Psoriatic Arthritis

[Guest guest]

> Hi ,

>

> I had an appointment with my rheumy today and, thanks to your

posts,

> I asked him about antibiotic therapy. He said we could try it, but

> I'm not sure he's using the same protocol you started with. Also,

he

> only wants to try it for a month and, if no improvement, start me

on

> a trial of sulfasalazine. From reading your messages and the info

on

> the Road Back site, this is not nearly long enough. I'm thinking I

> might send him a print-out of the AP from the Road Back. I've been

> stuck on the NSAID merry-go-round for about six months now and I'm

> ready to get off and make some progress! Oh, well...wish me luck.

>

> Take care,

>

Hi, - You are right, this is certainly not long enough. Your

doctor, I'm sure, knows that

sulfasalazine often takes at least six months to begin to work (as

does methotrexate and other DMARDS). This indicates that he doesn't

know anything about antibiotic treatment. It is definitely a good

idea to give him the info from the Road Back Foundation (RBF). They

are used to dealing with this, and have doctor info packages

available. (The best way to do this is to send it to him before your

appointment, with a note saying that you want to discuss it when you

see him. This gives him a chance to do his homework, and is a good

professional courtesy.)

I know, since I have done this without the help of a knowledgable

doctor myself, that it is much better if you can find someone who

knows this treatment and is supportive. If you post a request on the

RBF bulletin board or guest book, they will forward you a list of

doctors in your area who are familiar with antibiotic treatment. If

there is one near enough to you, this would be VERY good to do.

very best wishes --

[Guest guest]

> > >

> If you post a request on the

> RBF bulletin board or guest book, they will forward you a list of

> doctors in your area who are familiar with antibiotic treatment.

If

> there is one near enough to you, this would be VERY good to do.

I'll take your advice, . Thanks!

[Guest guest]

Just a note from me to second that opinion about DR Whitman..we drive to him

in NJ from Cincinnati..and I am so glad we do! He is a very good rheumy and

also good at tweaking the protocol for response..take care, DEBB

[Guest guest]

Hi Maureen,

You wrote that you're looking for studies involving psoriatic

arthritis (PA) and the antibiotic protocol (AP) I looked for quite a

while before starting starting the AP and found most studies were

geared towards RA, not PA. However one study I found from Hutt

Hospital, Wellington, New Zealand addressed " Minocycline Therapy in

Psoriatic Arthritis " , including the issue of concurrent DMARD use

while using minocycline. (The author of that study concluded: " 13/36

patients were on a DMARD at entry, and 8 have now ceased the DMARD

due to sufficient efficacy from the Minocycline or Doxycycline. " 3

out of the 36 were using methotrexate concurrently with minocycline.

2 of those ceased the methotrexate and 1 reduced the methotrexate due

to sufficient efficacy of the minocycline. "

(see: http://www.rheumatology.org.nz/cen998/ce03000.htm )

The treatment in that study was as follows:

" Treatment Usually commenced on Minocycline ( Some with Tetracycline,

Doxycycline ) Starting dose 100 mg x 3 per week if recent disease, or

on existing DMARD 50 mg x 3 per week if long standing untreated

disease. Attempted to reduce existing DMARD usage if observed any

benefit. Dose of Minocycline increased to 600 - 700 mg/week after a

few months Salazopyrin added in if insufficient benefit seen after

first couple of months and on 6-700 mg If side effects from

Minocycline, changed to Doxycycline, and then to Tetracycline Given

Penicillin VK if evidence of recent Streptococcal infection before

resuming Tetracyclines " .

Also, I've seen quite a few postings from different people with PA

who had success with the AP. Look on the following sites for some of

their testimonials:

http://www.remedyfind.com/rm-786-Antibiotic.asp

http://www.rheumatic.org/medhist.htm

As well, I have seen several reputable arthritis organizations that

recognize Minocin as an effective DMARD for PA, including the

Pack Arthritis Centre where I live, in Vancouver BC (it is part of

the main Vancouver hospital).

In response to your request for feedback from others with PA who are

trying the AP, here's a summary of my experience so far:

I'm 42 and I've had progressively worsening PA symptoms for the last

5 years. I developed psoriasis at age 19 and started having problems

with my fingers, toes & wrists at age 37 (including carpal tunnel and

trigger fingers). My first trigger finger was cured through an

operation. I was able to recognize subsequent flares in my fingers

earlier and they were cured more easily with cortisone -- injected

directly into the affected finger or toe.

