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Table of ContentsView All
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Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Prevention
It is not unusual for people—sometimes even medical professionals—to mistakepsoriatic arthritis(PsA) forsystemic lupus erythematosus(SLE), simply referred to as lupus. These two conditions share many symptoms, includingjoint painand skin symptoms. But they also have many differences and ways to tell them apart.
Both of these diseases cause inflammation throughout the body, as well as arthritis (joint pain and swelling). In PsA, the arthritis is erosive, leading to loss of bone and cartilage. In lupus, the arthritis is not erosive.
Verywell / Michela Buttignol
Lupus is an autoimmune disease in which the body produces abnormal antibodies (autoantibodies) that mistakenly attack the body’s own tissues. In PsA, inflammatory processes are overactive. It is considered immune-mediated. Autoantibodies are present, but they aren’t tested clinically.
This article will discusspsoriatic arthritisvs.lupus, and their similarities and differences, including symptoms, causes, treatment, and more.
PsA is a chronic, inflammatory disease of the joints and theentheses—the places where tendons and ligaments connect to bone. It is common in people with theinflammatory skin diseasepsoriasis.
Much like PsA, lupus is an inflammatory condition that causesinflammationand pain throughout your body. People with lupus experience joint pain, skin sensitivities, rashes, and problems with their internal organs.
Both PsA and lupus are autoimmune diseases, conditions in which the immune system malfunctions and attacks healthy tissues.
Psoriatic ArthritisJoint pain and swellingDactylitis (severe swelling of fingers and toes)Knee, hip, elbow, and chest painHeel and foot pain from enthesitis (inflammation of the entheses)Joint stiffness in the morning and after periods of inactivityChronic fatigueSkin symptoms, with or without psoriasisEye inflammation, redness and pain, blurred or cloudy vision, sensitivity to lightLupusMuscle and joint painSun or light sensitivityMouth ulcersChronic fatigueAnemia (lack of healthy red blood cells)Increased blood clottingBrain fogEye inflammationFeverRashesHair lossChest painLupus nephritis (complication affecting the kidneys)
Psoriatic ArthritisJoint pain and swellingDactylitis (severe swelling of fingers and toes)Knee, hip, elbow, and chest painHeel and foot pain from enthesitis (inflammation of the entheses)Joint stiffness in the morning and after periods of inactivityChronic fatigueSkin symptoms, with or without psoriasisEye inflammation, redness and pain, blurred or cloudy vision, sensitivity to light
Joint pain and swelling
Dactylitis (severe swelling of fingers and toes)
Knee, hip, elbow, and chest pain
Heel and foot pain from enthesitis (inflammation of the entheses)
Joint stiffness in the morning and after periods of inactivity
Chronic fatigue
Skin symptoms, with or without psoriasis
Eye inflammation, redness and pain, blurred or cloudy vision, sensitivity to light
LupusMuscle and joint painSun or light sensitivityMouth ulcersChronic fatigueAnemia (lack of healthy red blood cells)Increased blood clottingBrain fogEye inflammationFeverRashesHair lossChest painLupus nephritis (complication affecting the kidneys)
Muscle and joint pain
Sun or light sensitivity
Mouth ulcers
Anemia (lack of healthy red blood cells)
Increased blood clotting
Brain fog
Eye inflammation
Fever
Rashes
Hair loss
Chest pain
Lupus nephritis (complication affecting the kidneys)
Psoriatic Arthritis
Between 0.06% and 0.25% of the American population has PsA.However, PsA is very common in people with psoriasis—affecting about 30%.Psoriasis occurs because the immune system speeds up skin cell growth and causes skin cells to build up as itchy, red scales on the skin.
Psoriatic arthritis can develop slowly and cause mild symptoms, or it can develop quickly and aggressively. Some people may develop the condition after an injury or an illness, but researchers believe the condition is related to genetics.
PsA is known for causing many problems in the body. Most people with the condition will have multiple symptoms that range from mild to severe. The most common symptom of PsA is joint pain, swelling, and stiffness.
