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How Is Psoriatic Arthritis Linked to Psoriasis?

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Psoriatic arthritis (PsA) affects about 1 in 3 people with psoriasis. Psoriasis is a skin condition that causes itchy, red rashes on the body. Like PsA, which affects the joints in the body, it is a chronic inflammatory condition.1,2

It is more common for people to have psoriasis before developing PsA. However, some people do develop PsA before psoriasis.1

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What is psoriasis?

People with psoriasis have an overactive immune system that speeds up skin cell growth. Normally, skin cells go through a process of growing and falling off in the span of a month. But in people with psoriasis, skin cells complete this cycle in about 3 or 4 days.2,3

Rather than falling off, the skin cells collect on the skin’s surface. This buildup of skin cells causes red, scaly patches to appear on the skin. The patches can itch, burn, or sting.2,3

Who does it affect?

Psoriasis affects about 7.5 million people in the United States. It affects all genders equally. Psoriasis can start at any age, but it most commonly starts between the ages of 15 and 25.3

What are the causes of and risk factors for psoriasis?

While the direct cause of psoriasis is unknown, genetics and the immune system seem to play a role in its development. What experts are certain of is that psoriasis is not contagious. It cannot be spread from person to person. Instead, something triggers psoriasis to appear or its symptoms to get worse (flare).3

Psoriasis triggers can be different for everyone. Some common triggers are:4

  • Infections
  • Stress
  • Trauma to the skin (like a scratch, sunburn, or bug bite)
  • Weather
  • Certain medicines

Other risk factors for developing psoriasis include:4,5

  • Allergies
  • Certain foods
  • Smoking
  • Obesity
  • Alcohol use

What are the characteristics of psoriasis?

There are several types of psoriasis. The most common one is plaque psoriasis. It accounts for about 80 percent of people living with the skin condition.3

Plaque psoriasis causes round or oval red patches on the skin that are scaly, itchy, and painful. These patches mostly appear on the elbows, knees, and scalp. But they can appear anywhere on the body.2,3

Less common types of psoriasis include:3

  • Nail psoriasis – Causes pitting, abnormal growth, and discoloration of the fingernails or toenails. It is common for people with PsA to have nail psoriasis as a symptom.
  • Inverse psoriasis – Psoriasis that occurs in the folds of the skin. For example, it can appear around the groin or underneath the breasts.
  • Guttate psoriasis – More common in young adults and kids. This type appears as small red spots that flake or peel.
  • Pustular psoriasis – Causes pus-filled blisters to appear on the palms of the hands and soles of the feet. This is a more rare type of psoriasis.
  • Erythrodermic psoriasis – Marked by widespread redness and a peeling rash. It can come and go or it can be chronic. This is the least common type of psoriasis.

How does psoriasis affect quality of life?

Psoriasis is a persistent, chronic condition. Due to its symptoms and visible appearance, psoriasis can cause emotional distress.2,3,5

Anxiety, depression, anger, and thoughts of suicide may occur in people with psoriasis. For this reason, it is critical that treatments address not only the physical symptoms but the emotional and mental symptoms as well.5

What are the treatment options for psoriasis?

While there is no known cure for psoriasis, there are ways to treat it. The main goal of treatment is to control psoriasis symptoms and help reduce flares.6

Your treatment depends on the severity of your psoriasis. This is determined by how much of your body is affected by the disease.6

For mild to moderate psoriasis, treatment options include:6

  • Topical steroids (corticosteroids)
  • Topical creams without steroids
  • Light therapy (phototherapy)

For moderate to severe psoriasis, your doctor may recommend a combination of phototherapy and systemic drugs. Systemic drugs are prescription medicines that work throughout the body. They are taken either orally or given by injection or infusion. These are usually given when topical treatments and other therapies have not worked.6,7

Following a healthy lifestyle

Following a healthy lifestyle may reduce your chances of triggering a psoriasis flare. This includes:5

  • Following a healthy diet
  • Exercising regularly
  • Keeping your stress levels as low as possible

Talk with your doctor if you are living with psoriasis or psoriatic arthritis. Together, you can come up with a personal treatment plan that is right for you.

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