Psoriatic arthritis (PsA) is a diverse disease by manifestations, but also timing of cutaneous and musculoskeletal symptoms onset. Timely recognition of disease symptoms in primary care and referal to specialists is of importance in order to manage disease and associated comorbidities.To investigate whether the order of symptom onset associate with distinct clinical profiles of PsA.PsA patients were randomly invited to participate in the study at routine visit.  The study investigated 121 patients who recalled and reported order of symptom onset. Data on subjective and objective variables were analysed across the identified subgroups: those whose symptoms started with psoriasis (PF, 53.7%), arthritis (AF, 26.5%) or simultaneously both (S, 19.8%).In the PF subgroup, age at onset of musculoskeletal symptoms correlated negatively with time to PsA diagnosis (r=-0.44, p<0.001) and these patients had the most prominent dyslipidaemia. The S subgroup had the shortest time to diagnosis and a higher proportion of patients had less active PsA disease, and also a healthier lipid profile. Higher proportion of AF subgroup had higher disease activity at inclusion, were overweight (50%) or obese (35.5%), and waited the longest time to PSO diagnosis. Temporomandibular joint involvement was observed in 20.7% and axial PsA in 17.5%, with similar frequencies across the subgroups. Overall, 25.5% reported sexual problems, with the lowest frequency in the PF subgroup (16.5%). Depression was as common across the subgroups (19.6%).The study demonstrates that order of symptom onset in PsA is associated with different PsA profiles: the S group had shortest waiting time to diagnosis, healthier lipid profile and higher proportion of patients had low active disease, and suggest that timely diagnosis might provide better outcomes. The PF subgroup waited longest time for PsA diagnosis, in particular those who developed MSK symptoms at younger age; PF had most pro-atherogenic lipid profile and delayed treatment could be contributing factor. AF patients had high disease activity at inclusion, but also highest incidence of overweight or obesity, and could benefit of both inflammation and weight reducing therapies.Altogether we demonstrate that order of symptom onset reveal distinct PsA profiles and early diagnose is of importance.