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Nov 2015

Special Feature by DR. RAMESH KUMAR - Nov 2015


Special Feature by DR. RAMESH KUMAR, MD, OCEAN Rheumatology


Dear Doctor,

I was told that the rash on my elbows, knees and scalp was Psoriasis. The rash has a silvery white build up of skin on it and now I always feel tired. My joints feel stiff and achy and my fingers are swollen like sausages. Please explain this condition.

—Jane. K


Jane it is very likely that you have what is called Psoriatic Arthritis.

30% of people with psoriasis will eventually develop psoriatic arthritis. Although scientists do not know the cause of psoriasis, they do know that it is an autoimmune disease. This means that your immune system isn’t working like it should and begins attacking healthy tissue of your skin and joints. Psoriatic arthritis can start off with fatigue, joint pains, swelling and in some cases changes in the nails. 

Therefore, it is important that the sooner you get treatment, the less likely you are to have joint damage. Although there is no definitive test for psoriatic arthritis, your Rheumatologist will perform a physical exam and need a complete medical history. You may need blood tests, MRI’s, or x-rays. The aim would be to prevent joint damage and reduce the pain and swelling in order to continue a normal active lifestyle. Your Rheumatologist will develop a treatment plan that could include medicines that reduce symptoms such as nonsteroidal anti-inflammatory drugs (NSAIDS).

Other medicines could include disease-modifying antirheumatic drugs (DMARDS), which work to limit the effects of your overactive immune system, and biologics, which target a specific part of your immune system to reduce inflammation.  You may be advised to see an occupational or physical therapist that can teach you exercises to keep your joints strong and flexible to help reduce pain.

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