Psoriatic Arthritis Signs
Psoriatic arthritis signs and symptoms most commonly appear when the joint pain and swelling begin, and the psoriatic skin lesions have been present for a while. The typical skin lesion is a scaly, red, itchy patch. Ninety percent of PsA patients also have characteristic pitting, ridges, and discoloration of the fingernails and toenails.
Joint pain, stiffness, and swelling can affect all major and all minor joints, including the spine, from the neck to the lower back and both sacroiliac joints.
There are several common patterns of joint involvement. Unusually for an inflammatory arthritis, the most distal joints of the fingers (the DIP joints) are often involved.
Psoriasis signs and symptoms can vary from person to person but may include one or more of the following:
Red patches of skin covered with silvery scales; Small scaling spots (commonly seen in children); Dry, cracked skin that may bleed; Itching, burning or soreness; Thickened, pitted or ridged nails; Swollen and stiff joints; Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.
Mild cases of psoriasis may be a nuisance; more-severe cases can be painful, disfiguring and disabling.
Psoriatic arthritis also can affect the attachment of the tendons (attaching muscle to bone) and the ligaments (attaching bone to bone) surrounding joints. This is known as enthesopathy. It commonly shows up in the foot as Achilles tendonitis (the back of the heel) or a plantar fasciitis (sore heel).
The characteristic appearance of swollen fingers or toes, all the way down to the tips, with a sausage-like appearance and nail involvement is known as dactylitis.
Sometimes inflammatory eye conditions accompany the joint inflammation of psoriatic arthritis. The severity of this can vary, but the effects can be serious, even catastrophic if not treated.
As the skin lesions of psoriasis wax and wane, so does the joint involvement, although in an unpredictable pattern.
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