3.5 years ago I suggested to my rheumatologist that I had PA, given

all my symptoms. However, he only confirmed my diagnosis as PA in

August 2002. For 3.5 years he would not recognize my problems as PA,

despite my severe morning stiffness & pain, carpal tunnel in one

wrist, 4 trigger fingers (one finger needed an operation) , two sore

toes, sore hips, difficulty walking, psoriasis & minor pitting of a

few fingernails. Only when my finger nail actually lifted off one

finger, two joints on one finger swelled visibly and my flares became

more intense & prolonged ( & I developed an extremely sore shoulder),

did he finally confirm that I have PA. My x-rays still show no bone

damage.

I had a relatively manageable case of PA for the first 4 years.

Then, for the last 10 months, I went into a downward spiral of

worsening symptoms -- being in constant severe pain in many joints

and feeling very depressed.

The rheumatologist prescribed Sulfasalazine in Sept 2002 (up to that

point I only took ibuprofen). I tried it for a few weeks and it

seemed to be helping, but I had to stop because of side effects

(headaches, shortness of breath, worsening of psoriasis, mild hair

loss).

I started on Minocin (100 mg/day, MWF) in October 2002 and worked up

to 100mg/ day every day about 7 weeks ago. I think I might have

herxed after a few weeks on the minocin because my shoulder pain and

hip pains worsened to the point where I was in tears and couldn't

sleep. I finally had to take prednisone. After an initial bigger

dose of prednisone (20mgs for 5 days then tapering off), I took an

average of 3 mg/day (4 days on 3 days off). 5 days ago I stopped

needing the prednisone entirely. Suddenly, after being in a very bad

flare for 10 months, I feel really, really good. For the last 5

days, all of my symptoms have subsided in a big way. I still have

morning soreness for a few minutes when I wake up and my shoulder is

still a bit sore, but nothing like it was. I'm still taking

ibuprofen, which eliminates any residual swelling. I don't know

whether my drastic improvement has to do with the prednisone or the

minocin. I know it's too early to draw any conclusions, but I

haven't felt this good for a very long time. I'll keep the group

posted how it works out for me.

Sharon

>

> >I have never felt a herx etc (not even close). I suffer from

Psoriatic

> >Arthritis (similar to Reactive Arthritis), along with Psoriasis.

> >

> >Everything just seems to be getting worse slowly but surely. I

held my

> >ground (or declined VERY slowly while on the diet recommendations

for 1 year

> >- but haven't stuck to that as well).

>

> Hi Mike and others with PA--

> I am fairly new to this list.

> I too have Psoriatic Arthrititis and I am due to be starting AP in

mid

> January, just as soon as I can get siero off in the mail for

mycoplasma

> testing. What a deal it was to get ahold of the required lable for

overseas

> shipping!

>

> I'm so sorry you are not having success so far. Sounds like it's

time for a

> specialist with experience with PA patients.

>

> A problem with understanding what works with PA is that unlike most

of

> these other rheumatic diseases which seem to progress steadily if

> untreated, PA can be quite variable, ranging from virulent to quite

mild,

> and in many cases it goes into remission all on its own.

>

> I've found very few case histories which refer directly to people

with PA

> successfully using antibiotics. I've had PA for twenty years, and

until

> this year, my rather scary symptoms would disappear all on their

own (okay,

> I would improve diet and lifestyle) and then I'd stay in remission

for a

> few years. If I had used any treatment at all, I would have given

it the

> credit for sending me into remission. All treaments are so slow

that it

> would have been difficult to distinguish.

>

> Though I am doing quite well now with just a few " leftover

joints " and

> sed rate down to 10, I decided to go with the minocycline treatment

because

> this year's flair was so much more severe that it left me scared. I

am

> hoping that a herx will tell me soon if I am on the right track.

>

> I would be very interested in hearing other people's experiences

> treating PA with AP.

>

> I have a Roadback newsletter with an article about spondylitis,

which quite

> clearly states that they have NOT had much success treating that

condition

> with tetracyclines, and that the challenge will be to find the

antibiotic

> which will work for whatever mmicroorganism involved. (often

> Klebsiella?) This makes me wonder how often mycoplasmas are

involved with

> PA--I am getting tested though I do not hope to find anything, but

would

> otherwise always wonder.

>

> In the meantime, a huge factor for me seems to be diet. I will of

course

> stick to the diet that seems to have turned my situation around

this year

> (no sugar, low carbs, omega-3, lots of veggies, probiotics, water),

but

> unless I herx, knowing my 20 year history of repeated remission,

even if I

> rid myself of every last tender joint, I would not be able to

honestly say

> for sure if it were antibiotic properties of the AP that helped.

