Psoriatic Arthritis
Psoriatic arthritis is an inflammatory joint condition that affects roughly one in three people who have psoriasis. The immune system attacks the joints and tendons as well as the skin, producing pain, swelling, and stiffness that can range from mild to severely disabling.
Key points
- The immune system targets both joints and skin, with tendons also affected, producing swelling, pain and stiffness of variable severity.
- Dactylitis (whole-finger swelling) and enthesitis at tendon attachment points are distinctive features alongside morning stiffness lasting over half an hour.
- Early disease-modifying treatment, including agents such as leflunomide or biologics, aims to limit lasting joint damage.
What the condition looks and feels like
Joints can become swollen and warm, and morning stiffness lasting more than 30 minutes is common. Some people develop dactylitis (a whole finger or toe swells like a sausage) or enthesitis (pain where tendons attach to bone, especially the heel). Nail pitting and skin flares typically track alongside joint flares, though not always in sync. The pattern varies widely: some people have asymmetric joint involvement while others develop a symmetrical pattern similar to rheumatoid arthritis.
Slowing joint damage
Controlling inflammation early helps prevent permanent joint damage. Disease-modifying treatment with agents such as leflunomide can reduce both joint inflammation and some skin symptoms. Broader autoimmune support options, including biologics targeting specific immune pathways, are used when conventional therapy is insufficient. A rheumatologist should guide treatment choice, as the right approach depends on which joints are affected, the severity of skin disease, and other health factors.