Patient Articles

Psoriatic Arthritis

What Is Psoriatic Arthritis?

Psoriasis is a skin rash that is caused by inflammation. People with the most common type of psoriasis, plaque psoriasis, have a red rash covered by silvery scales.

Psoriatic arthritis (PsA) is a form of inflammatory arthritis. It is often seen in people with psoriasis or family history of psoriasis. Psoriatic arthritis is an autoimmune disease. In autoimmune diseases, the immune system attack cells from its own body, as if they were foreign invaders. This results in swollen, inflamed, and painful joints.
What Causes Psoriatic Arthritis?

One in four people with psoriasis also get PsA. People with more severe psoriasis are more likely to develop PsA. But there is no sure way of predicting which people with psoriasis will get PsA.

What Are the Symptoms?

One in four people with psoriasis also get PsA. People with more severe psoriasis are more likely to develop PsA. But there is no sure way of predicting which people with psoriasis will get PsA.

The symptoms of PsA usually are skin inflammation and scaling. In addition, joints are painful, swollen, and stiff. People with inflammation of the spine and hip joints have back or neck pain and stiffness. In contrast to other types of back pain, people with PsA feel worse at rest, and better after being active.

How Is It Diagnosed?

There is no one test to see whether you have PsA. But, if you have psoriasis and your joints begin to hurt, your doctor may suspect that you have PsA. You may need to have a blood test to see whether you have inflammation in your body.

Having painful inflammation can eat away the cartilage and even the bone in your joint. Damaged joints may also have irregular new bone growth. Sometimes, this can make two bones in a joint grow together. Then you cannot move this joint any more. An X-ray of your painful joints can show the damage done by PsA.

Psoriatic arthritis also can harm other parts of your body. Many people with PsA have problems with their circulation or their digestive system. Therefore, your doctor may also ask you about other health issues you may have.

What Is the Treatment?

Treatment helps to relieve the pain and stiffness in your joints. It also helps to heal your rash.

Anti-inflammatory Drugs

Non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen (eg, Aleve®), help control the inflammation and swelling in your joints. This will make your joints less painful and stiff. If you have severe pain, you may receive a corticosteroid (eg, prednisone) instead.

Methotrexate (Rheumatrex®) is one of the most important medications for treating people with PsA. You may start this medication at a low dose and take more over time. Methotrexate is available in pill form. It can also be prescribed as an injectible medication. You can learn how to inject yourself at home. Or you can come to your doctor’s office and get it there.

While taking methotrexate, you will have to have regular tests to see whether this medication is best for you. It is especially important that you follow your doctor’s directions carefully. This will help to manage side effects as well as possible.

If methotrexate does not work well for you, you may receive other medications. They include cyclosporine, sulfasalazine (Azulfidine®) and leflunamide (Arava®). But not everyone can benefit from these medications. Please see the Rheumatology Information articles on these medications.

TNF-alpha Inhibitors

These medications are also called biologics. They can help the inflammation in your joints and the rash on your skin. They can prevent joint damage as well. TNF-alpha inhibitors approved for the treatment of PsA include

  • Enbrel® (etanercept) injection
  • Remicade® (infliximab) intravenous (IV) infusion
  • Humira® (adalimumab) injection
  • Simponi® (golimumab) injection

Although TNF-alpha inhibitors can make many people with PsA feel a lot better, they can also have rare but potentially serious side effects. Very rarely, patients may have symptoms suggestive of multiple sclerosis. These include infections and skin cancer. TNF-alpha inhibitors can also make tuberculosis flare up again. Therefore, you will have a TB test before getting these medications. Make sure you understand the risks and benefits of these medications. And tell your doctor right away, if you feel sick!

Psoriatic Arthritis Resources

Find out more about PSA online at