The Link Between Psoriasis and Rheumatoid Arthritis, Explained

Here’s a closer look at the possible link between psoriasis and rheumatoid arthritis.

Like other autoimmune diseases, both psoriasis and rheumatoid arthritis (RA) happen because of a fault with the immune system that causes it to attack healthy tissues. The exact cause of this is not fully understood for either disease.

This abnormal immune response results in chronic inflammation. It mainly affects your skin if you have psoriasis, and your joints and other areas if you have rheumatoid arthritis.

Symptoms of both conditions also tend to come and go in cycles. You may have periods where symptoms get worse, called flares. These are often in response to certain triggers, such as smoking or infection.

Psoriasis is more commonly associated with psoriatic arthritis, but it’s also possible for someone with psoriasis to have RA. David Chetrit, MD, a rheumatologist at Carolina Health Specialists in Myrtle Beach, South Carolina, says, “Although there is no direct link between psoriasis and RA, individuals with one autoimmune disease often have a higher risk of developing another, due to shared underlying genetic and environmental factors.”

Does Having Psoriasis and RA Mean You Have Psoriatic Arthritis?

No. The two types of arthritis are different diseases.

One way to determine what form of arthritis you have is to examine your symptoms. Rheumatoid and psoriatic arthritis have some symptoms in common, such as joint pain, stiffness, and swelling. But rheumatoid arthritis joint symptoms are usually symmetrical, whereas psoriatic arthritis is more likely to affect a joint on just one side. The two types of arthritis also tend to affect different joints.

Your doctor will also ask if you have a family history of either form of arthritis. They may also order blood and imaging tests. People with rheumatoid arthritis usually have certain antibodies in their blood.

The diagnosis can be something of a gray area when psoriasis is involved. Says Dr. Chetrit, “Because these conditions share similar symptoms, such as joint pain, swelling, and stiffness, some patients initially receive a diagnosis of RA before later being reclassified as having PsA if skin symptoms emerge.”

There is some overlap in the treatments used for psoriasis and rheumatoid arthritis. Because these diseases involve dysfunction in your immune system, both may respond to drugs that lower your immune activity or reduce inflammation.

“Many treatments are effective in both conditions including methotrexate and biologic medications such as anti-TNF medications (adalimumab, etanercept, certolizumab, infliximab),” says Kimberly Trotter, MD, with the University of Chicago Medicine.

Corticosteroids, either oral or injected, are another type of anti-inflammatory drug that can treat both psoriasis and rheumatoid arthritis.

Other treatments for psoriasis include:

• Topical medications, including corticosteroids, synthetic vitamin D, coal tar, and salicylic acid
• Light therapy
• Retinoids, which are pills or creams derived from vitamin A
• Cyclosporine, another oral immunosuppressor

Other treatments for rheumatoid arthritis include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Other immunosuppressors, including hydroxychloroquine and sulfasalazine
• Other biologics, including abatacept, anakinra, and rituximab
• Physical therapy to improve flexibility
• Surgery to repair damaged joints

• Psoriasis and rheumatoid arthritis are both autoimmune conditions, and it’s possible to have both at once.
• It’s more common to have psoriatic arthritis along with psoriasis. Psoriatic arthritis and rheumatoid arthritis can be distinguished by the pattern of their symptoms and the presence or absence of certain blood markers.
• Speak with your doctor if you have psoriasis and notice any new or worsening joint pain, or pain that gets in the way of daily life.
• There are certain treatments that can help control both psoriasis and rheumatoid arthritis.