psoriatic arthritis ( symptoms, couses & treatment)

 

How do I cure psoriatic arthritis ?

After nearly 25 years living with psoriatic arthritis, I have quite a bit of treatment history. Back in the day when I was first diagnosed, women of childbearing age received more conservative treatment and there weren’t that many options as there are now. My symptoms have been polyarticular and migrate between my joints and associated tendons, bursar and soft tissues at varying severity.

First, the nonsteroidal anti-inflammatory‘s were given and I eventually developed G.I. issues from that.

Then I had a very big full body flare and was put on prednisone for six or seven years. Sometime during that time I was on a trial of sulfasalazine and had low white cell count so that was discontinued.

All along this time (8 years) I was trying to get pregnant, so the best course toward that end was to continue to wean down the prednisones and take as little as possible. While I was pregnant and nursing, I was not allowed to take any medication.

After I had my son and was done nursing by that time Enbrel had entered the market. I took it for six months with a good remission of my psoriasis and arthritis

Then I was hospitalized with what was thought to be viral meningitis. Two months later I contracted meningitis again and they realized that maybe the first time it was bacterial and it hadn’t been completely treated.

There were lots of side effects from the meningitis including spinal arthritis, chronic migraines, mood changes and dystopia. Combined with these was a big side effect from the prednisone;osteoporosis.

Then the treatment consisted of Forteo injections for increasing bone density,oral methotrexate and pain management.

After a while, no physician wanted to give me methotrexate tablets because I’d already had a pretty big dose and there was concern about liver problems so I switched to injections. I didn’t want to risk having another major infection and no one wanted to prescribe another biologic.

A dozen years after Enbrel, now on disability and I took Humira that for a year It stopped working. After that I took Cimzia. With both Humira and Cimzia I also injectable methotrexate. After being on Cimzia for less than a year I developed cellulitis and was in the hospital for eight days. Then the rheumatologist prescribed Otezla, which was like having stomach flu in a bottle ,and crazy-making with increased anxiety and depression,at the same time. Now, I take Voltaren and injections of Methotrexate.

As far as joint integrity, my spine shows the most evidence of damage. Otherwise, my joints are in fairly decent shape. I always have pain and options for pain relief are more limited these days. But, I have had significantly more pain after meningitis than before. The Humira and Cimzia helped but certainly didn’t make me almost normal like the Enbrel did before the two bouts of meningitis.

A lot has transpired on this arthritis journey but I prefer to look back and remember that I was able to have a baby, work most of my career and raise a child during this time.

What are the symptoms of psoriatic arthritis and psoriasis?

Symptoms:-

Usual cases are asymptomatic, pruritus can occur in 25% of cases.

Generalised erythrodermic disease may have loss of thermal regulation with a feeling of chilliness despite warm skin.

In early cases of joint involvement pain, tenderness and stiffness especially of the small joints of hands and feet may occur. There may be intense pain in the larger, the cervical and or the lumbosaccral joints.

Signs:-

The primary lesion is a papule with following four prominent features:

Sharp demarcation and clear-cut borders

Plenty of non-adherent silvery scales

A glossy erythema under the scale

Auspitzs sign positivity on mechanical removal of the scale by scraping, small blood droplets appear. This sign, however, is not present in inverse or pustular psoriasis.

Nail changes occur in fingernails in 50% and in toenails in 35% of cases as small pits on the nail-plate, yellowish macules under the nail plate and severe onychodystrophy.