Most people think of psoriasis as a condition that begins and ends with the skin. The dry, scaly patches and persistent itching are hard to ignore, so it’s easy to assume that’s where the problem stops. But for thousands of people, psoriasis is only part of a much bigger picture. Experts say psoriasis is an immune-mediated inflammatory disease, and in some people, the same inflammation that affects the skin can eventually spread to the joints, leading to psoriatic arthritis, a condition that can cause pain, stiffness, swelling and, if left untreated, permanent joint damage.