Axial psoriatic arthritis: An update for dermatologists

Alice B. Gottlieb, Joseph F. Merola

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations


Psoriasis is a chronic, immune-mediated, systemic, inflammatory disorder characterized by skin plaques and, often, nail disease and arthritis that contribute to reduced quality of life. Psoriatic arthritis—a heterogeneous, inflammatory, musculoskeletal disease that can cause permanent damage to both peripheral and axial joints—is the most common comorbidity of psoriasis. Axial disease occurs in 25% to 70% of patients with PsA, with some patients exclusively experiencing axial joint involvement. Early therapeutic intervention is important for preventing permanent joint and spine damage and loss of functionality in these patients. Because skin symptoms associated with psoriasis often precede psoriatic arthritis, dermatologists are uniquely positioned to play an important role in identifying and treating patients with psoriatic arthritis. Proactive screening of patients with all severities of psoriasis for the signs and symptoms of psoriatic arthritis is key to early diagnosis and intervention. In this review, we discuss the clinical presentation, risk factors, and treatment options for psoriatic arthritis with axial involvement, with the aim of helping dermatologists understand the disease and identify patients who might benefit from further assessment, treatment, and/or referral to a rheumatology practice.

Original languageEnglish
Pages (from-to)92-101
Number of pages10
JournalJournal of the American Academy of Dermatology
Issue number1
StatePublished - Jan 2021


  • axial disease
  • inflammatory arthritis
  • inflammatory back pain
  • psoriasis
  • psoriatic arthritis


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