What organs does psoriatic arthritis affect?
Psoriasis can affect internal organs as well as the skin
Not only can psoriasis affect the skin, but it can have devastating effects that can affect your internal organs.
The systemic inflammation inside the body that accompanies the disease is often overlooked. Patients may think that they are having success with their treatments if they cannot see the thick psoriasis plaques on their skin. However, patients can have serious consequences on their joints, arteries and other organs if not properly treated early to decrease the inflammation. It is important to know that psoriasis is an autoimmune disease. It is not contagious and is caused when the immune system attacks the skin.
As a result, scaly red patches or plaques occur on the skin. In addition to skin problems, some patients can develop psoriatic arthritis. Signs and symptoms of this are painful, stiff and swollen joints that can come and go. Psoriatic arthritis can affect any joint in the body, including the back or neck.
An early and accurate diagnosis of psoriatic arthritis is essential because persistent inflammation can cause damage to the joints. Nobody knows exactly what causes psoriatic arthritis, but it can affect anyone. Psoriatic arthritis typically occurs in people with skin psoriasis, but it can occur in people without skin psoriasis, particularly in those who have relatives with psoriasis. Sometimes certain heart medications like B-blockers can cause a psoriasis flare on the skin or it may be triggered by a streptococcal throat infection.
There is not a strong correlation between the severity of psoriasis and severity of psoriatic arthritis. In some people, it is mild, with just occasional flare ups. In others, it is continuous and can cause joint damage if not treated. Early diagnosis is important to avoid damage to joints. Patients with psoriatic disease are at an increased risk of developing other serious health conditions such as: Increased risk for some cancers; Increased risk of heart attack or stroke; Crohn’s Disease or Ulcerative colitis; Depression; Diabetes; Metabolic Syndrome; Obesity; Osteoporosis; Inflammation of the eye; Liver Disease. More: Hammerling: Don’t believe the hype; FDA-approved sunscreens are safe More: Hammerling: Laser treatments can help restore youthful look More: Hammerling: Spring is a time to spruce up your skin While there is no cure for psoriasis or psoriatic arthritis, there are a growing range of treatments available to help the disease from progression while decreasing pain as well as protection of joints and preserving the range of motion.
Most treatments are safe and effective for most people. In the past, there were not many options for psoriasis treatment. Some medications that have been used in the past are: topical steroids, Soriatane, Methotrexate, Cyclosporine, Enbrel, Humira, and phototherapy. There are positives and negatives to every medication. Topical steroids: can be effective, but ineffective on thick lesions as well as being messy or inconvenient if large surface areas need to be covered. A newer topical steroid that is cosmetically elegant is Enstilar Foam that rubs into the skin. Soriatane pills: can be helpful with patients who have psoriasis on the hands or feet. However, it cannot be used in patients trying to become pregnant. Blood work must be drawn several times a year.
Methotrexate: can be helpful but cannot be used in women trying to become pregnant or patients with poor kidney function. Blood work must be drawn several times a year.
Cyclosporine: works quickly like prednisone, but blood pressure and lab work must be monitored. Many providers do not usually use this as a long-term medication. Otezla pills: a newer option and no blood work is required, but patients do not like the side effects of diarrhea, nausea and some patients have become depressed while on it. Different types of newer medications called biologics are can be very effective such as Secukinumab (Cosentyx), which is an injection approved to treat psoriatic arthritis and helpful in treating psoriasis and psoriatic arthritis. Most providers order basic blood work annually. For maintenance, it’s only once a month injection with a pen which makes it a more comfortable easy experience.
The Effects of Psoriatic Arthritis on the Entire Body
Lana Barhum has been a freelance medical writer for over 14 years. She shares advice on living well with chronic disease.
Updated on February 27, 2022
Riteesha G. Reddy, MD, is a board-certified rheumatologist and internist at a private practice in Dallas, Texas.
Table of Contents
Table of Contents
People with psoriatic arthritis (PsA) usually have symptoms of both psoriasis and arthritis. Psoriasis is an inflammatory skin condition where skin cells build up and form scales and itchy, dry patches and arthritis inflammation in one or more joints, causing pain and stiffness. Arthritis is the swelling and tenderness of one or more joints.
The inflammation associated with PsA impacts more than just the joints and skin. It can also affect many body systems.
Here is what you need to know about the effects of PsA on the body, including on a person’s joints, muscles, skin, vision, digestive health, and respiratory health.
The musculoskeletal system includes both the muscular and skeletal systems. The musculoskeletal system is made up the skeleton, muscles, tendons, ligaments, joints, and connective tissues. Both systems give humans the ability to move and provide support, form, and stability to the body. In people with PsA, the musculoskeletal system can be adversely affected.
PsA is known for causing inflammation of the joints. It can affect one joint or many. Swollen, stiff, and painful joints are classic symptoms of PsA. Inflammation can limit joint range of motion, making it harder to move the joints. It can cause severe neck and back pain, making it harder to bend the spine. PsA can affect the joints of the fingers and toes, causing them to swell up and take on a sausage-like appearance.