Psoriatic arthritis is considered a type of inflammatory arthritis because joint inflammation occurs as a result of an overactive immune that affects many joints throughout the body at once.
Additional common symptoms of PsA are:
Lupus
According to the Lupus Foundation of America, lupus affects 1.5 million Americans and 5 million people worldwide.Most people with lupus are females of childbearing age, but the condition can affect anyone regardless of age or sex, including males,children, and teens.
Lupus is less common in White populations than in Black, Latinx, Native American, and Pacific Islander populations.
There are different types of lupus, the most common of which is SLE. Other types of lupus are:
The symptoms of lupus usually come and go. The condition flares up (symptoms worsen) and sometimes goes into remission (periods when it improves).
Lupus symptoms might include:
Lupus is also known for causing symptoms and conditions that affect the brain, spinal cord, or nerves.Examples of these symptoms or conditions are:
Both PsA and lupus start in theimmune system—the body’s defense against foreign substances, such as bacteria and viruses. With autoimmune diseases like PsA and lupus, the immune system malfunctions and attacks its own healthy tissues. Treatment focuses on calming inflammatory and autoimmune processes.
The cause of PsA is unknown, but researchers suspect it develops from a combination of genetic and environmental factors. They also think immune system troubles,infections, physical and emotional traumas, and obesity might play a part in the development of the condition.
The people with the highest risk for PsA are people with psoriasis.About 30% of this group will go on to develop PsA. Of course, not everyone with PsA will have psoriasis first and some people with PsA never get psoriasis.
Research studies show people with PsA have increased levels oftumor necrosis factor(TNF) in their joints and affected skin areas.TNF is an inflammatory protein responsible for conditions like PsA and lupus. High levels of TNF can overwhelm the immune system and inhibit its ability to control inflammation.
Your risk for PsA is high if the PsA or psoriasis runs in your family. Over 40% of people with PsA have a family member with PsA or psoriasis.
PsA affects people of all sexes equally.It most commonly affects people in middle age, but anyone can get PsA regardless of age, including children. Psoriatic arthritis isdiagnosed more often in White peoplethan in people who are Black,Latinx,or South Asian.
Symptoms of Psoriatic Arthritis
Researchers believe lupus develops in response to a combination of factors, including hormones, genes, and environmental triggers.
Hormones: Researchers have looked at the relationship betweenestrogenand lupus.While people of all sexes produce estrogen, estrogen levels are higher in females. Additionally, females experience more lupus symptoms before their monthly periods and during pregnancy when their estrogen levels are highest.
However, the studies of people taking estrogen birth control or using postmenopausal therapy haven’t found any increase in lupus disease activity, so much of the research on estrogen and lupus has provided mixed answers.
Genetics: Researchers have identified more than 50 genes linked to lupus.These are genes mostly seen in people with lupus. While many of these genes are not shown to directly cause the disease, they are believed to contribute to it.
However, genes alone are not enough to cause the condition. Additionally, while family history increases your risk, you can still develop lupus without a family history of the condition.
Research has also foundcertain ethnic groups, including people of African, Asian, Native American, Hawaiian, or Pacific Island backgrounds, have a greater risk for lupus.Researchers believe this is because these groups have lupus-related genes in common.
Environment: Most researchers think lupus is linked to environmental triggers, such as viruses or chemicals.When these types of triggers encounter a genetically susceptible person, the disease develops.
Researchers have not yet identified specific triggers, but they have some theories. Potential triggers might include ultraviolet light, infections and other illnesses, sulfa drugs, medications that can make a person sun-sensitive, chronic stress, trauma, and exposure to silica dust (in industrial settings)
Causes and Risk Factors of Lupus
There is no single test that can confirm PsA or lupus, but doctors will employ different testing methods to determine the source of your symptoms.
