Psoriatic arthritis and psoriasis: need for a multidisciplinary approach.

Psoriatic arthritis is a progressive and often destructive form of seronegative inflammatory arthritis that is associated with psoriasis. It can be difficult to diagnose because it can present in a number of different ways, often indistinguishable from noninflammatory arthropathies such as osteoarthritis as well as inflammatory arthritis such as gout. Severe arthritis may be observed in the absence of psoriasis, or mild arthritis may be seen in the presence of moderate-to-severe psoriasis. A high index of suspicion, screening of psoriasis patients, and close follow-up and evaluation with rheumatology often is needed to make the diagnosis. Early recognition of the disorder and timely therapy can prevent long-term complications, such as permanent joint destruction and disability. With the advent of biologic agents, we are better equipped to manage psoriatic arthritis today. Because dermatologists are on the front-line of psoriasis management, we are perfectly poised to identify and help improve care for patients who suffer from both psoriasis and psoriatic arthritis.