Rheumatology

Psoriatic Arthritis

If you have psoriasis, a dermatological condition that causes red patchy skin, you are at increased risk of developing psoriatic arthritis. Usually—but not always—people experience the rash first. In fact, some people have psoriasis for as long as ten years before any signs of arthritis appear. At Mount Sinai, we can help.

Psoriatic arthritis causes joint pain, stiffness, and swelling. The pain can affect any of your joints and can be anywhere from mild to severe. For some people, the pain is constant; for others, it comes and goes.  Psoriatic arthritis usually causes swollen fingers and toes, as well as pain in the foot and lower back. You might also develop dents or ridges in your fingernails and may experience fatigue. If left untreated, psoriatic arthritis can lead to deformity.

This type of arthritis affects men and women equally. It is more likely to happen to someone between the ages of 30 and 50, though it can start as early as childhood. It happens when your body’s immune system begins to attack healthy cells, instead of infections. This is called an autoimmune disease. Doctors do not know what prompts the body to start this process, though we suspect family history or genetics plays a role.  

If you have psoriatic arthritis, certain trigger can cause a flare-up or make your symptoms worse. These include:

  • Certain bacterial infections
  • Cold weather
  • Hormonal changes
  • Injury
  • Stress
  • Smoking

We diagnose psoriatic arthritis by a physical exam. We may also use blood work and imaging tests, such as X-rays and magnetic resonance imaging (MRI) scans.

Treatments We Offer

We can treat psoriatic arthritis to improve your quality of life and suppress disease. We work closely with dermatologists to coordinate your care. At Mount Sinai, we prescribe medications and, if necessary, perform a surgical procedure. Typically, we use topical medications to treat the skin condition. For the inflammation, we use different types of medications, sometimes in combination:

  • Nonsteroidal anti-inflammatory drugs: Can reduce inflammation and help you feel better
  • Disease-modifying antirheumatic drugs: Can slow the progression of the disease
  • Immunosuppressants: Can help keep your immune system from attacking your body
  • Biologic medications: Can help control the pain and joint damage. An example is TNF-alpha inhibitors.

We may also use a combination of these medications.