Have Psoriasis? Here’s How You Can Reduce Your Risk of Psoriatic Arthritis

Psoriasis and psoriatic arthritis (PsA) are both psoriatic diseases, which means they are related. Psoriasis increases your risk of PsA, but this doesn't mean you will get it.

While there's no guaranteed way for people with psoriasis to prevent PsA, managing certain controllable risk factors can reduce your chances of developing it.

Let's break down which risk factors can and can't be managed to help prevent PsA.

• HLA-B08
• HLA-B27
• HLA-B38
• HLA-B39
• HLA-B44
• HLA-B57
• HLA-C06
• IL-23R

It's worth noting that these aren't the only genes linked to these diseases. Also, the presence of these genetic markers does not mean a person will develop these diseases.

Some people with these genetic markers never develop symptoms. In many cases, having a genetic marker may increase the chance of someone possibly developing a disease, but other factors are necessary for the disease to actually occur.

If you have family members with psoriasis or know you have genetic features linked to psoriasis, be sure to see a doctor if symptoms of psoriasis or PsA start to appear.

They include:

• Streptococcal infection, such as strep throat

  [3]

• Recent use of antibiotics, such as fluoroquinolones

  [4]

• Joint trauma, in people with psoriasis

  [5]

More research is needed to confirm a link between these factors and PsA.

If you have psoriasis, these factors may only trigger PsA or a flare if you already have a genetic feature relating to both diseases.

Other health conditions may increase your risk of developing PsA. Research suggests that people with psoriasis who have one or more of the other health conditions below are more likely to develop PsA.

Obesity

According to Eric Ruderman, MD, a rheumatologist and a professor of medicine in the division of rheumatology at Northwestern University Feinberg School of Medicine in Chicago, "There is no question there is a link between obesity and psoriasis, and that there is a higher risk in those with obesity of developing psoriatic arthritis on top of psoriasis."

Dr. Ruderman adds that "diet is not one-size-fits-all" but recommends limiting processed foods and excess sugar and aiming for a balanced diet with lots of vegetables.

"If you believe that specific foods may trigger your psoriatic arthritis symptoms, it may be reasonable to avoid those foods for two to four weeks to see if your symptoms improve, but there are no particular foods that we generally recommend avoiding if you have psoriatic arthritis," Ruderman says.

Musculoskeletal Conditions

People with psoriasis who have nonspecific musculoskeletal symptoms, such as joint pain, fatigue, and stiffness, often go on to develop PsA. The link is unclear. Rather than being a cause, these could be early symptoms of PsA.

If you have psoriasis, taking measures to avoid traumatic injuries and overuse could help delay or prevent PsA.

Depression and Anxiety

Seeking treatment for depression, anxiety, and other mood disorders may improve your quality of life with psoriasis and lower your PsA risk.

There's not enough evidence to say whether psoriatic arthritis is more likely to affect particular groups of people, but it's clear that health inequity plays a role in the outcome for some people.

While more work is needed to confirm this, ensuring everyone with psoriasis has equal access to effective treatment could reduce the risk and prevalence of PsA.

There's some evidence that early psoriasis treatment with biologic drugs may reduce inflammation and, with it, the risk of PsA.

Speak to your doctor about whether biologics may be suitable for you if you have psoriasis and are concerned about preventing PsA.

If you have psoriasis, knowing the early signs of psoriatic arthritis can help you access prompt treatment. Early treatment can prevent joint damage.

• Swollen or "sausage" fingers and toes, a hallmark sign of PsA
• Foot pain, especially at the back of your heel or in the sole of your foot
• Lower back pain
• Eye inflammation
• Nail symptoms, such as pitting, crumbling, or separation from the nail bed

Make sure you follow your treatment plan for psoriasis, as it may help prevent a worsening of psoriasis or progression of psoriatic disease.

• While there is no guaranteed way to prevent psoriatic arthritis in individuals with psoriasis, managing controllable risk factors such as obesity and joint trauma may reduce the likelihood you’ll develop this condition.
• Address mental health issues like depression and anxiety, which can exacerbate inflammation. This will not only improve life with psoriasis but may also lower the possibility of developing psoriatic arthritis.
• Early treatment and adhering to therapy plans for psoriasis — including considering biologics when appropriate — can potentially reduce inflammation and minimize the risk of progression to psoriatic arthritis.