Psoriatic arthritis: when psoriasis attacks joints
An often delayed diagnosis
Dr. Marc Lefèvre
Rheumatologist
In simple terms
Biotherapies anti-TNF, anti-IL-17, anti-IL-23: targeted treatments revolutionize PsA.
An inflammatory spondyloarthritis
Psoriatic arthritis affects 20-30% of psoriasis patients. Joint involvement may precede or follow skin lesions.
Clinical forms
Asymmetric oligoarthritis, distal interphalangeal involvement, mutilating form, axial form (spondylitis), enthesitis, dactylitis ("sausage finger"). Nail involvement (pitting, onycholysis) is a clue.
Diagnosis
Personal/family history of psoriasis, joint ultrasound, MRI. CASPAR criteria.
Treatments
- NSAIDs: mild forms
- Methotrexate, leflunomide: peripheral forms
- Anti-TNF: very effective on skin and joints
- Anti-IL-17 (secukinumab, ixekizumab), anti-IL-23 (guselkumab, risankizumab)
- JAK inhibitors (upadacitinib, tofacitinib)
Overall approach
Weight loss if overweight, smoking cessation, treatment of associated comorbidities (cardiovascular, metabolic).
The words explained
Medical terms used above, in everyday language.
- Inflammation
- The body's reaction to injury or irritation: redness, swelling, heat or pain.
- Diagnosis
- The moment a doctor identifies which illness is causing your symptoms.
- Cardiovascular
- Related to the heart and blood vessels.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
Frequently asked questions
- What is Psoriatic arthritis: when psoriasis attacks joints?
- Biotherapies anti-TNF, anti-IL-17, anti-IL-23: targeted treatments revolutionize PsA.
- What are the main symptoms or signs of Psoriatic arthritis: when psoriasis attacks joints?
- Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
- When should you see a doctor for Psoriatic arthritis: when psoriasis attacks joints?
- See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.
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