There are a few factors that can increase the risk of developing PsA, the greatest of these being a diagnosis of psoriasis. In individuals that do develop PsA, this diagnosis typically follows a diagnosis of psoriasis one to two decades later (with a typical onset between ages 30 and 50). Nail involvement seen as “pitting” and/or discolouration and lifting of nails is an important early sign.
Genetic factors are also thought to contribute to PsA. Although the exact mechanisms of inheritance are still unknown, having a first-degree relative (parent, sibling, child if latent) greatly increases one’s chance of developing PsA.
PsA can be latent and be brought about via a number of “triggers” such as injury, infection, emotional/physical stress, hormonal changes, especially in genetically predisposed individuals (see below).
Like psoriasis, the pathophysiology of PsA “ebbs and flows”, resulting in periods of remission (no or reduced symptoms) and relapse (return or worsening of symptoms). Given the systemic nature of the disease, people with PsA often identify certain triggers that bring out or worsen existing symptoms.
Some common triggers include the following:
- Emotional and physical stress
- Change in diet, high intake of processed sugar and fat, weight gain
- Tobacco use
- Changing or stopping medication
Understanding your triggers and being able to recognize early signs of recurring symptoms is an important part of reducing the incidence and severity of flare-ups.
- DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995 - . Record No. T113795, Psoriatic Arthritis; [updated 2018 Nov 30, cited place cited date here].
- Gottlieb A, Merola JF. Psoriatic arthritis for dermatologists. J Dermatolog Treat. 2020 Nov;31(7):662-679. doi: 10.1080/09546634.2019.1605142. Epub 2019 May 7. PMID: 31014154.
- Tiwari V, Brent LH. Psoriatic Arthritis. 2020 Aug 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 31613490.
- Veale DJ, Fearon U. The pathogenesis of psoriatic arthritis. Lancet. 2018 Jun 2;391(10136):2273-2284. doi: 10.1016/S0140-6736(18)30830-4. Epub 2018 Jun 1. PMID: 29893226.