Empowering Women with Psoriatic Arthritis: Improving the Patient Journey

More than 8 million Americans and 125 million people worldwide have psoriasis, a chronic inflammatory skin disease that is characterized by patches of red or discolored and irritated skin, often covered by flaky white or gray scales, depending on the skin type. An estimated 10-30% of people with psoriasis also develop psoriatic arthritis (PsA), a type of inflammatory arthritis linked to psoriasis. Of those with PsA, 85% develop the skin disease before the joint disease. Psoriasis often appears between the ages of 15-25, while PsA usually develops between the ages of 30-50. 

Both psoriasis and psoriatic arthritis can have significant impacts on quality of life. Symptoms such as joint pain and swelling, bone deformity, discolored and scaly skin patches, and fatigue can be widespread, painful, and debilitating. Nearly 60% of people with psoriasis and approximately 40% of people with PsA report that the disease is a large problem in their everyday life. Studies show that although PsA occurs equally in women and men, women often experience more fatigue and functional limitations, and are less likely to respond to some treatments and achieve remission than men. Moreover, after menopause, women are at an increased risk to develop comorbidities such as fibromyalgia, cardiovascular disease, and Crohn’s disease. 

There is no diagnostic test for PsA; therefore, if patients are not assessed for joint pain during clinical encounters for psoriasis care, significant diagnostic delays can result, and timely diagnosis of PsA is critical to avoid irreversible joint damage. Furthermore, psoriasis is often under-diagnosed among African Americans and other individuals with skin of color due to differences in clinical presentation, likely resulting in a subsequent under-diagnosis of PsA as well. Addressing gaps in research, clinical care, and health care policy, as well as disparities in diagnosis and treatment, would significantly improve the burden on women living with psoriatic arthritis. 

The Society for Women’s Health Research (SWHR) convened an interdisciplinary Psoriatic Arthritis Working Group of health care providers, researchers, patients and patient advocates, and health care policy leaders for a closed, roundtable meeting in June 2022. During the roundtable, the Working Group discussed the significant health, social, and economic impact of psoriatic arthritis on women’s health across the lifespan.