Table of ContentsView AllTable of ContentsSigns and SymptomsCausesAssociated ConditionsDiagnosisTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Signs and Symptoms
Causes
Associated Conditions
Diagnosis
Treatment
Coping
“Dactylitis” is the clinical name for when your fingers and toes are swollen, tender, warm, and inflamed due to apsoriatic arthritis (PsA) flare-upor an associated condition. The name comes from the Greek word for finger (“dactylos”).
With dactylitis, your fingers can become so swollen that they look like sausages, which is why this condition and characteristic symptom is sometimes referred to as “sausage fingers” or “sausage digits.” Swelling in the toes can make it difficult to get around.
Verywell / Jessica Olah
Signs and Symptoms of Dactylitis
Dactylitis in PsA, a chronic, inflammatory disease of the joints that can also cause a skin disorder called psoriasis, often occurs asymmetrically, meaning on just one side of the body. It involves the feet more than the hands, and it affects multiple digits (fingers or toes) at the same time.
Dactylitis is common in 16%–49% of people who experience psoriatic arthritis.It can be the first sign of the illness, and it may also be the only symptom for several months or years before other symptoms of PsA develop.
Symptoms in affected fingers or toes include:
Symptoms of Psoriatic Arthritis
The underlying cause of dactylitis in PsA is an overactive autoimmune response, when your body mistakenly attacks healthy tissue. It results in inflammation in the finger or toe joints, making digits swell. When you have PsA, you can experience skin symptoms and joint pain on one or both sides of your body andpsoriasis, scaly, itchy patches of skin, anywhere on your body.
Genetics
Around 25% of patients with autoimmune diseases have a tendency to develop additional autoimmune disorders.Factors that may cause PsA or other autoimmune diseases include genetics and the environment.
Researchers say three genes in particular cause inflammatory illnesses. These genes are:
Dactylitis in PsA, in particular, is associated with specific gene expressions called human leukocyte antigen (HLA) B alleles that are part of your immune system. Specific HLAs that are established genetic markers for dactylitis in PsA include:
A specific gene signature associated with inflammatory diseases can be identified. It significantly overlaps with other gene structures associated with digestive disorders, cancers, and disorders affecting brain functioning (neurodegenerative disorders).
Will a Gene Guarantee a Diagnosis?Just because you have certain signature genes doesn’t mean you will develop an autoimmune disorder or inflammatory disease, though. Some gene expressions need specific triggering to activate, such as certain symptoms that only appear after injury or infection.
Will a Gene Guarantee a Diagnosis?
Just because you have certain signature genes doesn’t mean you will develop an autoimmune disorder or inflammatory disease, though. Some gene expressions need specific triggering to activate, such as certain symptoms that only appear after injury or infection.
Besides PsA, you may have other underlying conditions that contribute to or cause dactylitis. Researchers have used ultrasound and magnetic resonance imaging (MRI) technologies to gain a deeper understanding of dactylitis, but the exact cause is still unknown.
Conditions that may cause dactylitis other than psoriatic arthritis include:
Hormonal Changes During Menstruation and PregnancyThe hormonal changes leading up to and during menstruation as well as throughout pregnancy can cause whole-body fluid retention, but common localized sites of swelling include hands and feet. While the hormonal changes can’t always be treated, swelling can be managed with different treatment options.
Hormonal Changes During Menstruation and Pregnancy
The hormonal changes leading up to and during menstruation as well as throughout pregnancy can cause whole-body fluid retention, but common localized sites of swelling include hands and feet. While the hormonal changes can’t always be treated, swelling can be managed with different treatment options.
Best Ways to Reduce Arthritis Inflammation in Joints
Your doctor will diagnose dactylitis based on a physical examination, X-rays or MRI (magnetic resonance imaging) scans, and your symptom history. You will also likely be tested for various biomarkers, or indicators, in your blood that can provide a better idea of current levels of inflammation or damage.These tests can also help narrow down treatment options and indicate whether you have other conditions that may be causing the swelling.
Some examples include blood tests andsynovial fluid analyses(to test the thick liquid that lubricates joints) that can help your doctor rule out other types of arthritis, such asgout,rheumatoid arthritis (RA), orosteoarthritis (OA).
If the cause of dactylitis is PsA, you will likely work with a rheumatologist (a specialist who diagnoses and treats diseases of the muscles, bones, joints, ligaments, and tendons) to determine the best course of treatment to help manage symptoms.
