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Study Finds Injury Triggers Psoriatic Arthritis

For some people with psoriatic disease, an injury can trigger the onset of psoriatic arthritis.

Study Finds Injury Triggers Psoriatic Arthritis

Up to 20% of people with psoriasis may also develop psoriatic arthritis (PsA), a condition causing pain and inflammation in and around the joints—most often in the fingers or toes. Doctors don’t know what causes the skin disease to begin attacking the joints, but a 2015 study found one trigger that can increase the risk by up to 50%: injury.

A large study from researchers in Iceland and at Harvard found that people with psoriasis were more likely to develop psoriatic arthritis if they were exposed to physical trauma (particularly in the bone or joint).

The researchers analyzed medical records of more than 70,000 people with psoriasis between 1995 and 2003. Of those, 15,416 patients were exposed to trauma, either involving the skin, nerves, bones or joints. According to the analysis, people who suffered a bone injury were 46% more likely to develop PsA than those who were trauma-free. Those with a joint injury had a 50%-higher risk. Skin or nerve trauma, on the other hand, didn’t appear to be connected with PsA at all.

The connection between minor trauma and PsA isn’t new. Dermatologists have long known that a minor skin injury (like a scrape or sunburn) can trigger a new patch of psoriasis. They even have a name for it: the Koebner phenomenon. Experts have suggested that the same thing may happen to the joints after an injury. The theory is that the trauma causes the immune system to go haywire somehow, leading to the scaly, red and white patches of psoriasis or the swelling, stiffness and pain of PsA.

Obviously, you can’t completely protect yourself from an injury. But, if you have psoriasis, you may be able to modify your risk of psoriatic arthritis with the right treatment plan. Make sure you talk to your dermatologist about your symptoms and track any changes, so your healthcare team can help you avoid the potential for PsA as best as possible.

Medically reviewed in August 2019.

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