Psoriasis and Psoriatic Arthritis Connection is now available in an audio format – press play to listen or scroll to continue reading.
Psoriasis and psoriatic arthritis are a chronic illness combo that many don’t know about. Considering that one in three people with psoriasis may develop psoriatic arthritis, it is surprising that more people aren’t aware of the connection. I was diagnosed with psoriasis in 2001. And had I seen a doctor who was well educated in this chronic illness, I may have received my diagnosis of psoriatic arthritis a lot sooner.
Learn more about the connection and talk to your doctor if you suspect you have one or both conditions.
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Medical Disclaimer: I am not a medical professional and am by no means issuing medical advice. Always discuss your health concerns with your doctors!
My Diagnosis
My body presented symptoms of psoriatic arthritis long before I developed a rash from psoriasis. Unfortunately, I was not aware of this form of arthritis. And apparently, neither was the physician who diagnosed me with psoriasis. Think I am kidding?
He laughed and sent me home twice, telling me to use an over-the-counter shampoo for the small rash-causing discomfort. He didn’t take me seriously until I returned for the third time and was covered head to toe. Even then, he had to leave the exam room to do some research (yes, he admitted it). He was giddy once he realized that I had a (his words) textbook case of psoriasis. He even invited the rest of the doctors and nurses in his practice to have a look. Apparently, none of them had ever seen someone with psoriasis. If this happens to you, RUN!!! At the very least, ask for a referral to a dermatologist and rheumatologist.
Instead of researching psoriasis and its symptoms, I followed my doctor’s advice and only treated the rash. I received my psoriatic arthritis diagnosis two years later, only after being referred to a rheumatologist for fibromyalgia. And it was all because I wore open-toed shoes for my visit. My rheumatologist took one look at my toenails and immediately knew what was going on.
How Psoriatic Arthritis is Diagnosed
When my rheumatologist inquired about my symptoms, he asked if I had psoriasis. I told him that I had been diagnosed with it two years earlier but hadn’t had a breakout in about a year. He proceeded to educate me in a manner that should have been done when originally diagnosed. He shared that the rash may come and go, but the disease was still there. Another tidbit he shared was that it is possible to have psoriatic arthritis and NOT have psoriasis, while not common.
Physicians must rely on the process of elimination to diagnose #psoriaticarthritis. Learn more here!
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There is not a specific test available for psoriatic arthritis. Your rheumatologist will do what mine did, consider your symptoms, health history, and perform a vast array of tests to rule out other possibilities. Until a psoriatic arthritis diagnostic test is created, our physicians must rely on the process of elimination.
Psoriatic Arthritis Symptoms
Psoriatic arthritis symptoms include but are not limited to the following:
- Psoriasis
- Joint pain
- Fatigue
- Joint stiffness
- Pain and swelling in tendons
- Joint swelling
- Reduction in range of motion
- Changes in nails, finger, and/or toe. Pitting and/or separating from the nail bed may occur.
- Redness and eye pain.
Keep in mind that psoriatic arthritis symptoms can occur before developing a rash. While commonly experienced in fingers, back, and feet, joint pain, stiffness, and swelling can occur anywhere in your body. Psoriatic arthritis may affect one or both sides of your body.
Tell your doctor immediately if you have psoriasis and begin to experience pain. If untreated, psoriatic arthritis may cause severe damage.
Treatment for Psoriasis and Psoriatic Arthritis
There is no cure for either of these chronic illnesses. The focus of treatment is to control symptoms, reduce pain, and prevent future damage.
Treatment options include but are not limited to:
- Topicals: There are various over-the-counter, natural, and prescription options. Most frequently used are corticosteroids and steroids.
- Oral Treatments: Otezla and Xeljanz/Xeljanz XR.
- Phototherapy: Ultraviolet light B, excimer laser, sunlight, PUVA, and tanning beds.
- Systemics: Acitretin (Soriatane) Cyclosporine, Methotrexate
- Biologics: for people with moderate to severe psoriasis and psoriatic arthritis who have not responded to other forms of treatment. Psoriatic disease biologics are administered via injection or (IV) infusion. Learn more about biologics here.
- Complementary and alternative medicine: These options include but are not limited to nutrition, exercise, herbal remedies, aromatherapy, meditation, mindfulness, acupressure, acupuncture, massage, Reiki, and my personal favorite PEMF therapy.
Talk to your doctor if you have psoriasis and any of the symptoms above. If you are experiencing psoriatic arthritis symptoms, talk to your doctor, and also family members. Ten percent of the population inherits one or more of the genes that create a predisposition to psoriasis. But only 2-3% develop the disease. Knowing if your parents have it could be valuable information for your doctor.
This is really interesting thank you. Whilst searching for reasons for my own pain I come across this and wondered if it could be a possibilit y. I had mentioned it to my doctor who performed a routine blood test which showed nothing, however if my next treatment doesn’t ease the pain she is referring me to a rheumatologist.
A rheumatologist is the way to go. Hope you get some answers soon.
This is such an in-depth post! Thanks for sharing it. When I was first diagnosed with autoimmune arthritis, I was diagnosed with PsA due to strong family history of psoriasis. Since then, we’ve changed it to RA because that fits better.
Thank you! This is why they really need to find a way to test for PsA. The process of elimination isn’t reliable enough.
This is an area that interests me because of my daughter. When she was just 3 years old we took her to see a rheumatologist for her knee pain. They suggested she may have arthritis but as there was no swelling the GP dismissed it. When she was 8 years old (and still suffering knee pain) she had to have an operation and the consultant said that he had discovered her ligaments were lax. Back to the rheumatologist who diagnosed Elhers Danlos Syndrome. Then at 11 yrs she started seeing a geneticist who can’t seem to fit her in a box genetically. Last year she started getting really bad psoriasis on all her lower joints, knees mostly, but also hips and ankles. I asked about arthritic psoriasis but again it was dismissed because there is no swelling. It seems my daughter is a bit of an anomaly and I wonder if we will ever find out what is wrong with her.
That is interesting. When diagnosed, I didn’t have any swelling. My body was inflamed, but I didn’t have visibly swollen joints. Not everyone with PsA does and there are actually 3 several forms of PsA. You may want to visit the Psoriasis Foundation for more information. I’ve provided the link at the bottom of the post along with the Mayo clinic. Both have tons of information regarding all the forms and symptoms. It’s frustrating not having an answer. I hope you and she get one someday.
I’ve heard this from several other people while trying to get diagnosed as well. The Dr just tells them nope it can’t be PsA unless there’s swelling. I was finally diagnosed in July of last year and I had swelling sometimes and other times I didn’t have swelling at all even when my pain was at its worst. I guess I just wanted to say keeping pushing them if you don’t have the option of finding another doctor, and if you do have the option to get another Rheumatologist I would do that as well because they should know it doesn’t take swelling for it to be PsA. It took years for me to get diagnosed and one of the many things I’ve learned is that no one with fight for you (or your child’s) health unless you do. If I had left it up to my doctors to figure it out I would probably still not be diagnosed. Wishing the best of luck, I hope you find some relief for your child and hopefully some relief for yourself as well.
Thank you for sharing Victoria. Like you I didn’t have swelling at the time of my diagnosis. But a few years later I began experiencing it in my fingers. And now 17 years later, I have just begun experiencing swelling in my hands. I agree, find another rheumatologist.