NSAIDs
NSAIDs (nonsteroidal anti-inflammatory drugs)are typically the first-line treatment for pain relief and reducing inflammation.These come in over-the-counter (OTC) and prescription strengths depending on pain severity.
OTC NSAIDs include Advil and Motrin (ibuprofen), Aleve, (naproxen), and aspirin. Side effects typically include upset stomach, dry mouth, and drowsiness. These medications can be dangerous if taken in high, frequent doses, potentially causing gastritis, ulcers, and kidney dysfunction.
Topical pain relievers
Ointments and creams are available to reduce pain and swelling in the fingers and to help with symptoms of psoriasis. The American Academy of Dermatology recommends products that contain calamine, camphor, hydrocortisone, or menthol.These ingredients tend to work best on itchy psoriasis.
Due to the sensitive nature of skin with psoriasis, be sure to check the label for ingredients that could cause burning, itching, or other adverse reactions. Do a patch test on a small area of skin before applying to a larger area.
OTC creams containinghydrocortisone1% or prescription-strength 2.5% applied twice daily are said to be effective in many cases. Stronger options do exist, if needed.
DIP Psoriatic Arthritis (DIP PsA) Symptoms and Treatment
Prescriptions
In addition to prescription-strength NSAIDs and hydrocortisone cream, you can ask your doctor or dermatologist about safe and effective options like:
Opioid WarningOpioids can be highly addictive and should not be taken for extended periods of time. Side effects of narcotic painkillers include constipation, stomach upset, dizziness, itchy skin, and drowsiness or sedation.
Opioid Warning
Opioids can be highly addictive and should not be taken for extended periods of time. Side effects of narcotic painkillers include constipation, stomach upset, dizziness, itchy skin, and drowsiness or sedation.
Newer drugs are also available for psoriatic arthritis and include:
Coping with PsAcan include making lifestyle changes, including those in the following list.
Product changes
Take an assessment of your current soaps, detergents, and lotions. Do they have skin-drying ingredients? Or, do they leave a filmy residue on your skin? Many skin care products can trigger psoriasis symptoms.
Use scent- and dye-free options to reduce irritation. Look for options with coal tar, an ingredient derived from coal that can help reduce psoriasis symptoms, including redness, swelling, and itching.
Reduce and manage stress
Any steps to reduce or manage your stress levels in general can also help delay PsA flare-ups. Stress contributes to inflammation and both of them create challenges to other activities that are necessary for general well-being like exercising, stretching, or socializing with others.
Reducing stress can include things like offloading some tasks from your proverbial plate or learning to get comfortable with “good enough.”
Nutritional choices
If you have dactylitis from psoriatic arthritis or another condition, you may have already noticed how consuming certain foods and beverages can worsen symptoms. Certain ingredients, especially if consumed in excess, can make joint or skin inflammation symptoms worse.
Foods that increase fluid retention include those with added salt and highly processed foods. It’s important to monitor how your favorite foods affect your symptoms, including swelling, and act accordingly.
What Are the Best Anti-Inflammatory Foods?
