The Critical Need for Multidisciplinary Care and Early Screening in PsA

At the SDPA Fall 2025 conference, Shikha Singla, MD, associate professor of medicine at the Medical College of Wisconsin and Medical Director of the Psoriatic Arthritis Program, discussed the complexities of psoriatic arthritis (PsA) and psoriasis during her session with Kenneth Gordon, MD.¹ She emphasized the importance of multidisciplinary care, noting that effective management often requires collaboration among dermatologists, rheumatologists, gastroenterologists, and ophthalmologists. While the presentation focused primarily on joint involvement, it also addressed the significant overlap between psoriasis and PsA.

Singla highlighted a unique clinic model where dermatologists screen patients for PsA and immediately involve a rheumatologist, eliminating long referral delays. This real-time collaboration allows specialists to discuss and decide which disease domain—skin, joints, or others—is most burdensome for the patient, ensuring that treatment decisions are patient-centered and efficient.

During the session, she shared key insights on epidemiology, pathogenesis, and clinical differentiation of PsA. Dermatologists were encouraged to become proficient in basic joint examination techniques, as joint pain in psoriasis patients can result from various causes, including osteoarthritis, rheumatoid arthritis, or fibromyalgia.

Understanding how to recognize inflammatory arthritis and identify red flag signs can lead to earlier diagnosis and referral. The session also reviewed current management strategies, including both conventional disease-modifying agents and biologics. While some biologics demonstrate superior efficacy in psoriasis, comparable data for PsA remain limited, underscoring the need for collaborative decision-making between dermatologists and rheumatologists.

Singla stressed the need for routine PsA screening in psoriasis patients, as approximately ¼ to 1/3 will develop PsA, often years after their initial diagnosis. The National Psoriasis Foundation recommends screening every 6 months, as delays beyond this period can result in irreversible joint damage and reduced quality of life.

Finally, she identified major unmet needs in PsA treatment. Despite a wide range of available therapies, about half of patients fail to achieve a 70% clinical improvement (ACR70 response). Singla concluded by calling for continued research and education to better distinguish inflammatory from non-inflammatory pain sources and to optimize treatment outcomes for this complex and challenging disease.

Reference

1. Gordan K, Singla S. Psoriasis and Psoriatic Arthritis. Presented at: Society of Dermatology Physician Associates Fall 2025 Conference; November 5-9, 2025; San Antonio, Texas.