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Psoriatic arthritis is part of the big group of spondylarthropaties, presenting numerous clinical forms and having both musculoskeletal and extraarticular manifestations. Usually, the disease diagnosis is set after the presence of clinical signs of skin psoriasis. In that case, the diagnosis is made quite easily. The condition puts a lot of problems regarding differential diagnosis especially in the situation when it precedes the onset of skin lesions. Regarding the presented case, a correct diagnosis of psoriatic arthritis “sine psoriasis” was made after about 20 years of disease evolution, at which time the specific nail lesions of psoriasis appeared.