Although people can be diagnosed with PsA without skin involvement, they will most likely have a family member with skin psoriasis. For example, my mother has psoriasis, my two siblings and I have psoriasis, and one out of three of my daughters has shown signs of psoriasis—all on our scalp, and I sometimes get it on my face in small patches.
Psoriasis is an inflammatory skin condition, while psoriatic arthritis is an inflammation of the joints and entheses (enthesitis).
Symptoms Of These Two Autoimmune Diseases
Symptoms of Psoriasis
Symptoms of psoriasis depend on what kind you have and how bad it is. Psoriasis makes knees, elbows, and fingernails red, itchy, flaky, and pitted. Most people’s psoriasis symptoms get worse for a few weeks or months, and then they get better. This could get better during remission too.
- Scaly silver patches (mainly on the elbows, knees, and scalp)
- Strep throat may cause red spots or sores.
- Redness (often found in folds of the body, such as in the elbows, knees, armpits, or groin)
- Red or silvery scalp patches (that may lead to hair loss)
- Body blisters (most often on the hands and feet)
- Itchy, scorching skin
- Skin cracking
- False nails
Symptoms of Psoriatic Arthritis
Unlike Psoriasis, PsA has symptoms in the joints, spine, and enthesea. The symptoms are like psoriasis in that they vary by type and severity.
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- Skin Plaques. Red spots with silvery scales can cover large parts of the body or show up on the scalp, elbows, knees, and ears.
- Swollen Fingers & Toes. Dactylitis makes the toes and fingers look like “sausages”.
- Painful Joints. Joint pain and stiffness (usually in the hands, knees, and ankles on one side) or inflammation in the spine’s joints (axial involvement).
- Enthesitis. Achilles tendonitis or plantar fasciitis are caused by inflammation of the enthesis.
- Nail Changes. Pitting, thickening, ridging (Beau’s line), crumbling, color changes, nail bed separation, subungual (debris under the nail).
If you have Psoriasis and suspect PsA, there are several warning signs for when to contact a rheumatologist:
- Red, heated, swollen joints
- Long-term joint discomfort
- Stiff joints (greater than one hour)
- Joint discomfort and health changes (i.e., joint pain and fatigue or joint pain and low-grade fever)
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How Do Psoriasis & PsA Begin To Intertwine?
“For every ten people who walk in the door with psoriasis, about three or four of them will eventually get PsA,” says Elaine Husni, MD, MPH, vice chair of the department of rheumatic & immunologic diseases at the Cleveland Clinic in Ohio. Skin and joint problems can happen simultaneously, or the joint problems can show up first. Most of the time, joint pain comes seven to ten years after the skin issue.
Psoriasis can show up in places that are hard to see or are close to the body, like the scalp, intergluteal cleft, belly button, or ear. Small psoriasis spots on the scalp and buttocks could be missed, which would make the diagnosis take longer.
Psoriasis could be the cause of a bit of dandruff on your head. Studies show that Psoriasis of the scalp, nails, and groin is linked to PsA. Your PsA risk may be higher if you have psoriasis in these hidden places.
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