Psoriatic Arthritis

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Signs and Symptoms

Symptoms of psoriatic arthritis vary from mild to severe. In most cases, symptoms of psoriasis (scaly, itchy patches of skin) develop before (sometimes years before) other symptoms.

Initial symptoms may be acute, which means they may be severe and develop suddenly. As the disease progresses, flares (periods of worsening) and remissions (periods of improvement) are common.

Symptoms of psoriatic arthritis include pain, tenderness, and swelling in the joints (may be accompanied by stiffness), and scaly, itchy patches on the skin. Joint pain often affects the wrists, knees, ankles, fingers, and toes. Scaly patches of skin are common on the elbows, knees, and scalp, and in folds of skin.

Fingernail and toenail involvement may include loosening of the nails, and the development of ridges and pits in the nails. Extensive nail involvement is associated with severe arthritis of the hands and the feet.

In some cases, psoriatic arthritis affects the eyes, causing conjunctivitis (inflammation of the outer layer of the eye and the inner lining of the eyelid) and uveitis (inflammation of the middle layer of the eye).

Complications
Arthritis mutilans (severe joint deformity and destruction) occurs in 5–15% of patients who have psoriatic arthritis. In most cases, this condition affects the small joints in the hands and feet. Rarely, psoriatic arthritis can cause neurological and cardiovascular (e.g., insufficiency of the aorta) complications.

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