Psoriatic arthritis

Oliver FitzGerald, Alexis Ogdie, Vinod Chandran, Laura C. Coates, Arthur Kavanaugh, William Tillett, Ying Ying Leung, Maarten deWit, Jose U. Scher, Philip J. Mease

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Psoriatic arthritis (PsA) is a complex inflammatory disease with heterogeneous clinical features, which complicates psoriasis in 30% of patients. There are no diagnostic criteria or tests available. Diagnosis is most commonly made by identifying inflammatory musculoskeletal features in joints, entheses or the spine in the presence of skin and/or nail psoriasis and in the usual absence of rheumatoid factor and anti-cyclic citrullinated peptide. The evolution of psoriasis to PsA may occur in stages, although the mechanisms are unclear. In many patients, there may be little or no relationship between severity of musculoskeletal inflammation and severity of skin or nail psoriasis. The reason for this disease heterogeneity may be explained by differences in genotype, especially in the HLA region. New targeted therapies for PsA have been approved with additional therapies in development. These developments have substantially improved both short-term and long-term outcomes including a reduction in musculoskeletal and skin manifestations and in radiographic damage. With efforts underway aimed at improving our understanding of the molecular basis for the heterogeneity of PsA, a personalized approach to treating PsA may become possible.

Original languageEnglish
Article number59
JournalNature Reviews Disease Primers
Issue number1
Early online date12 Aug 2021
Publication statusPublished - 12 Aug 2021

ASJC Scopus subject areas

  • Medicine(all)


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