Tendon and ligament pain may also be seen in psoriatic arthritis. That means you may experience pain and swelling in the heels, soles of the feet, and around the elbows.
PsA can cause arthritis mutilans, a condition occurring in 5% of the people with PsA. Arthritis mutilans is a severe form of arthritis that can destroy the joints of the hands and feet, causing permanent disability and disfigurement. Fortunately, medications, including biologics, can help to prevent arthritis mutilans.
Chronic inflammation associated with PsA can damage the cartilage that covers the ends of bones. As PsA progresses, damaged cartilage will cause bones to rub against each other. In addition to damaging joints, chronic inflammation can cause cartilage damage to ligaments, tendons, and muscles, which leads to insufficient joint support and joint and muscle weakness.
Skin, Hair, and Nails
Most people with PsA also have psoriasis, and one in four people with psoriasis also have PsA. Psoriasis causes red, rough skin patches with silvery scales. These patches can appear anywhere on the body, but usually show up around elbows, knees, hands, and feet. Additional symptoms of psoriasis include tenderness and itching. The skin around the joints may appear cracked and blisters may form.
Psoriasis patches that resemble dandruff can appear on the scalp. These patches look like large scales and tend to be red and itchy. Scalp psoriasis patches may cause severe shedding. Scratching causes flakes in the hair and on the shoulders.
Nail psoriasis results in nails to be pitted (dents in the nails), deformed, thick, and discolored. It may also cause nails to separate from the nail bed. Up to 35% of people with psoriasis and up to 85% of those with PsA have nail symptoms, according to the National Psoriasis Foundation.
Inflammation from PsA can affect the eyes. According to the American Psoriasis Foundation, around 7% of people with PsA will develop uveitis, a type of eye inflammation of the middle layer of the eye wall called the uvea. Uveitis often comes on suddenly and will get worse quickly.
Symptoms of uveitis include eye redness and pain, and blurred vision. The condition can affect one or both eyes. Uveitis—if undiagnosed and untreated—can eventually lead to loss of vision.
Psoriasis can also affect the lid (blepharitis), conjunctiva or cornea, with complications including conjunctival hyperemia and conjunctivitis, ectropion and trichiasis and corneal dryness with punctate keratitis and corneal melting. This may occur in up to 70% of people with PsA .
Psoriatic arthritis is an autoimmune disease, which means it affects the way the body’s immune system functions. When the immune system is functioning normally, it fights against bacteria and viruses. Autoimmune disorders cause the body to turn against itself and start attacking healthy issues even though there is no reason to, i.e. there are no viruses or bacteria.
PsA’s overactive immune response causes the body to attack joints, tendons, ligaments, and skin. Researchers are not really sure why this occurs, but they think certain bacterial infections may trigger PsA.
Having a weakened immune system due to the medications used to treat PsA can cause you to get sick more easily, especially when it comes to viruses, such as the flu. A compromised immune system also means longer recovery periods and challenges and setbacks in treating PsA.
Studies have shown people with psoriatic arthritis have an increased risk for anxiety and depression. According to a survey reported in the April 2014 Journal of Rheumatology, more that 36% of people with PsA had anxiety and 22% had depression.
Physical pain and other aspects of PsA will have an impact on a person’s emotional health. In addition to dealing with the disease, a person may feel uncertain about the future because they don’t know the direction their health will take. They may worry about worsening health and providing and carrying for loved ones. PsA may affect self-esteem and cause embarrassment, especially when treatment isn’t helping to manage disease symptoms.
Mental health risks are higher in people whose PsA isn’t well-managed. If you start to notice symptoms of depression or anxiety, talk to your healthcare provider who can help you find treatment options.
There is a link between psoriatic arthritis and inflammatory bowel disease (IBD). IBD includes Crohn’s disease and ulcerative colitis (UC). Crohn’s is known for affecting the stomach and intestines, while UC affects the lower part of the GI tract, which includes the colon and rectum.
People with PsA have a higher risk for IBD in comparison to the rest of the population, according to a 2017 report in the Annals of Rheumatic Disease.
Cardiovascular disease in people with chronic inflammatory diseases, such as PsA, is a major cause of illness and death, this according to the American College of Cardiology. Chronic inflammation is known for damaging blood vessels and making them thick, hard, and scarred. These problems increase your risk for heart attack and stroke.
PsA increases the risk for metabolic syndrome. Metabolic syndrome is a collection of conditions, including high blood pressure and diabetes.
It is a good idea to get your blood pressure checked regularly and work with your healthcare provider to lose weight, if needed. Talk to your healthcare provider if you notice some of the telltale signs of type 2 diabetes, such as constant hunger, increased thirst, and extreme fatigue.
A Word From Verywell
Having PsA doesn’t mean you cannot manage its effects. The best thing you can do is to stay on top of your PsA treatments. If you are experiencing more frequent disease flare-ups (periods where disease activity is high), talk your healthcare provider about changing medications or additional treatment options. You can also reduce your risk for many of the whole-body effects of PsA by staying active, managing stress, eating healthy, and quitting alcohol and smoking.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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- Alinaghi F, Calov M, Kristensen LE, et al. Prevalence of psoriatic arthritis in patients with psoriasis: A systematic review and meta-analysis of observational and clinical studies. J Am Acad Dermatol. 2019 Jan;80(1):251-265.e19. doi:10.1016/j.jaad.2018.06.027
- National Psoriasis Foundation. Managing nail psoriasis.
