What are the 5 types of psoriatic arthritis

What are the 5 types of psoriatic arthritis?

Psoriatic Arthritis (PsA), a chronic inflammatory condition, affects about 30% of people diagnosed with psoriasis. If you’ve found yourself wondering, “What are the 5 types of psoriatic arthritis?“, you are not alone. By understanding these types and their potential connections to other health conditions, individuals can better navigate their PsA journey.

At the SNS Rheumatology Clinic, we strive to provide comprehensive care and support to patients with PsA. Our team of experienced rheumatologists is well-versed in the five types of psoriatic arthritis, tailoring treatment plans to meet the unique needs of each individual.

Unveiling the 5 Types of Psoriatic Arthritis

What are the 5 types of psoriatic arthritis

There are five recognized types of PsA, each with its own distinctive characteristics and symptoms. 

  1. Symmetric PsA: Affecting about half of all PsA patients, symmetric PsA mirrors rheumatoid arthritis in the way it impacts the same joints on both sides of the body. It can reduce physical function and impact the quality of life.
  2. Asymmetric PsA: Accounting for roughly 35% of PsA cases, this type affects different joints on each side or only one side of the body. It is generally milder than its symmetric counterpart. 
  3. Distal Interphalangeal Predominant (DIP) PsA: This less common type primarily affects the distal joints of the fingers and toes, those closest to the nail. It’s seen in about 10% of PsA cases. 
  4. Spondylitis PsA: In this variant, the spinal column is the target of inflammation. It leads to a painful stiffness in the neck, lower back, and the sacroiliac region. 
  5. Arthritis Mutilans: This is the rarest yet most severe form of PsA, sometimes referred to as mutilating arthritis. It affects less than 5% of PsA patients and can lead to severe deformation and disability if not managed promptly. 

According to the National Library of Medicine: “Psoriatic arthritis affects an estimated 24 in 10,000 people. Between 5 and 10 percent of people with psoriasis develop psoriatic arthritis, according to most estimates. Some studies suggest a figure as high as 30 percent. Psoriasis itself is a common disorder, affecting approximately 2 to 3 percent of the population worldwide.”

Psoriatic Arthritis and Migraines: An Intriguing Connection

Living with PsA can be challenging, not just because of joint issues but also due to associated conditions like migraines. Research indicates a greater prevalence of migraines among PsA patients compared to the general population. Chronic inflammation, a common feature in PsA, may contribute to triggering migraines. Recognizing this link is crucial, as effective management of PsA could potentially help decrease the frequency and intensity of migraines.

Hypermobility and Psoriatic Arthritis: An Unexpected Pairing

Hypermobility, a condition where joints move beyond the normal range, has been observed in some individuals with PsA. While the relationship between hypermobility and psoriatic arthritis is yet to be fully understood, knowing about this potential association can be beneficial. Individuals with PsA who also experience joint hypermobility may need to follow specific exercise regimens or precautions to protect their joints and manage their symptoms effectively. 

Can Trauma Cause Psoriatic Arthritis? Unravelling the Truth

Interestingly, some evidence suggests that physical trauma might trigger PsA in certain individuals. While this connection requires further investigation, it serves as a reminder of the importance of treating physical injuries promptly. Understanding that trauma could potentially exacerbate or trigger PsA is essential, especially for those with psoriasis or a family history of PsA.

Diving Deeper into Psoriatic Arthritis

Understanding the five types of psoriatic arthritis is only the beginning of navigating this complex condition. As we delve further into its intricacies, we see connections to other conditions, the most significant being migraines, hypermobility, and a potential link to trauma.

Psoriatic Arthritis and Migraines: A Complex Relationship

Psoriatic arthritis and migraines share a common feature – inflammation. Chronic inflammation, a cornerstone of PsA, may play a role in the onset and exacerbation of migraines. Various studies have noted an increased frequency of migraines in PsA patients compared to those without the condition. 

While the exact mechanism remains unknown, some researchers propose that PsA-related inflammation could trigger a cascade of events leading to the dilation of blood vessels in the brain, a key factor in the onset of migraines. 

As reported by the National Centre of biotechnology information: “The prevalence of psoriasis is approximately 2% to 3% in the worldwide population. Because the occurrence of psoriasis varies depending on the distance from the equator, the prevalence in Asian countries is relatively lower than that in Western countries.”

Further complicating the situation is the impact of PsA-related stress and fatigue on migraines. Both conditions can intertwine and exacerbate one another, leading to a relentless cycle that can be challenging to disrupt. Recognizing this complex interplay between psoriatic arthritis and migraines is crucial in formulating effective treatment plans and self-care strategies.

Hypermobility and Psoriatic Arthritis: An Unusual Combination

The link between hypermobility and psoriatic arthritis is not as well-defined as the connection with migraines. Hypermobility, characterised by an unusually large range of joint movement, is more typically associated with conditions like Ehlers-Danlos syndrome. However, anecdotal evidence and a handful of studies suggest it might be more common in PsA patients than previously thought. 

Why could this be the case? One theory suggests that chronic inflammation associated with PsA might damage joint tissues over time, leading to an increased range of motion. This connection, however complex and undefined, is essential to understand as it could affect a patient’s physical therapy plan or daily activities. 

Trauma and Psoriatic Arthritis: Unravelling Potential Triggers

The question, “Can trauma cause psoriatic arthritis?” is not easy to answer. Nevertheless, burgeoning research implies that trauma could potentially initiate PsA in individuals who have specific genetic susceptibilities. 

The concept, known as the “deep Koebner phenomenon,” posits that a physical injury to the skin or joint could potentially initiate an inflammatory response that leads to PsA in individuals with psoriasis. Although the link between trauma and PsA onset is far from definitive, it’s a fascinating area of study that could offer new insights into PsA triggers and prevention strategies.


Psoriatic arthritis is a multifaceted disease that intertwines with various aspects of an individual’s health. As we’ve seen, the connections between PsA, migraines, hypermobility, and trauma are complex and require further exploration. 

Nonetheless, understanding these relationships can provide a more comprehensive view of PsA and its impact on individuals’ lives. It can guide treatment approaches, help individuals manage their symptoms more effectively, and offer hope for future research and potential new therapies. 

Arming oneself with knowledge about the 5 types of psoriatic arthritis and its associated conditions is not just empowering – it’s a significant step towards taking control of one’s health journey. After all, the more we understand about PsA, the better equipped we are to live well with this condition.

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Dr. Qaisar Usmani

Meet Dr. Qaisar Usmani, a Board Certified Rheumatologist with over 20 years of experience in the field, currently serving as Section Chief at Monmouth Medical Center and GPHA, Inc. in Pennsylvania, specializing in the treatment of various Rheumatic and Musculoskeletal diseases.

Dr. Sadia Ghafoor
Dr. Sadia Ghafoor

Meet Dr. Sadia Ghafoor, a board certified specialist in rheumatology who completed her medical training at the University of Medicine and Dentistry School of Osteopathic Medicine and her fellowship in rheumatology at the State University of New York Stony Brook campus, with additional board certification in internal medicine.

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