Understanding causes

Psoriasis without clinical joint pain, but with already existing bone structure changes (enthesiophytes)

Psoriatic arthritis (PsA) is a chronic joint inflammation that occurs primarily in the hands and feet and typically together with psoriasis of the skin and nails. Since most of those affected already suffer from psoriasis of the skin and nails before PsA occurs, it can be assumed that the inflammation of the skin spreads to the joints during the course of the disease. However, the exact causes of this disease have not yet been clarified.

Facts and figures around the disease

Studies have shown that four out of five patients with psoriasis develop psoriatic arthritis during the five to fifteen years following the onset of the disease. In principle, the disease can occur at any age, with most people between the ages of 20 and 50 at the onset of the disease.

Typical symptoms and course of the disease

PsA is a chronic disease that usually occurs in relapses with long rest periods and improvements. In many cases its onset is insidious. Typical signs are painful, swollen and reddened finger and toe joints or a whole finger or toe. This can lead to bone formation around the joints, which leads to mobility restrictions.

How does the physician make the diagnosis?

Classical examination of joints for pain and swelling to assess disease activity
Clarification of functional limitations of the spinal column
Measurement of rheumatoid factor and ACPA (antibodies against citrullinated proteins)
Measurement of the uric acid level in the blood
Measurement of inflammation values
Use of imaging techniques: X-ray, sonography or magnetic resonance imaging

How is the disease treated?

In principle, the choice of therapy is based on a consensus between rheumatologists and dermatologists.

Systemic immunosuppressants such as methotrexate, TNF inhibitors or ciclosporin
Biologika, like Rituximab, Abatacept or Tocilizumab spread, for it Secukinumab specify
Small molecules: apremilast
Physiotherapy