>

> All this to say that I sure wish there were more studies and case

studies

> on PA and AP, and again, I would sure love to read the experiences

> of those of you with PA who have been on AP. How many have been

> successful with only mino or doxy? Did you herx? Did any of you

test

> positive for mycoplasma (or anything else)?

>

> If you write to me privately I will write a summary to the list.

>

> Thanks to all for the support and info,

>

> the Maureen in Italy

>

> ---

> Maureen Fay Young, B. Arch.

> Technical translator: Italian > English

> Florence, Italy

> tel/fax +39 055717721

> cell: +39 3398734952

> U.S. eFax: (509) 472-4003

> email: maureen@f...

> ---

[Guest guest]

....Not at all sure if the following items are of interest, but here it

is. I have been diagnosed with RA, although I lack a few of the criteria

for it, I have enough of the symptoms to be included in that group. I

have had off and on bouts with psoriasis, the very last and severe onset

was after the birth of my second child, then the psoriasis raged, right

up until I was pregnant with my 3rd. Then it went away , not to return.

When I first saw Dr. Whitman in NJ, He noted that my medical history had

the Psoriasis element in it. He talked about PA being one of those

rheumatic conditions in the " reactive arthritis " group. He had me try

sulfasalizine, since that particular drug sometimes brings about

dramatic reversals in reactive arthritis cases.

Well, sulfasalazine did not help me. But then the Dx of PA had no super

firm basis, since the psoriasis may have been only coincidental with the

onset of RA.

So, the info I have to give you, after that long story, is that

sulfasalizine can work wonders, according to Dr. Whitman, a skilled

rheumatologost and internal med doc - particularly with reactive type

arthritis.

It might be worth a follow-up, to see Dr. Whitman, although if you don't

live near NJ, it's a long trip, I flew out there from Denver, and glad I

did.

King

Maureen Young wrote:

> At 16.37 11/01/03, Mike wrote:

>

> >I have never felt a herx etc (not even close). I suffer from Psoriatic

> >Arthritis (similar to Reactive Arthritis), along with Psoriasis.

> >

> >Everything just seems to be getting worse slowly but surely. I held my

> >ground (or declined VERY slowly while on the diet recommendations for

> 1 year

> >- but haven't stuck to that as well).

>

> Hi Mike and others with PA--

> I am fairly new to this list.

> I too have Psoriatic Arthrititis and I am due to be starting AP in mid

> January, just as soon as I can get siero off in the mail for mycoplasma

> testing. What a deal it was to get ahold of the required lable for

> overseas

> shipping!

>

> I'm so sorry you are not having success so far. Sounds like it's time

> for a

> specialist with experience with PA patients.

>

> A problem with understanding what works with PA is that unlike most of

> these other rheumatic diseases which seem to progress steadily if

> untreated, PA can be quite variable, ranging from virulent to quite mild,

> and in many cases it goes into remission all on its own.

>

> I've found very few case histories which refer directly to people with PA

> successfully using antibiotics. I've had PA for twenty years, and until

> this year, my rather scary symptoms would disappear all on their own

> (okay,

> I would improve diet and lifestyle) and then I'd stay in remission for a

> few years. If I had used any treatment at all, I would have given it the

> credit for sending me into remission. All treaments are so slow that it

> would have been difficult to distinguish.

>

> Though I am doing quite well now with just a few " leftover joints " and

> sed rate down to 10, I decided to go with the minocycline treatment

> because

> this year's flair was so much more severe that it left me scared. I am

> hoping that a herx will tell me soon if I am on the right track.

>

> I would be very interested in hearing other people's experiences

> treating PA with AP.

>

> I have a Roadback newsletter with an article about spondylitis, which

> quite

> clearly states that they have NOT had much success treating that

> condition

> with tetracyclines, and that the challenge will be to find the antibiotic

> which will work for whatever mmicroorganism involved. (often

> Klebsiella?) This makes me wonder how often mycoplasmas are involved

> with

> PA--I am getting tested though I do not hope to find anything, but would

> otherwise always wonder.

>

> In the meantime, a huge factor for me seems to be diet. I will of course

> stick to the diet that seems to have turned my situation around this year

> (no sugar, low carbs, omega-3, lots of veggies, probiotics, water), but

> unless I herx, knowing my 20 year history of repeated remission, even

> if I

> rid myself of every last tender joint, I would not be able to honestly

> say

> for sure if it were antibiotic properties of the AP that helped.

