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Living with Psoriasis requires managing every aspect that affects the skin – from eating to clothing, lifestyle, and medicine. But managing Psoriasis may not limit to the skin. It could go beyond - four out of ten people who suffer from Psoriasis may develop Psoriatic Arthritis. 
Psoriasis and Psoriatic Arthritis are two conditions that fall under the same spectrum called Psoriatic Disease. Although they are connected in many ways, they are not necessarily predictive of one another and differences exist. Understanding their connection and how they are similar as well as different is vital to early detection and effective management.
How are Psoriasis and Psoriatic Arthritis similar?
Both Psoriasis and Psoriatic Arthritis reflect underlying immune system problems. In Psoriasis, the overactive immune system causes the skin cells to develop rapidly. In Psoriatic Arthritis, white blood cells target the body’s tissues instead of protecting the body against foreign substances.
Environmental factors like smoking, stress, weather changes, infections, etc. have been implicated as ‘triggers’ for both conditions. These triggers may worsen symptoms and lead to a flare up. Furthermore, the symptoms for both conditions are often cyclical, where symptom flares are often followed by brief periods of remission or reduced disease activity.
In both the conditions, the symptoms cannot be completely stopped. They can only be controlled with regular treatment and adhering to certain lifestyle changes.
How are Psoriasis and Psoriatic Arthritis different?
Psoriasis causes patches of red, scaly skin while Psoriatic Arthritis sets off joint swelling and pain that can lead to permanent damage. Most people who suffer from Psoriatic Arthritis develop skin symptoms first, but it is not always the case.
There is no connection between the location of the Psoriasis plaques and the joints affected by Psoriatic Arthritis. A person may have skin lesions on the elbow, but no pain, swelling or difficulty in moving it. Similarly, a person may have swollen toes but no redness, scales, or flakes on the feet.
How does the know-how make a difference?
Being aware of these similarities and differences can help in early detection of signs and subsequent diagnosis. In turn, it plays an important role in disease management. For Psoriatic Arthritis, validated screening tools also exist - such as the Psoriasis Epidemiology Screening Tool (PEST) that is used to assess the risk of developing Psoriatic Arthritis. Experts recommend that those with Psoriasis must assess their risk of developing Psoriatic Arthritis by completing the PEST questionnaire every six months and discussing the results with a Dermatologist.
Both Psoriasis and Psoriatic Arthritis are complex diseases that can have a lasting impact on all aspects of life. It is important that you understand them both well, take the medications prescribed, avoid triggers, complete the PEST questionnaire regularly and discuss results with your Dermatologist so that you can lead a healthy and fulfilling life.
Mease PJ, et al. J Am Acad Dermatol. 2013 Nov;69(5):729-735
Healthline. How are Psoriasis and Psoriatic Arthritis Connected? Available [online] at: https://www.healthline.com/health/psoriatic-arthritis/connection-to-psoriasis.
WebMD. The Link Between Psoriatic Arthritis and Psoriasis. Available [online] at: https://www.webmd.com/arthritis/psoriatic-arthritis/link-between-psoriasis-and-psoriatic-arthritis. Accessed on 8 March 2021.
Medical News Today. Psoriasis and psoriatic arthritis: Is there a link? Available [online] at: https://www.medicalnewstoday.com/articles/323672. As accessed on 12 March 2021.
PSORIASIS EPIDEMIOLOGY SCREENING TOOL (PEST). Available [online] at: https://www.bad.org.uk/shared/get-file.ashx?id=1655&itemtype=document#:~:text=PEST%20is%20a%20validated%20screening,to%20rheumatology%20should%20be%20considered. Accessed on 12 March 2021.