Psoriatic arthritis is a complex and heterogeneous disease with significant challenges in diagnosis and management. A delayed diagnosis can lead to irreversible joint damage, reduced treatment efficacy, and it is difficult to achieve remission. When skin involvement is minimal, there are more chances to miss the diagnosis. As such, inappropriate therapies may be applied, such as corticosteroids, exacerbating skin disease and leaving other manifestations uncontrolled. The heterogeneous presentation of psoriatic arthritis, affecting joints, entheses, axial skeleton, skin, intestines and eye, necessitates a comprehensive treatment approach tailored to each domain. Depression is another significant problem in psoriatic arthritis, where medication toxicity, cardiovascular and metabolic complications have a profound impact on mental health. Nowadays, dermatologists are more aware and use screening tools like the PEST that allow patients to be diagnosed at an early stage. Treatment should aim at a personalised level, taking into account comorbidities and areas/organs involved but always in remission or alternatively in LDA. Regular monitoring of comorbidities, mental health and medication side effects ensures a holistic care, improving long-term outcomes and quality of life for patients with psoriatic arthritis.