Pictures of Psoriatic Arthritis: What Does the Autoimmune Disease Look Like?

Symptoms of psoriatic arthritis can include stiff, swollen, painful joints, as well as changes to the fingernails.

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Photo: Getty Images

Psoriatic arthritis is an autoimmune disease that is related to psoriasis, a skin condition characterized by red patches and scales on the skin that can be itchy and painful. According to a 2019 study in the Journal of the American Academy of Dermatology, one in four people with psoriasis will develop psoriatic arthritis.

In the majority of people with psoriatic arthritis, the skin symptoms (psoriasis) develop first, followed by the arthritis; however, in some people, the skin and joint symptoms start at the same time, and in 10–15% the arthritis shows up first.

Psoriatic arthritis is characterized by swelling, pain, and stiffness in the joints. This painful condition can affect any joint in the body, but most often it impacts the fingers and toes, as well as the ankles, knees, wrists, and lower back or spine.

Because many symptoms of psoriatic arthritis—like joint pain and fatigue—can be vague, it is often referred to as an "invisible" disease. These types of symptoms are also common with other conditions, including rheumatoid arthritis, sometimes making psoriatic arthritis difficult to diagnose.

However, other psoriatic arthritis symptoms are more identifiable.

What Are the Common Symptoms of Psoriatic Arthritis?

The symptoms of psoriatic arthritis can differ greatly from person to person. As already mentioned, stiff, swollen, painful joints are a common sign of psoriatic arthritis, and the number of joints affected by the disease can vary.

At times a person with psoriatic arthritis may only exhibit symptoms on one or two of their joints, while at other times the disease can impact several joints at once.

Often—although not always—psoriatic arthritis is asymmetrical, meaning a joint on one side of the body is affected while the mirror-image joint feels normal. For example, in the picture below, you can see the right hand has psoriatic arthritis, but the left hand doesn't appear to be affected.

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Copyright 2017 American College of American

Copyright 2017 American College of Rheumatology

Even joints that are close to each other on the body can be impacted very differently. "You can have severely involved joints [with] nearby joints showing almost complete preservation," said Ted Mikuls, MD, professor of internal medicine in the division of rheumatology at the University of Nebraska Medical Center in Omaha. "It can be very spotty."

Fingers Affected by Psoriatic Arthritis Have Distinguishing Features

Psoriatic arthritis symptoms in the fingers can be very distinctive. One of these symptoms can be that the last knuckle of the finger (near the nail) swells and becomes inflamed, while other joints in the finger remain unaffected.

Other telltale signs of psoriatic arthritis can be seen on the nails themselves: Pitting, grooving, or other textural changes on the nail bed; changes in color; or thickening of the nails. Sometimes the nails can separate from the nail bed. These changes in the nails occur in about 80-90% of people with psoriatic arthritis and can be confused with a fungal infection.

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Copyright 2017 American College of American

Copyright 2017 American College of Rheumatology

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Copyright 2017 American College of American

Copyright 2017 American College of Rheumatology

Psoriatic Arthritis Can Cause Deformity and Swelling of Fingers and Toes

Dactylitis, aka "sausage toes and fingers", is another common symptom of psoriatic arthritis. This is when the entire finger or toe swells up and looks like a sausage. According to research, dactylitis occurs in 16-49% of people with psoriatic arthritis.

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Copyright 2017 American College of Rheumatology

Other Symptoms of Psoriatic Arthritis

Since psoriatic arthritis involves inflammation throughout the body, it can also affect other parts of the body in addition to the joints. Fatigue is a common—albeit vague—symptom. Psoriatic arthritis can affect the tendons and ligaments in the feet (as opposed to just the toes). And the joints in the low back can also be affected by inflammation due to psoriatic arthritis.

Psoriatic arthritis can affect the eyes, too. According to the Arthritis Foundation, uveitis occurs when the vascular layer of the eye, called the uvea, becomes inflamed. If the eyes are affected, symptoms can include pain, redness, blurred vision, and light sensitivity. If left untreated, uveitis can cause vision loss.

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