Skin Rash, Sore Joints? Professor Nicola Ralph on Psoriatic Arthritis in the Irish Independent
Professor Nicola Ralph, Consultant Dermatologist at the Institute of Dermatologists, recently featured in the Irish Independent's Stay Well series, helping readers understand the link between psoriasis and psoriatic arthritis (PsA), an autoimmune condition that can affect the joints as well as the skin.
Written by Features Writer Emer Harrington, the piece was prompted by British actor Adam Thomas speaking publicly about living with PsA during his time on I'm a Celebrity South Africa, describing the physical and emotional toll of the condition. It is a useful prompt, since PsA is thought to affect around 30,000 people in Ireland, many of whom may not connect their joint symptoms back to their skin.
What Is Psoriatic Arthritis?
PsA is an autoimmune, inflammatory form of arthritis closely linked to psoriasis. According to the article, up to one in three people with psoriasis will go on to develop PsA. Professor Ralph explained that it generally appears in people who already have psoriasis of the skin, often for years beforehand, although in occasional cases it can develop without any visible skin involvement at all. She noted that a significant proportion of psoriasis patients, broadly in the region of 20 to 30 per cent, may develop psoriatic arthritis at some point in their lifetime, with those who experience nail changes being more likely to go on to develop joint symptoms.
What Are the Early Warning Signs?
One of the most useful points Professor Ralph raised is that the skin and nails often give early warning of PsA before joint pain ever appears. She pointed to two key signs worth watching for: cutaneous psoriasis, which shows up as pink or red scaly patches with silvery white scales, and changes to the nails, including thickening, pitting, or discolouration. In her experience, these visible changes are typically noticed well before a patient experiences any joint symptoms, which makes them a valuable early indicator rather than something to dismiss as a cosmetic issue.
The wider article also explores how PsA differs from age-related osteoarthritis, the psychological toll of living with a chronic, often invisible condition, and how diagnosis and treatment, including biologic therapies and physiotherapy, have advanced in recent years.
Why Early Recognition Matters
Joint damage caused by PsA can become permanent if left untreated, which is why Professor Ralph's emphasis on recognising the early skin and nail signs is so important. For anyone with psoriasis noticing new nail changes or unexplained joint stiffness, that combination is worth paying attention to and discussing with a healthcare professional.
You can read the full article, “Stay Well: I have a skin rash and sore joints — could it be psoriatic arthritis?”, on Independent.ie.
Many thanks to Emer Harrington and the Irish Independent for featuring Professor Nicola Ralph's expertise in this piece.
