Psoriatic Arthritis and Other Conditions Linked to Psoriasis
The joint symptoms to look out for if you have psoriasis, how psoriatic arthritis is treated, and other linked conditions.
Part of our psoriasis guide.
Get urgent help first. Call 999 or go to A&E if your skin suddenly becomes red and inflamed over most of your body, or you have widespread pus-filled spots, especially with a fever, chills or feeling very unwell. These can be signs of erythrodermic or generalised pustular psoriasis, which are emergencies. See a GP soon if you have painful, swollen joints. Online treatment isn't suitable in these situations.
Key fact: up to 1 in 3 people with psoriasis develop psoriatic arthritis, which causes painful, stiff and swollen joints. Spotting it early matters because treatment can prevent lasting joint damage.
Adults only online, and not in pregnancy or breastfeeding. Access Doctor's online psoriasis service is for adults aged 18 and over, and can't supply treatment if you're pregnant or breastfeeding: your GP or midwife can help. Children with psoriasis should see their GP.
What is psoriatic arthritis?
Psoriatic arthritis is a type of inflammatory arthritis that affects up to 1 in 3 people with psoriasis. It often develops some years after the skin psoriasis starts, but it can come first. It can affect any joint, as well as the places where tendons attach to bone, and the spine.
Psoriatic arthritis symptoms and early signs
- Painful, swollen, stiff joints, often in the fingers, toes, knees or ankles, sometimes on one side only.
- Stiffness in the morning lasting more than 30 minutes.
- A whole finger or toe swelling up like a sausage (dactylitis).
- Heel pain or pain at the back of the heel (where the Achilles tendon attaches).
- Lower back pain and stiffness that is worse after rest.
- Nail changes such as pitting and lifting, which are common in psoriatic arthritis.
- Tiredness, which can be a significant symptom.
See your GP if you have psoriasis and joint pain, stiffness or swelling. Early treatment can prevent permanent joint damage. NICE recommends that people with psoriasis are checked for psoriatic arthritis at least once a year, often using a short questionnaire called PEST.
Psoriatic arthritis vs other arthritis
| Psoriatic arthritis | Rheumatoid arthritis | Osteoarthritis | |
|---|---|---|---|
| Pattern | Often uneven; fingers, toes, spine | Usually both sides evenly; hands and wrists | Wear and tear; knees, hips, hands |
| Skin and nails | Psoriasis and nail changes | No psoriasis | No psoriasis |
| Morning stiffness | Yes, often over 30 minutes | Yes, often over 30 minutes | Short, under 30 minutes |
| Swollen whole finger or toe | Common | Uncommon | Rare |
How psoriatic arthritis is treated
Psoriatic arthritis is managed by a rheumatologist. Treatment may include anti-inflammatory painkillers, steroid injections into a joint, and disease-modifying medicines such as methotrexate. Biologic injections are very effective for both the joints and the skin. Exercise, physiotherapy and keeping to a healthy weight also help. Treatment for skin psoriasis applied to the skin doesn't treat the joints. See tablets, injections and light therapy.
Other conditions linked with psoriasis
- Heart disease and stroke: psoriasis, especially severe psoriasis, is linked with a higher risk. Not smoking, staying active and checking blood pressure and cholesterol help.
- Type 2 diabetes and obesity.
- Depression and anxiety: common with psoriasis and treatable. Tell your GP if you feel low.
- Inflammatory bowel disease (Crohn's disease and ulcerative colitis).
- Eye inflammation (uveitis): see someone urgently if you have a painful, red eye with blurred vision or sensitivity to light.
- Fatty liver disease, linked with weight and metabolism; and liver effects from alcohol and some psoriasis medicines.
This is why people with psoriasis are encouraged to have regular health checks. You may see "psoriasis of the liver" searched online: this isn't a type of psoriasis, and is usually a mishearing of cirrhosis of the liver.
UK safety and reporting side effects
Prescription psoriasis treatments are only supplied after a GPhC-registered pharmacist independent prescriber reviews your consultation, including where your psoriasis is, how much skin it covers and what you have used before. Always read the patient information leaflet. Since 2024, UK steroid packs show their strength on the front (mild, moderate, strong or very strong). The MHRA advises using topical steroids for the shortest time needed, and to tell a healthcare professional if your skin flares badly after you stop a steroid you have used for a long time, which can be a topical steroid withdrawal reaction.
If you think you've had a side effect, tell your pharmacist or doctor. You can also report it to the MHRA through the Yellow Card scheme.
Getting help
Psoriatic arthritis needs a GP and a rheumatologist; it can't be treated online. For skin psoriasis on the body, arms or legs, see our psoriasis treatment page and our treatment options guide.
Frequently Asked Questions
What are the first signs of psoriatic arthritis?
Joint pain, swelling or stiffness, often in the fingers or toes, stiffness in the morning lasting more than 30 minutes, a whole finger or toe swelling up, heel pain and nail changes. See your GP if you notice any of these.
What is the difference between arthritis and psoriatic arthritis?
Psoriatic arthritis is an inflammatory arthritis linked to psoriasis. Unlike osteoarthritis (wear and tear), it causes prolonged morning stiffness and swelling, and unlike rheumatoid arthritis it often affects joints unevenly and comes with psoriasis and nail changes.
What happens if psoriatic arthritis is left untreated?
It can cause permanent joint damage and deformity over time. Early treatment from a rheumatologist can control inflammation and protect the joints.
What organ is linked to psoriasis?
Psoriasis is linked with the heart and blood vessels, the joints, the eyes, the bowel and the liver. Severe psoriasis in particular is associated with a higher risk of heart disease, so regular health checks are recommended.
Can psoriasis affect your eyes?
Yes. Psoriasis and psoriatic arthritis are linked with uveitis, an inflammation inside the eye. Get help the same day if you have a painful, red eye with blurred vision or sensitivity to light.
References
- NHS. Psoriatic arthritis. nhs.uk
- NICE. Psoriasis: assessment and management (CG153). nice.org.uk
- NICE Clinical Knowledge Summaries. Psoriasis. cks.nice.org.uk
- NHS. Psoriasis. nhs.uk
Medical disclaimer: This article is for information only and isn’t medical advice. Prescription psoriasis treatments need a clinical consultation before they can be supplied. If your skin is red all over, you have widespread pus spots, a fever or you feel unwell, seek medical advice the same day. In a medical emergency, call 999.