- Collins C. National Psoriasis Foundation. Uveitis: A threat to eyesight.
- Rajguru JP, Maya D, Kumar D, Suri P, Bhardwaj S, Patel ND. Update on psoriasis: A review. J Family Med Prim Care. 2020 Jan; 9(1): 20–24. doi:10.4103/jfmpc.jfmpc_689_19
- McDough E, Ayearst R, Eder L, et al. Depression and anxiety in psoriatic disease: Prevalence and associated factors. The Journal of Rheumatology April 2014, jrheum.130797; doi:10.3899/jrheum.130797
- Charlton R, Green A, Shaddick G, et al. Risk of uveitis and inflammatory bowel disease in people with psoriatic arthritis: a population-based cohort study. Ann Rheum Dis. 2018 Feb;77(2):277-280. doi: 10.1136/annrheumdis-2017-212328
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By Lana Barhum
Lana Barhum has been a freelance medical writer since 2009. She shares advice on living well with chronic disease.
What organs does psoriatic arthritis affect?
Those living with psoriatic arthritis are also at risk of developing a related health condition (known as a comorbidity), like heart disease, diabetes and obesity.
Health Conditions Linked to Psoriatic Arthritis
It is important to visit your primary care provider regularly to screen for these diseases because you may not notice or feel symptoms for some of these health conditions. In addition, if some of these conditions are caught early, they can be easily treated with lifestyle changes or medications. Evidence shows that people who effectively treat PsA can also lower the risk of other comorbidities. In 2019, the National Psoriasis Foundation and American Academy of Dermatology published guidelines on the treatment of psoriasis with attention to comorbidities. The guidelines state the following health conditions as comorbidities of PsA. People living with PsA are at risk for the same comorbidities as psoriasis.
Psoriasis is an inflammatory disease that presents on the skin in plaques and scales but also can lead to inflammation in other parts of the body. Not everyone with PsA has or will develop psoriasis. An estimated 30 percent of people with psoriasis develop PsA.
Cardiovascular disease (also known as heart disease) refers to numerous conditions including heart attack, stroke, heart failure, arrythmia (irregular heart rhythm) and heart valve problems.
Metabolic syndrome refers to the presence of increased blood pressure, high blood sugar, excess body fat and abnormal cholesterol levels, which increase the risk of heart disease, stroke and type 2 diabetes.
Obesity is a complex chronic disease involving genetic and environmental factors. Obesity is defined as too much body fat (especially around the waist) that presents a health risk. Obesity may increase the risk of chronic diseases such as cardiovascular disease, diabetes and cancer. Body Mass Index (BMI) uses a person’s height and weight to determine obesity. A person with a BMI of 30 or more is generally considered to have obesity.
Hypertension is another name for high blood pressure, which refers to the pressure of blood pushing against the walls of the arteries. Hypertension is very common and increases the risk for cardiovascular disease and stroke.
Dyslipidemia refers to the consistent high levels of cholesterol and other lipids (also called fats) in the blood. Dyslipidemia may increase risk of cardiovascular disease.
Type 2 diabetes (also called insulin resistance) refers to cells in the body that do not respond normally to insulin. Normally insulin works to let blood sugar into the cells in the body to use as energy. Type 2 diabetes may increase the risk of cardiovascular disease, vision loss and kidney disease.
Anxiety and Depression
People with anxiety disorders often struggle with intense feelings of anxiety, worry, fear and/or panic. Anxiety can interfere with daily activities and may last a long time. People with depression experience a persistent sad mood that lasts a long time and interferes with daily activities.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) refers to conditions characterized by inflammation in the gastrointestinal tract. The two most common inflammatory bowel diseases are ulcerative colitis and Crohn’s disease.
Cancer describes diseases in which abnormal cells divide without control and may spread into nearby tissue. There are more than 100 types of cancers and are often named after the area in the body where the cancer forms.
Chronic kidney disease occurs when the kidneys are damaged or cannot filter blood as well as normal kidneys. As a result, extra fluid and waste from the blood stay in the body and may lead to other health problems.
Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts during sleep. This happens when the muscles in the throat relax, blocking the airway.
Chronic Obstructive Pulmonary Disease (COPD)
Chronic obstructive pulmonary disease refers to a group of diseases that cause breathing-related problems and airflow blockage.
Uveitis refers to inflammation in the eye which affects the middle layer of tissue in the eye wall (uvea). Symptoms include eye redness, pain and blurred vision and symptoms may come on suddenly and progress quickly.
Hepatic (liver) Disease
Hepatic disease refers to inflammation of the liver that disrupts the liver’s function and which can lead to permanent kidney damage.
Comorbidities Quick Guide
Learn more about comorbidities and ways to lower your risk. And, for those living with chronic pain due to psoriatic arthritis, request our free Chronic Pain Kit to best manage it.