Psoriatic arthritis represents a diverse spectrum of disease, which is a distinct clinical entity. In the foot there can be changes to the toenails, skin lesions and red swollen joints. On rare occasion this condition may also present with heel pain.
Psoriasis is most often associated with patches of skin dryness and scaling. The toenails may demonstrate ‘pitting' which can be discerned from a more common toenail condition called fungal toenails. On rare occasions the patient may present with one or more painful, red and swollen toes. This can occur without obvious evidence of skin lesions. Quite often the only presenting skin lesion may be behind an ear or in the scalp.
There are no blood tests to diagnosis psoriatic arthritis. X-ray finding can assist in making the diagnosis. Characteristic skin lesions are most important in making the diagnosis.
A qualified family practice physician, interest or rheumatologist should manage treatment for the generalized symptoms of the disease. Your podiatrist can manage the localized treatment of heel pain associated with this condition. This may include cortisone injections, calf stretching and special inserts for the shoes called orthotics. Toe and joint deformities in the foot may require surgical intervention.