DEAR DR. GOTT: I am a 59-year-old male. I am fairly active. I have read your column for some time and have tried your numerous recommendations and remedies for psoriasis as well as prescription ointments and creams.

In 2007, I started developing pain in the joints of my feet and hands. When I touch these areas, they are painful and feel swollen.

Can this pain be related to my psoriasis condition? I read somewhere that psoriasis can cause an arthritic condition. What can I do to prevent further damage? I fear my joint pain will worsen as I get older and hope you can help me.

DEAR READER: Up to 30 percent of people with psoriasis develop psoriatic arthritis. Men are more commonly affected than are women.Psoriatic arthritis usually develops between the ages of 30 and 50 and often after psoriasis has been diagnosed on the body. Rarely, the arthritis develops before the skin manifestations.Like other forms of arthritis, joint pain, swelling and stiffness are the primary symptoms. There are five variations of psoriatic arthritis. The most severe but least common is known as arthritis mutilans, which causes severe, painful and disabling joint pain that can, over time, destroy the small bones of the hands (primarily the fingers), leading to permanent deformity and disability.Another rare variation, known as distal interphalangeal joint predominant psoriatic arthritis, causes pain and swelling of the finger joints nearest the nails. There may also be discoloration, pitting and thickening of the nails similar to that caused by fungus.A third type, spondylitis, causes swelling and stiffness of the neck and lower back. It may also affect the ligaments and tendons that attach to the spine. Over time, this type of psoriatic arthritis can cause painful, difficult movement.The final two types are asymmetric and symmetric, which are the most common types of psoriatic arthritis. Symptoms of both generally resemble that of osteoarthritis and/or rheumatoid arthritis, and may be initially misdiagnosed as such. Asymmetric usually affects fewer than five joints on one side of the body or different joints on both sides of the body (such as the left knee, right shoulder, etc.). It is the mildest form.Symmetric often affects more than five joints equally on both sides of the body, such as both hips and both knees. The psoriasis associated with this form is often severe.There is no definitive test for psoriatic arthritis, but there are tests for other types. I urge you to return to your physician for examination and testing. Perhaps you have osteoarthritis or rheumatoid arthritis. If he or she is uncomfortable making a diagnosis, request a referral to a rheumatologist. This type of specialist is up-to-date on autoimmune disorders such as rheumatoid and psoriatic arthritis.In the meantime, over-the-counter anti-inflammatory medications such as ibuprofen may help ease the swelling and pain. Regular exercise and the use of hot and cold packs may also provide some relief. Other possible over-the-counter treatment options include glucosamine/chondroitin and fish-oil supplements.It is important to discuss this issue and any OTC relief options you may choose with your physician prior to initiating them. This may help ensure the risk of interactions between medications (both prescription and not) are minimal.

To contact the doctor, address letters to Dr. Gott c/o United Media, 200 Madison Ave., 4th fl., New York, NY 10016.