Instead of lesions, psoriasis can sometimes lead to arthritis. The clinical presentation is highly variable, and psoriatic arthritis often occurs alongside other forms. The most common effect of this type of arthritis is painful inflammation that affects the joints and their surrounding connective tissue, usually in the fingers and toes. Inflammation can then lead to sausage-like swelling called dactylitis. Some people develop psoriatic arthritis in the hips, knees, spine, and sacroiliac joint, though these areas are less common.

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