Specialist for Arthritis and Psoriatic Arthritis
A rheumatologist is the specialist who should primarily care for arthritis issues, including psoriatic arthritis. 1
Primary Specialist Responsibility
Rheumatologists are the designated experts for managing the musculoskeletal manifestations of psoriatic arthritis, given their extensive experience with the many drugs used to treat rheumatic and musculoskeletal diseases, including critical aspects of safety and comorbidities. 1
The 2024 EULAR (European League Against Rheumatism) guidelines explicitly state that rheumatologists should be the primary specialists caring for patients with psoriatic arthritis, with a level of agreement of 9.7/10 among expert taskforce members. 1
When Dermatology Collaboration is Required
When clinically relevant skin involvement is present alongside joint disease, a rheumatologist and dermatologist should collaborate in diagnosis and management. 1
Dermatologists are the primary specialists for managing skin manifestations of psoriasis, while rheumatologists handle the joint disease. 2
Patients with psoriasis should be referred to a rheumatologist when they develop joint pain, stiffness, swelling, enthesitis (tendon/ligament insertion inflammation), dactylitis ("sausage digits"), or nail involvement. 2
Multidisciplinary Approach
Psoriatic arthritis is a heterogeneous and potentially severe disease that may require multidisciplinary treatment, though the rheumatologist remains the primary coordinator of musculoskeletal care. 1
Consultation with other specialists (ophthalmology for uveitis, gastroenterology for inflammatory bowel disease) may be helpful in individual clinical scenarios. 1
Clinical Context
This specialist designation is critical because psoriatic arthritis can cause progressive joint damage in 50% of patients if left uncontrolled, affecting quality of life through symptom burden, structural damage, and loss of function. 3
Treatment decisions must be based on shared decision-making between the patient and rheumatologist, considering efficacy, safety, patient preferences, and costs. 1