Fast Five Quiz: Psoriatic Arthritis Presentation and Diagnosis

Herbert S. Diamond, MD; Eric M. Ruderman, MD


December 23, 2021

Figure 2. Psoriatic arthritis in hands, radiograph.

Psoriatic arthritis is a clinically heterogeneous disease. It may be present with or without obvious skin lesions, with nominal skin involvement (eg, scalp, umbilicus, intergluteal cleft), or with only nail malformations. Joint tenderness may occur to a lesser degree than with rheumatoid arthritis.

As in other spondyloarthropathies, enthesitis—which reflects inflammation at tendon or ligament insertions into bone—may be seen in psoriatic arthritis. Similarly, dactylitis with sausage digits occurs in up to 49% of patients with psoriatic arthritis.

Nail involvement in psoriasis is considered a significant psychological and social problem that leads to functional impairment in affected patients. Up to 90% of patients with psoriatic arthritis have nail lesions, which can impede daily and occupational activities and contribute to a diminished quality of life. Nail involvement can also be the source of severe pain.

Learn more about the manifestations of psoriatic arthritis.


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