Three panels showing some of the worst areas for psoriasis - the joints, behind the ear, and in the armpit inverse areas, painful plaques, flaking skin, pain, discomfort, comic book style adult Black female, adult male, senior female

What Are Skin Symptoms Experienced With Psoriatic Arthritis?

Written by: Emily Downward | Last reviewed: June 2022. | Last updated: October 2022

Psoriatic arthritis (PsA) generally occurs in people with existing psoriasis. That is a chronic inflammatory disease affecting the skin.

In most people with PsA, psoriasis occurs several years before PsA. However, in about 10 to 15 percent of cases, PsA will develop before psoriasis. The skin lesions that affect people with PsA are actually due to psoriasis.1

Psoriasis skin lesions

Psoriasis is an autoimmune disease that causes red, scaly, raised patches on the skin. The skin lesions, or plaques, most often appear on the scalp, knees, elbows, lower back, and feet. They are often itchy and painful, and they can crack and bleed.

The plaques may vary in size and can appear as distinct patches or join together to cover a large area of the skin.2,3There are several varieties of psoriasis. The most common is plaque psoriasis, which affects 80 to 90 percent of all people with psoriasis.

Plaque psoriasis is characterized by a gradual appearance of lesions. The condition comes and goes with triggers. Common triggers include stress, infections, and cold temperatures.2,3

Psoriasis is a persistent, long-lasting condition. It cannot be cured, though people with PsA may have periods of remission with no symptoms of the disease.2

How is psoriasis diagnosed?

A dermatologist or other doctor diagnoses psoriasis by examining the affected skin. In some cases, a biopsy or sample of the skin is taken for exam under a microscope.

Doctors will also ask about the person's family history of psoriasis. About 30 percent of people with psoriasis have a family member with the disease.2

How is psoriasis treated?

Treatment of psoriasis is based on the severity of the disease. This is determined by both the surface area of the skin affected and the impact of the condition on the person's quality of life. Treatment options include topical drugs, oral drugs, biologics, and phototherapy.

Some psoriasis treatments, such as biologics, are also used to treat psoriatic arthritis.2

Topical treatments applied directly to the skin are often the first treatment option for psoriasis. Phototherapy uses ultraviolet light on the skin. It is done either at a doctor’s office or at home with a specific phototherapy unit. 2

Oral drugs for psoriasis include methotrexate, systemic retinoids (acitretin and isotretinoin), and immunosuppressants.2 Biologics are often used for moderate to severe psoriasis. They are given by injection or intravenously (IV). Biologics used for psoriasis include:2

  • Ilumya
  • Siliq
  • Skyrizi
  • Taltz
  • Tremfya
  • Cimzia (certolizumab pegol)
  • Enbrel (etanercept)
  • Humira (adalimumab)
  • Remicade (infliximab)
  • Simponi (golimumab)
  • Stelara (ustekinumab)
  • Cosentyx (secukinumab)
  • Taltz (ixekizumab)

Stress reduction is also important for people with psoriasis since stress is a common trigger. Many people with PsA also benefit from dietary changes. These changes may have benefits for weight loss, heart health, and reducing inflammation.2

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