If your fingers or toes are swelling or flaring up, talk to your doctor. The causes of dactylitis are many and can range from factors out of your control (genetics) to those you can change (lifestyle modifications). It’s good to know why your body is creating this type of inflammation. Seeing a doctor will identify the cause of your dactylitis, which can help you find the right solutions, get the quickest relief possible, and keep future flare-ups atbay.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kaeley GS. Eder L. Aydin SZ, Gutierrez M, Bakewell C.Dactylitis: A hallmark of psoriatic arthritis.Seminars in Arthritis and Rheumatism. 2018 Oct;48(2):263-273. doi:10.1016/j.semarthrit.2018.02.002Mohan MP, Ramesh TC.Multiple autoimmune syndrome.Indian J Dermatol Venereol Leprol. 2003 Jul-Aug;69(4):298-299.Zhao Y, Forst CV, Sayegh CE, Wang IM, Yang X, Zhang B.Molecular and genetic inflammation networks in major human diseases.Mol Biosyst. 2016 Jul 19;12(8):2318-2341. doi:10.1039/c6mb00240dCleveland Clinic.Edema.UpToDate.Patient information: Psoriatic arthritis (Beyond the basics).Food and Drug Administration.Finding and learning about side effects (adverse reactions).American Academy of Dermatology Association.What psoriasis treatments are available without a prescription?.Barrea L, Savanelli MC, Di Somma C, Napolitano M, Megna M, Colao A, Savastano S.Vitamin D and its role in psoriasis: An overview of the dermatologist and nutritionist.Rev Endocr Metab Disord. 2017 Feb 7 ;18(2):195-205. doi: 10.1007/s11154-017-9411-6.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kaeley GS. Eder L. Aydin SZ, Gutierrez M, Bakewell C.Dactylitis: A hallmark of psoriatic arthritis.Seminars in Arthritis and Rheumatism. 2018 Oct;48(2):263-273. doi:10.1016/j.semarthrit.2018.02.002Mohan MP, Ramesh TC.Multiple autoimmune syndrome.Indian J Dermatol Venereol Leprol. 2003 Jul-Aug;69(4):298-299.Zhao Y, Forst CV, Sayegh CE, Wang IM, Yang X, Zhang B.Molecular and genetic inflammation networks in major human diseases.Mol Biosyst. 2016 Jul 19;12(8):2318-2341. doi:10.1039/c6mb00240dCleveland Clinic.Edema.UpToDate.Patient information: Psoriatic arthritis (Beyond the basics).Food and Drug Administration.Finding and learning about side effects (adverse reactions).American Academy of Dermatology Association.What psoriasis treatments are available without a prescription?.Barrea L, Savanelli MC, Di Somma C, Napolitano M, Megna M, Colao A, Savastano S.Vitamin D and its role in psoriasis: An overview of the dermatologist and nutritionist.Rev Endocr Metab Disord. 2017 Feb 7 ;18(2):195-205. doi: 10.1007/s11154-017-9411-6.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kaeley GS. Eder L. Aydin SZ, Gutierrez M, Bakewell C.Dactylitis: A hallmark of psoriatic arthritis.Seminars in Arthritis and Rheumatism. 2018 Oct;48(2):263-273. doi:10.1016/j.semarthrit.2018.02.002Mohan MP, Ramesh TC.Multiple autoimmune syndrome.Indian J Dermatol Venereol Leprol. 2003 Jul-Aug;69(4):298-299.Zhao Y, Forst CV, Sayegh CE, Wang IM, Yang X, Zhang B.Molecular and genetic inflammation networks in major human diseases.Mol Biosyst. 2016 Jul 19;12(8):2318-2341. doi:10.1039/c6mb00240dCleveland Clinic.Edema.UpToDate.Patient information: Psoriatic arthritis (Beyond the basics).Food and Drug Administration.Finding and learning about side effects (adverse reactions).American Academy of Dermatology Association.What psoriasis treatments are available without a prescription?.Barrea L, Savanelli MC, Di Somma C, Napolitano M, Megna M, Colao A, Savastano S.Vitamin D and its role in psoriasis: An overview of the dermatologist and nutritionist.Rev Endocr Metab Disord. 2017 Feb 7 ;18(2):195-205. doi: 10.1007/s11154-017-9411-6.
Kaeley GS. Eder L. Aydin SZ, Gutierrez M, Bakewell C.Dactylitis: A hallmark of psoriatic arthritis.Seminars in Arthritis and Rheumatism. 2018 Oct;48(2):263-273. doi:10.1016/j.semarthrit.2018.02.002
Mohan MP, Ramesh TC.Multiple autoimmune syndrome.Indian J Dermatol Venereol Leprol. 2003 Jul-Aug;69(4):298-299.
Zhao Y, Forst CV, Sayegh CE, Wang IM, Yang X, Zhang B.Molecular and genetic inflammation networks in major human diseases.Mol Biosyst. 2016 Jul 19;12(8):2318-2341. doi:10.1039/c6mb00240d
Cleveland Clinic.Edema.
UpToDate.Patient information: Psoriatic arthritis (Beyond the basics).
Food and Drug Administration.Finding and learning about side effects (adverse reactions).
American Academy of Dermatology Association.What psoriasis treatments are available without a prescription?.
Barrea L, Savanelli MC, Di Somma C, Napolitano M, Megna M, Colao A, Savastano S.Vitamin D and its role in psoriasis: An overview of the dermatologist and nutritionist.Rev Endocr Metab Disord. 2017 Feb 7 ;18(2):195-205. doi: 10.1007/s11154-017-9411-6.
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