1. Psoriatic Arthritis Pictures
2. Adult Skin Problems Slideshow

Medical Author:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Catherine Burt Driver, MD

Catherine Burt Driver, MD

Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

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People with psoriatic arthritis might not have obvious skin findings, or they might have minimal scaly red skin on the scalp, in the bellybutton, or between the buttocks. Some people with psoriatic arthritis might just have nail abnormalities and arthritis and no other skin symptoms. In one study, arthritis was noted more frequently in people with severe skin involvement. In another study, pustular psoriasis was associated with more severe psoriatic arthritis.

People with psoriatic arthritis may have various nail changes (nail psoriasis). The nails may loosen (onycholysis) and there may be lines going across the nails (side to side rather than root to tip) or yellow spots in the nails. There may also be little pits in the nails. The more pits in your nails, the more likely psoriasis will be present. Usually, if skin and arthritis symptoms begin at the same time, nail findings begin too. Often, if one has symptoms in the joints at the ends of the fingers or toes, then those nails will be affected. Eighty percent of people with psoriatic arthritis have nail abnormalities. Only 20% of people with uncomplicated psoriasis have nail changes. Nail abnormalities are usually present in people who have severe arthritis with deformity in the hands and feet. The nails can also become infected with fungus. The doctor will assess them and prescribe antifungal medications if so.

Usually, psoriasis occurs before arthritis, sometimes as much as 20 years before arthritis. Tell your doctor if you have a family history of psoriasis.

Thirty percent of people with psoriatic arthritis have eye symptoms. Eye inflammation (conjunctivitis) occurs in 20%, and inflammation of the iris (iritis), the colored part of your eye, occurs in 7%. Children with juvenile psoriatic arthritis (see below) should be examined every year by an eye doctor to check for eye problems.

Inflammation may occur where your muscles and tendons connect to the bones, especially in the heel and the sole of the foot.

Initial symptoms of psoriatic arthritis may be severe. If symptoms are only in the foot or toe, they may be mistaken for those of gout. (People with psoriasis can have gout. Looking at the joint fluid for gout crystals usually can make the diagnosis clear.) Other people with psoriatic arthritis may only have stiffness and pain and few physically obvious problems. People with HIV often have more severe skin symptoms.

Must Read Articles Related to Psoriatic Arthritis

Arthritis Arthritis is inflammation of the joints. Causes include injury, abnormal metabolism (such as gout), inheritance (such as in osteoarthritis), infections (such as...learn more >>

Iritis The iris is a circular, pigmented membrane that provides the eye its color and forms the pupil of the eye. The iris is made up of muscular fibers that control ...learn more >>

Joint Pain Joint pain can be caused by injury or disease affecting any of the ligaments, bursae, or tendons surrounding the joint. Pain also occurs with joint inflammation...learn more >>

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