Psoriatic arthritis is an arthritis seen in individuals who have psoriasis. And we find that about 30% of individuals with psoriasis may have psoriatic arthritis to varying degrees. When you talk to a rheumatologist, or when you see patients from a rheumatologist, frequently there is a lot of arthritis but very little psoriasis. It may be that there is a sub-group of people with very little skin involvement, but their joints are very affected. Typically, the patient will complain of pain in the joint and stiffness in the morning that may last for half an hour or an hour, and as the day goes on, their symptoms improve. And there are a number of different subtypes of this arthritis–you can either define them as arthritis occurring along the spine, or arthritis that occurs on the fingers, the distal joints or perhaps on a single joint. And there is often inflammation where tendons are attached to bones. The difference in arthritis and psoriasis in the skin is that the skin can recover. You have a patch of psoriasis, you treat it, and the skin goes back to normal for all intents and purposes. A joint that has been inflamed potentially scars, and you have destruction of collagen that is life-long. It’s very important for us as dermatologists to recognize the early signs of arthritis because we now know there are these biologics, which are probably much better than older drugs, in trying to prevent the destruction of joints.
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