What is Psoriatic Arthritis?
- Grace
- 12 hours ago
- 3 min read
Psoriatic Arthritis: What Nursing Students Need to Know
Psoriatic arthritis (PsA) is a chronic, inflammatory form of arthritis that occurs in some patients with psoriasis, an autoimmune skin disorder. About 30% of people with psoriasis will develop psoriatic arthritis, often years after their first skin symptoms appear . For nursing students, understanding PsA is essential since it presents unique challenges in both diagnosis and management.
What Is Psoriatic Arthritis?
Psoriatic arthritis is an autoimmune condition in which the immune system mistakenly attacks healthy skin and joint tissues. This results in inflammation, pain, swelling, and stiffness, often accompanied by scaly skin patches typical of psoriasis.
Key features:
Affects both joints and skin.
Can occur at any age, but most often develops between ages 30–50.
Has periods of flare-ups and remission.
Signs and Symptoms
Nurses should be able to recognize PsA since early treatment helps prevent permanent joint damage. Common signs include:
Joint pain and swelling (often asymmetric).
Dactylitis (“sausage digits”)—swelling of entire fingers or toes.
Enthesitis—pain where tendons/ligaments attach to bone (e.g., Achilles tendon).
Psoriasis patches—red, scaly plaques often on the scalp, elbows, or knees.
Nail changes—pitting, ridges, or separation of the nail from the nail bed.
Why This Is Important for Nursing Students
Holistic Care: PsA affects both the skin and musculoskeletal system, requiring multi-system assessments.
Misdiagnosis Risk: PsA may mimic rheumatoid arthritis, osteoarthritis, or gout, so nurses play a key role in early recognition.
Chronic Disease Management: Nurses often support patients with long-term biologic therapies and help them navigate side effects and adherence.
Diagnosis and Treatment
Diagnosis involves a combination of clinical signs, patient history, bloodwork (to rule out RA), and imaging (X-ray, MRI, ultrasound).
Treatment options:
NSAIDs: Reduce pain and inflammation.
DMARDs (e.g., methotrexate): Slow disease progression.
Biologics (e.g., TNF inhibitors, IL-17 inhibitors): Target immune system pathways.
Lifestyle: Exercise, weight management, and smoking cessation improve outcomes.
Home Treatment and Self-Care
Patients with psoriatic arthritis benefit from combining medical therapy with lifestyle strategies:
Apply moisturizers to manage psoriasis plaques and prevent cracking.
Use heat therapy (warm baths, heating pads) for stiffness.
Low-impact exercise such as swimming or yoga to maintain mobility.
Rest during flares while balancing with activity during remission.
Stress management (mindfulness, counseling), since stress can trigger flares.
Case Scenario
A 36-year-old patient with a 10-year history of psoriasis presents with swollen fingers and stiffness in the morning lasting over an hour. Their nails show pitting and separation. Blood tests are negative for rheumatoid factor.
Question for Nursing Students: What condition should be suspected, and what would be a priority nursing intervention?
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RESOURCES:
Author - Saving Grace Medical Academy Ltd
Grace. T
Medical Content Writer
Answers & Explanations
Answer: Psoriatic arthritis. Priority interventions include pain management, referral to a rheumatologist, patient education on adherence to DMARD/biologic
therapy, and lifestyle modifications.