Does anyone have RA and Psoriasis? If so, how are you been treated fo?

Posted by eleazarandroxy @eleazarandroxy, Jun 13 7:22pm

I am a psoriasis sufferer for many years and have been taken Methotrexate-6 pills every week. About 10 years ago I was also diagnosed with RA and finally found relief with Orencia.
Currently, my psoriasis is really bad, and my rheumatologist and dermatologist are trying to agree on a medicine that will treat both of them. Any advice?

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Triamcinolone cream is what they have me using

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@eleanzarandrotsky. Welcome to Mayo Clinic Connect! I’m so glad you found this site. While we wait for members to join the conversation, I suggest that you go to the RA discussion group and the Skin Health Group.
https://connect.mayoclinic.org/discussion/rheumatoid-arthritis-ra-introduce-yourself-and-meet-others/ This group is for RA and started awhile ago but continues today.
The second link goes to a podcast done some years ago
https://connect.mayoclinic.org/blog/podcasts/newsfeed-post/got-itchy-red-skin/
Have you thought about getting in touch with a rheumatologist or dermatologist at a major medical center or university teaching hospital? They may have an answer for you.

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Have your doctors ruled out psoriatic arthritis? It's a distinct but related disease to both psoriasis and rheumatoid arthritis, and it can present first with arthritis symptoms.

I have seronegative rheumatoid arthritis plus various skin conditions that I believe are psoriatic-like or pre-psoriasis. I'm on Plaquenil, methotrexate, and Enbrel with triamcinolone for skin flares. I started on the plaquenil, but the symptoms broke through so my rheumatologist added methotrexate, and then again added Enbrel.

Maybe it's time to ask your doctors about the biologics. For example, Enbrel is approved for rheumatoid arthritis, psoriasis, and psoriatic arthritis (plus two other conditions). The other agents also have approvals for these and related diseases.

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Did you try avoiding the foods that trigger psoriasis?

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Hi
I have psoriasis and then the joints of my hands became very swollen,painful,stiff.I became overwhelmed with severe fatigue as if a truck ran me over.It took at least a couple of hours before I felt like I could move more easily and my hands limited every daily activity.Opening car door,,buttons,jars that had already been opened from new,doing my shoe laces to pulling on winter boots .After getting to see a Rheumatologist and doing bloodwork,ultrasound of both hands ,and X-ray of hands , was diagnosed with Psoriatic Arthritis.
The rash actually started first on my front shins up to my knee.Dermatologists told me I was scratching myself and prescribed cortisone type creams and fucidin ,Elidel.and MometasoneFuroate cream.The only cream that works is the Mometasone .However I started getting flare ups on my face of itchy patches of bumpy nodules as well as on my scalp ,and neck . Was going mad with the itching and spreading of the face rash which I’m getting diagnosed in a month when I finally get to see a Dermatologist.
I have the typical psoriasis plaque on my knees ,elbows ,forearm,but these go away with Mometasone ,and keeping my skin clean and moisturizing after a shower.
Psoriatic Arthritis is very damaging to fingers joints.My Dr told me the disease damages the ligaments holding the bones in place ,and this is what causes the occasional slipping of the joint over to one side ,or loss’s of grip when holding a glass of water,
Also there is a lot of pain in Psoriatic Arthritis.
It’s a terrible disease.
Your joints become inflamed and painful and then disfigured.
The best medicine that stops this damage is Biologics
These medications are amazing at what they do .
You should read up on the physiological process of how they work.
I can’t remember exactly their process so looking it up is helpful because you can advocate for yourself on which Biologic works best for you.
I was on Cosentyx for 18 months with amazing results at first.I could see the swelling reducing which meant the joint integrity was being preserved not destroyed.
However it started having more swelling and pain,So I asked my Rheumatologist to try a different type.I tried
Humera which is very popular and successful.
It actually did nothing
So I looked up the other types of biologics and found one group that works differently
It’s Taltz from EI Lily drug company and it’s doing amazing for me
My fingers are no longer swollen
I still get stiffness in the morning but doing exercises for your g
Hands I’d very important to keep stretches and strengthening using a soft ball,or I sew and like to hand wash some items which exercise by squeezing water out ,and picking up pins in sewing and cutting fabric etc
So if you have a hobby it’s very important to keep socializing and making things for people etc
The one aspect of Psoriatic Arthritis is the depression one feels as you can no longer do what you used to do for enjoyment.So I started walking every day and sewing and swimming
Keep in mind if you overdo an activity it will be very painful night
I got Morphine low dose for nights or days of bad pain.Otherwise I use Tylenol Extra Strength because I have heart disease.
The Biologics help reduce pain for sure
But it can’t stop you from having fun one day and overdoing it
We still have to live and enjoy life
I hope this helps you understand how I dealt with my diagnosis.It started in 2018 and my first visit to a Dermatologist was 3 years later because everyone told me it was just psoriasis.
Finally when my hands became so badly covered in plaques and skin cracking open and bleeding did I get to see a second Dermatologist who was knowledgeable on Biologics and funding of the cost
I live in Canada so it’s different in USA
Here the Trillium programme covers the full cost.
The specialist makes the referral to them and they do a phone call assessment of what your physical limitations are as well as the Drs report
Now I receive this Taltz from a special pharmacy in Ontario that delivers to your door the biologic .They deliver it anywhere in Ontario if you are travelling.
I hope your journey is less rocky than mine but eventually everything works out if you try hard enough.

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I just wanted to add that sleep,diet and exercise are excellent at helping reduce symptoms.
Eating more fruits and vegetables as well as activity to keep joints moving.
I love chocolate and still eat it almost daily.
It is actually good for pain Coffee is another good pain reliever
But everything in moderation and especially if bloodwork is off then you need to adjust your special foods like chocolate

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Very difficult to be certain if one has psoriatic or rheumatoid arthritis with
the psoriasis developing first it might suggest it is psoriatic arthritis.
If your RA serology is positive that complicates classification.
Your doctors don’t need to agree on all the findings if they can suggest a biologic that has effects in both diseases as the cytokine targets of the
inflammation can overlap. Orencia should not be used with other biologics
Consider a Mediterranean diet and have your cardiovascular risk evaluated.
A good start might be a broad spectrum target like a TNF agent.
Humira is working well for my PsA.

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