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Consistent with this concept, up to 30% of individuals with PsO eventually develop PsA, a chronic inflammatory arthropathy affecting peripheral joints, entheses, and the axial skeleton ( Early PsA may display nonspecific musculoskeletal symptoms, such as inflammatory arthralgia or morning stiffness, even in the absence of overt synovitis or radiographic erosions ( At the pathogenic level, PsO and PsA share core inflammatory mechanisms driven by dysregulation of the IL17/IL23 and Tumour Necrosis Factor (TNF)- cytokine axes ( These immune pathways are closely intertwined with metabolic abnormalities, particularly obesity and adipose tissue dysfunction