Psoriasis and Psoriatic Arthritis Symptoms

Question

I have severe psoriatic arthritis, I have tried remicade, humira, and enbrel with no avail. I broke out like chicken pox/measles when I took humuria and let it work out of my system. My face is now breaking out, especially around my eyes, massive scalp yeck, and losing tons of hair. I am over 50, and never had this problem in my younger years. It is getting worse year after year. Is there no help?

Answer

Severe skin psoriasis often requires higher doses of TNF inhibitors than the joint symptoms of psoriatic arthritis do.  Also, the TNF inhibitors work better in combination with methotrexate for both psoriasis and psoriatic arthritis.  For psoriasis, additional biologic agents are available (alefacept and efalizumab) that are licensed to treat moderate to severe plaque psoriasis; however, these agents have little to no effect on the joint symptoms of psoriatic arthritis.  Your dermatologist is the best resource for learning more about these drugs and whether they would be of benefit to you.  

Jon Giles, MD

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