Since psoriatic arthritis (PA) is an autoimmune disorder, this means that the body turns on itself, in fact, attacks its own joints. While PA can develop at any time, the most likely onset age is between 30 and 50 years, with most cases presenting the first signs between the fourth and fifth decades. This article will look at the types of psoriatic arthritis.

Chronic and progressive psoriatic arthritis affects men and women equally. There is a higher percentage of North Americans and Europeans who develop the disease compared to Asians. Most people (approximately 85%) live with psoriasis before developing PA; however, there is a small proportion of people who develop PA without suffering from psoriasis.

Medical scientists have not yet identified the exact cause of psoriatic arthritis. However, most doctors agreed that the combination of genetics and the environment plays a role in the development of this condition. The biggest indicator of whether someone is developing PA if they are already suffering from psoriasis. The second indicator of PA has a family member who has lived with the disease or lives with psoriasis. In most cases, people developing psoriatic arthritis have a parent or sibling who also had a disease or had psoriasis. Environmental factors, such as stress and the reduction of certain bacterial or viral infections (such as the streptococcal throat), are thought to play a role in the onset of PA.

How to identify psoriatic arthritis


Treating Psoriatic Arthritis – A Review of Principles and Techniques


Types of psoriatic arthritis

The three most important common types of arthritis are osteoarthritis, rheumatoid arthritis, and psoriatic arthritis have many overlapping symptoms, making a diagnosis of PA difficult. In many cases, the presence of psoriasis is a determining and distinctive factor in the diagnosis of PA.

After you have been diagnosed with psoriatic arthritis, your doctor will most likely classify you into one of five types of PA.

  • Symmetric PA.
  • Asymmetric PA.
  • Distal PA.
  • Spondylitis.
  • Mutating arthritis.

Symmetric PA.

In this form of psoriatic arthritis, joints on both sides of the body are affected. The most common types of psoriatic arthritis, symmetrical PA, affect about 50% of the population. Symptoms are most similar to those of rheumatoid arthritis. 

Asymmetric PA.

Affecting approximately 35% of the population with PA, asymmetric psoriatic arthritis appears in different joints on different sides of the body. Instead of having both knees inflamed, your knee may be affected by PA on the right side of your body, and your left elbow may be caused by pain and inflammation at the same time.

Distal PA.

Distal psoriatic arthritis affects the fingers and toes. This type of PA is characteristic of inflamed joints and changes in the nails, including the pigment of nails, white spots in the nails, rising from the nail bed.


Spondylitis is a type of PA that primarily affects the back and spine. Painful swelling and inflammation in these areas are classic symptoms of spondylitis.

Mutating arthritis.

It affects only a very small percentage of patients with PA (approximately 5% of the population), and this is the most difficult type. Mutating arthritis causes permanent deformities in the fingers and toes, destroying the joints so much that full recovery is usually unattainable.

Symptoms of Psoriatic Arthritis

If you suspect that you or a loved one is affected by psoriatic arthritis, what are the signs and symptoms that you should look for? The following is a list of some of the most common symptoms of PA. You may have only a couple of symptoms on this list, or there may be several.  

  • Joint pain.
  • Inflammation.
  • Hard joints – especially after sleeping or resting for extended periods of time.
  • Generalized fatigue.
  • Swelling and pain in the tendons.
  • Swollen toes and toes (“sausage-like appearance” called dactylitis).
  • Reduced range of motion.
  • A nail ulcer or any other type of nail change that looks like a nail fungus.
  • Eye pain and redness are mimicking signs of conjunctivitis (i.e., pink eye).
  • Lower back pain.
  • Pain in the heel.

Differences of rheumatoid arthritis from psoriatic


Psoriatic Arthritis: What it is, Causes, Symptoms and Treatment

If you experience any of the above symptoms and suspect that you may suffer from psoriatic arthritis, consult your doctor. Your doctor will conduct a general physical examination, ask you a series of questions about your symptoms and family history, and also do some work with blood.

Because psoriatic arthritis has many overlapping symptoms with osteoarthritis, rheumatoid arthritis, and gout, your doctor may do some tests to rule out these other types of arthritis. For example, you can take rheumatoid factor (RF) tests and anti-CCP antibodies to rule out associated rheumatoid arthritis, x-rays to examine joint damage and inflammation, and a bone density scan to measure your bone health. Although the exact cause of psoriatic arthritis is unknown, many people with PA (approximately 40–50%) have the HLA-B27 genotype. A simple blood test can confirm this genotype in the body. Types of psoriatic arthritis see above. 

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