Do you have itchy, scaly skin on your elbows, knees, scalp, navel or ears?  Do your fingernails and toenails sometimes lift up? Do your joints and surrounding tendons swell?  Do your fingers resemble little sausages?  Well, you just might have psoriatic arthritis.

Psoriasis is a chronic inflammatory skin disease and is characterized by a scaly, itchy skin rash, often on the elbows, knees, scalp, behind the ears, or on the navel.  Psoriasis is a very common skin condition and occurs in one to two percent of Caucasians.  Although it may develop at any age, it most commonly occurs in the late teens.  Furthermore, between ten to thirty percent of those who suffer with psoriasis will develop psoriatic arthritis (PsA).  Usually, if you have psoriatic arthritis, you would develop psoriasis in your late teens, followed by arthritis in your thirties or forties.  However, some patients do develop arthritic symptoms prior to psoriasis and some patients develop both at the same time.

Psoriatic arthritis is a chronic inflammatory arthritis and autoimmune disease, which occurs when our immune system mistakes our own joint tissue for a foreign invader, attacking it and causing inflammation.  When the inflammatory process advances, chemical mediators released from white blood cells damage cartilage, bone, and ligaments causing joints to become deformed, impairing function.   Even though the exact cause of psoriatic arthritis is not yet fully understood, studies have shown that it can affect both genders equally.  In addition, genetic predisposition, infection, trauma, and other environmental triggers play an important role in the cause of PsA.

About 95% of people with psoriatic arthritis experience swelling of the hand, wrist, elbow, knee, ankle, foot joints, and their surrounding tendons.  Such swelling gives fingers and toes a sausage-like appearance, which makes grasping an object or making a fist very painful.  PsA also frequently affects tendons such as the Achilles tendon (in the heel) or plantar fascia (in the sole of the foot).  Patients experience foot pain particularly in the morning when taking their first steps.  The other five percent of people with psoriatic arthritis have inflammation of the spinal joints.  This form of psoriatic arthritis most commonly affects joints in the neck, lower back and sacroiliac joints (tailbone area).  The pain is worse at night and first thing in the morning.

While the course of psoriatic arthritis varies, most people do reasonably well and are able to lead productive lives.  However, in about twenty percent of people, this disease may become deforming and destructive.   Fifteen percent of patients with PsA will become severely disabled, which warrants early diagnosis and aggressive treatment to prevent joint damage and deformities.