Investigating the Relationship Between Psoriatic Arthritis and Peyronie's Disease: A Case Study Analysis

The relationship between psoriatic arthritis (PsA) and Peyronie's disease (PD) remains poorly understood. PsA is a chronic immune-mediated inflammatory disease, whereas PD is a fibroproliferative disorder of the penile tunica albuginea that leads to penile curvature, pain, and sexual dysfunction. Both conditions involve chronic inflammation and dysregulated tissue remodeling. We report the case of a 42-year-old man with long-standing PsA who developed acute inflammatory PD shortly after discontinuing biologic therapy because of loss of insurance and medication nonadherence. The patient presented with new-onset penile pain and a palpable dorsal plaque in the setting of uncontrolled psoriatic disease. Penile ultrasound demonstrated fibrous plaque formation with linear calcifications consistent with early PD. Management included oral pentoxifylline, topical nitroglycerin, and resumption of systemic immunosuppression with secukinumab through a patient-assistance program, resulting in improvement in both penile symptoms and psoriatic disease activity. To contextualize this presentation, we performed a narrative review of the literature examining reported associations between PD and autoimmune or fibroinflammatory conditions. Prior studies have reported heterogeneous epidemiologic findings, with some suggesting an increased prevalence of psoriasis and PsA among men with PD, while others support a shared profibrotic biology mediated by transforming growth factor-β rather than by classic autoimmunity. This case highlights a potential temporal and pathophysiologic association between uncontrolled systemic inflammation and localized penile fibrosis and underscores the impact of social determinants of health on disease progression. Awareness of this possible association may prompt earlier urologic evaluation in patients with inflammatory arthritis and emphasizes the importance of maintaining continuity of biologic therapy in chronic immune-mediated disease.