Psoriatic arthritis
An inflammatory condition associated with psoriasis. It may affect joints, entheses, digits and the spine.
About the condition
An inflammatory condition associated with psoriasis. It may affect joints, entheses, digits and the spine.
The disease affects joints, spine and tendon insertions. Arthritis sometimes precedes visible skin psoriasis.
Symptoms
Swollen joints, dactylitis, enthesitis, back pain, psoriasis and nail changes may occur. Joint symptoms sometimes precede skin manifestations.
Whole-digit swelling, heel pain and nail pitting are characteristic. Joint number and symmetry vary.
Diagnosis
Joints, entheses, skin and nails are assessed. Tests and imaging clarify involvement and exclude other causes; there is no single diagnostic test.
Examine scalp, nails, skin folds and entheses. There is no single confirmatory blood test; exclude RA, gout and joint infection.
Treatment
Treatment is tailored to the main domains: joints, spine, entheses and skin. Disease-modifying, biologic or targeted therapies are used when indicated.
Selection depends on joint, skin and axial involvement. DMARDs, biologics or targeted agents are used; IBD and uveitis influence the approach.
Monitoring
DAPSA mainly assesses peripheral arthritis; skin and other manifestations need separate assessment. Function and treatment safety are also monitored.
DAPSA and MDA assist assessment but do not cover every manifestation. Monitor skin, function, weight, blood pressure and metabolic risks.
Sources
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