Each condition has diagnostic criteria that are used in classification. The classification criteria for psoriatic arthritis (CASPAR) was developed for clinical trials.The 2019 joint European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR) classification criteria may be used for SLE.
Diagnosing PsA can be complex. Some telltale signs of PsA can help aid in a diagnosis, including inflammation of one or more joints, tendon inflammation, swollen fingers and toes, spine inflammation, and nail and skin symptoms. Your doctor will look for and ask you about these specific symptoms if they suspect PsA.
Your healthcare professional will also request arheumatoid factor(RF) test. RF is a protein found in the blood of people withrheumatoid arthritis(RA), another type of inflammatory arthritis that attacks the lining of the joints.
Another blood test used to rule out RA is ananti-cyclic citrullinated peptide(anti-CCP) antibody test. Both RF and anti-CCP testing will be negative in people with PsA.An X-ray of the hands and feet can look for any bone or joint damage that has already occurred.Psoriatic arthritis often causes bone erosionsand other joint damage not seen with other rheumatic conditions.
Your doctor may request additional testing and blood work to rule out other causes of symptoms if they are still unsure of your diagnosis.
Lupus can be hard to diagnose because it causes symptoms that are seen in other conditions, including other autoimmune diseases. People can have lupus for many years before they are diagnosed.
If you start to experience symptoms of lupus, your doctor needs to know right away. They will use many different testing methods to determine the source of your symptoms.
In reaching a diagnosis, your doctor will:
Your healthcare provider will also request additional testing to rule out other conditions that might be confused with lupus.
Both PsA and lupus are lifelong conditions that require long-term care. Doctors can recommend the best treatments for each condition. Sometimes, these treatments overlap.
Many treatment options are effective for treating symptoms of PsA. Your doctor will prescribe medications based on disease and symptom severity.
Treatment options for PsA include:
People with PsA who have skin symptoms might also be treated withtopical treatments, including corticosteroid creams and anti-inflammatory medications. Skin symptoms can also be treated withphototherapy(exposing the skin to UV light), which can reduce and manage itching and skin pain.
Surgery is rarely an option for treating PsA, but it is recommended in situations in which joints have been severely damaged and to relieve pain and improve your mobility.
Additional interventions for treating and managing PsA are:
There are several types of medicines used to treat lupus. Your healthcare provider will determine what drugs might best help based on your symptom and disease severity.
Different types of treatments for lupus might include:
Both PsA and lupus are linked to genetic and environmental factors and that means it may not be possible to prevent them.
Researchers know that people with psoriasis have a higher risk for PsA and some people have genetic markers that put them at risk for the condition. However, there is no treatment or tool to prevent someone from getting PsA. And there is no way to predict who may go on to develop the condition.
Some triggers and risk factors for PsA can be prevented—things like smoking, diet, and chronic stress. But even with managing these types of triggers, a person can still end up with PsA.
If PsA or psoriasis runs in your family and you have concerns about your risk, reach out to your healthcare provider for a discussion and evaluation. This way you can get ahead of any problems and reduce the risk for serious joint damage, which is often seen early in PsA.
Much like PsA, lupus is not preventable. Researchers have tried to identify early signs of lupus in hopes of intervening to prevent the start of the condition.
For example, they have looked at people who are predisposed genetically and who might experience environmental insults, such as infections. These types of studies have been helpful, but they have not provided answers on ways to prevent the condition.
Because of the limited answers, doctors recommend that people with a family history of the condition do what they can to reduce their risk. This includes things like not smoking, getting adequate sleep, eating healthily, and maintaining a healthy weight.
Summary
Psoriatic arthritis and lupus are both autoimmune conditions that affect the skin and joints. While they share some similar symptoms, they are separate conditions. It is possible to have both conditions because their disease processes are similar.
Once a diagnosis can be confirmed, both PsA and lupus can be treated and managed effectively. They are both lifelong conditions, and neither can be cured. If either of these conditions runs in your family, talk to your doctor about your specific risk and what you can do to reduce it.
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