David Ozeri, MD, is a board-certified rheumatologist. He is based in Tel Aviv, Israel, where he does research at Sheba Medical Center. Previously, he practiced at New York-Presbyterian Hospital.
Psoriatic arthritis (PsA) is an inflammatory form of arthritis integrally linked to the autoimmune disease psoriasis. Symptoms include:
Psoriatic arthritis can develop in people who don’t have a history of psoriasis, but it’s preceded by psoriasis around 85% of the time.
The causes of PsA are poorly understood, but genetics and environmental factors are believed to be at the root of the condition. Treatment focuses primarily on alleviating inflammation with either oral or injected medications. Surgery is rarely needed.
Psoriatic arthritis affects up to 1% of the U.S. population, affecting men and women equally. It’s typically diagnosed between ages 30 and 50, but it can occur at any age.
Most of the time, psoriasis is the first symptom of psoriatic arthritis. It causes silvery-white skin lesions called plaques, which may appear on your scalp, elbows, knees, and lower back. Eventually, pain and stiffness develop as inflammation spreads from the skin to the joints and/or connective tissues.
Psoriatic arthritis is broadly divided into two groups- axial, which involves the spine and hips, and non-axial, which involves the peripheral joints.
It can be further classified into 5 types:
While no diet is shown to cure PsA, inflammatory foods may exacerbate symptoms. They include:
An anti-inflammatory diet emphasizes whole grains, oily fish, dark green leafy vegetables, and fruits.
Psoriasis causes patches of red, rough skin with silvery scales. They’re most often around the joints of elbows, knees, hands, and feet. The skin surrounding the joint may develop blisters and appear cracked. On the scalp, it may look like dandruff.
“Auto” means “self.” In autoimmune disease, your immune system attacks a healthy part of your body as if it were a virus or bacterium. This causes inflammation, which is a normal part of the immune response but becomes a problem when it’s chronic. Chronic inflammation causes pain, stiffness, lost range of motion, and other symptoms. More than 100 autoimmune diseases have been discovered.
Inflammatory arthritis is an umbrella term for types of arthritis typically involving inflammation, autoimmunity, and multiple joints. Pain, stiffness, and other symptoms stem from chronic inflammation caused by an immune system that’s mistakenly attacking the body’s healthy tissues as if they were infectious agents. Some types of inflammatory arthritis are psoriatic arthritis, rheumatoid arthritis, reactive arthritis, and gout.
Inflammatory disease is a category that includes autoimmune diseases such as psoriatic arthritis, rheumatoid arthritis, and lupus. In all of these illnesses, inflammation is the primary driver of pain, loss of mobility, and, in some cases, tissue damage and disability.
Plaques are patches on the skin that are raised, red, rough, and have silvery scales. They’re often extremely itchy and can be painful. Plaques are caused by psoriasis or psoriatic arthritis, which are both conditions that involve autoimmune damage to the skin.
Psoriasis is an immune-mediated disease in which the immune system damages skin cells and causes them to build up on the surface of the skin. This causes plaques, which are red, rough, scaly patches. In some people, psoriasis eventually leads to psoriatic arthritis, which involves skin symptoms plus joint pain and swelling.
The uvea is a portion of your eye that includes the iris (the colored part). Uveitis is inflammation of the uvea, which can cause blurred vision, eye pain, light sensitivity, redness, and dark floating spots in the vision. Uveitis is one of several eye problems that can be complications of autoimmune diseases like psoriatic arthritis.
Veale DJ, Ritchlin C, Fitzgerald O. Immunopathology of psoriasis and psoriatic arthritis. Ann Rheum Dis. 2005;64 Suppl 2:ii26-9. doi:10.1136/ard.2004.031740
Merola JF, Espinoza LR, Fleischmann R. Distinguishing rheumatoid arthritis from psoriatic arthritis. RMD Open. 2018;4(2):e000656. doi:10.1136/rmdopen-2018-000656
Liu JT, Yeh HM, Liu SY, Chen KT. Psoriatic arthritis: Epidemiology, diagnosis, and treatment. World J Orthop. 2014;5(4):537–543. doi:10.5312/wjo.v5.i4.537
Cleveland Clinic Center for Continuing Education. Psoriatic Arthritis. Updated October 2016.