The Role of the Dermatologist in Identification and Treatment of the Early Stages of Psoriatic Arthritis

Skin Therapy Letter. 2008;13(4):4-8. 

In This Article

Treatment

When treating the cutaneous and joint manifestations, as in PsA, each aspect of the disease must be considered. The 2 may be treated independently, although a number ofsystemic therapies may benefit both. Treatment options that can improve both PsA and psoriasis include:

  1. Traditional systemic agents

    • Cyclosporine (3-5mg/kg PO daily)

    • Methotrexate (doses ranging from 15-25mg PO/IM weekly)

  2. Biologic agents (with indication for PsA)

    • Etanercept (50mg SC bi-weekly)

    • Infliximab (5mg/kg IV at week 0, 2, 6 and then every8 weeks)

    • Adalimumab (40mg SC every 2 weeks)

However, some may help one while adversely affecting the other. Drugs that can induce disease exacerbation include:[20]

  1. Drugs that treat arthritis, but may worsen psoriasis

    • Gold

    • Systemic corticosteroids

    • Hydroxychloroquine

  2. Drugs that treat psoriasis, but may worsen arthritis

    • Acitretin

    • Efalizumab

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