important that you speak to your Family Doctor, Nurse or Dermatologist.  Your doctor may send you to a Rheumatologist who specializes in diseases of the joints. 

Early treatment is important in preventing the possible debilitating effects of arthritis.  Many patients who are successfully treating both their skin and joints after many years of not caring to treat their psoriatic arthritis have told me that they are so happy with their ability to move and be free from the fatigue and morning stiffness that they once had endured.  They feel that they have their life back again.

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Andrew Gosse:

Yes, they are. About 30 to 35 % of people with psoriasis will develop psoriatic arthritis at some point in their lives.

We have yet to find any underlying genetic marker that could help determine who will develop it and who will not. It is completely unknown, at the moment. And to the best of my knowledge, patients affected by different types of psoriasis will have basically the same probability of being affected by psoriatic arthritis.

This highlights the overwhelming importance, for psoriasis patients, to make sure to bring any joint swelling, pain or stiffness to the attention of their doctor. When psoriasis patients experience symptoms of arthritis, they should be referred to a rheumatologist as soon as possible. Too many patients do not associate these symptoms to their psoriasis and believe it is a complete other thing.

The important message to get across is that someone with psoriasis who feels stiffness or swelling of joints should really take this seriously. It is a call to immediate action.

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Painful joints might hide something else

I want to know what it is