The progression and severity of PsA varies from person to person, and can often be difficult to predict. Most patients develop PsA after years of having skin psoriasis. However, joint involvement may occur before skin psoriasis and sometimes joint and skin symptoms come on around the same time. Moreover, symptoms can change over time (improve or worsen) and have a seasonal component (being particularly worse in the colder months).
Given that having psoriasis is the most significant risk factor for developing PsA, it is important to be mindful of specific symptoms that may influence progression to PsA, namely skin patches on the scalp and fingernail involvement. Other early signs include arthritic symptoms, such as stiffness and swelling of joints, particularly in the fingers, toes, ankles, and knees. Following these early symptoms, PsA will gradually progress, resulting in more frequent “flare-ups” that may start to impact other joints in the body. If early diagnosis and treatments are not made, the inflammatory damage resulting from PsA can cause symptoms that worsen quality of life and day-to-day function, such as fatigue, reduced mobility, and depression.