It isn’t unusual for Dr. Erin Boh, DO, MD, to see 10 or 12 cases of psoriasis every day at the Dermatology Clinic at Charity Hospital in New Orleans. And not a single patient leaves her office without Dr. Boh having at least thought about whether that person might have psoriatic arthritis (PsA).

Dr. Boh, who is the clinic’s dermatology director and also a professor of dermatology at Tulane University, knows how important proactive vigilance is in diagnosing and treating psoriatic arthritis. 

“Early detection is so important, it’s why, in my setting, we examine and question even the 20-year-olds,” she says. “As part of our regular exam, we have patients fill out questionnaires about joints and stiffness in the morning, even if they haven’t said anything about that.”

Diagnosing and then treating the inflammation that characterizes the disease before it causes joint damage is critical. However, Dr. Boh believes she’s in the minority in her field when it comes to carefully keeping an eye out for signs of psoriatic arthritis among those diagnosed with psoriasis.

“General dermatologists don’t do that as often, but there are some of us trying to educate our colleagues to do that earlier in the game so we don’t miss the joint disease. It is a very hard condition to diagnose.”

Denise Ladelia, 37, of Rochester, N.Y., found that out the hard way. When she was diagnosed with psoriasis at 15, her dermatologist never mentioned the possibility of psoriatic arthritis. She was caught off guard when the disease flared four years later.

“I went to a rheumatologist who diagnosed it right away,” she says. “At that time, we knew nothing about psoriatic arthritis. I went back to my dermatologist and asked why he never mentioned this to me. He said, ‘If I told everyone who had joints ache about psoriatic arthritis, everyone would think they had it.’ That made me pretty mad.”