Psoriatic arthritis (PsA) manifests clinically as a heterogeneous disease with phenotypically highly variable expression. Most of those affected already suffer from skin psoriasis. Predicting which psoriasis patients are at increased risk for developing joint involvement is proving difficult, but is critical for early therapeutic intervention. These and other challenges in the management of PsA were discussed from an interdisciplinary perspective at the World Psoriasis & Psoriatic Arthritis Congress.