>

> All this to say that I sure wish there were more studies and case studies

> on PA and AP, and again, I would sure love to read the experiences

> of those of you with PA who have been on AP. How many have been

> successful with only mino or doxy? Did you herx? Did any of you test

> positive for mycoplasma (or anything else)?

>

> If you write to me privately I will write a summary to the list.

>

> Thanks to all for the support and info,

>

> the Maureen in Italy

>

> ---

> Maureen Fay Young, B. Arch.

> Technical translator: Italian > English

> Florence, Italy

> tel/fax +39 055717721

> cell: +39 3398734952

> U.S. eFax: (509) 472-4003

> email: maureen@...

> ---

>

>

>

[Guest guest]

After reading this post I felt a sense of hope. I just started taking

MTX (20mg) and have been on Volturen for NSAID's. I haven't had any

side effects or results from the MTX but I only took 1 dose last

week. My rhuemy said MTX helps PA patients more so then other

arthritis type. He also said people sometimes go on MTX for 6 months

and go off and are in full remission(I wish). I no there are bad side

effects that could happen but reading posts like this gives me light

in dark times.

Cheers

Shane

> I was diagnosed with PA at age 39 in September of 2002. It started

> with my left middle knuckle hurting and it was swollen. Since I am

> active all the time, I thought I must have hit it on something.

[Guest guest]

There are medicines to treat your stomach. I can't imagine living w/o my

arthritis medicine. I just had to add protonix to protect my stomach. Get

back to a rhuemy and get on with life. Once you have the pain under

control--then try the exercise and natural remedies to see if you can

maintain that level.

Ks Di

[Guest guest]

I use milk.. plain ordinary 1/2 fat cows milk! If I take my NSAIDS or

neurofen without I get severe stomach pain followed by the squirts..

however if I take my medicine with milk I get no bad effects *and* a dose

of calcuim intot he bargain :-)

Cheers,

Phil.

-----------------------------------------------------------------

Phil Launchbury

Network Administrator

VNU Entertainment Media UK Ltd.

Telephone: +44 (0)1252 742588

Fax: +44(0)1252 742501

Email: PLaunchbury@...

" Costello " <costello@...>

02/05/2003 16:01

Please respond to

< >

cc:

Subject: Re: [ ] Psoriatic Arthritis

There are medicines to treat your stomach. I can't imagine living w/o my

arthritis medicine. I just had to add protonix to protect my stomach. Get

back to a rhuemy and get on with life. Once you have the pain under

control--then try the exercise and natural remedies to see if you can

maintain that level.

Ks Di

Please visit our Psoriatic Arthritis Group's informational web page at:

http://www.wpunj.edu/pa/ -- created and edited by list member

aka(raharris@...).

Also,in August 2001,list member Jack aka Cornishpro@... began

to conduct extensive research which he publishes as the " Psoriatic

Arthritis Research Newsletter " , monthly in our email and digest format.

Many thanks to Jack. Back issues of the newsletter are stored on our PA

webpage as well as the archives of the list.

Don't forget that the list archives comprise a tremendous amount of

information (Over three years of messages and answers).Feel free to browse

them at your convenience.

LET'S HEAR FROM SOME OF YOU LURKERS out there! If you have a comment or

question, chances are there is a person who has been around a while who

can help you out with AT LEAST an educated guess for an answer! If not,we

can steer you in the right direction with a good website to go to,

Blessings and Peace,

Atwood-Stack, Founder

Alan , Web & List Editor

Jack , Newsletter Editor

Pat Bias, List Editor

Ron Dotson, List Editor

Orin, List Editor

, List Editor

and any others who help in any way (thank you!)

[Guest guest]

In a message dated 12/17/2003 12:24:12 AM Eastern Standard Time,

ccurrie@... writes:

> Are there any good books or journals written on

> the subject of Psoriatic Arthritis?

Hi Chuck, I haven't found a book yet:-( This message board is better than a

book though. Someday, when I have lots of time, I will write one so that there

is something to go read when you find out you have this...

[Guest guest]

Hi, Peyton:

Classic psoriatic arthritis may have some pathogenic component, but I think

the majority of cases--to the first order--are caused by a sort of allergic

reaction to gliadin, the protein in gluten. Somehow, it causes celiac/sprue

and interferes with nutrient absorption as well as the polyarthritis caused

by increased intestinal permeability.

Going gluten-free has helped many people, perhaps it would help you, also,

rheumatic psoriatic arthritis

>

> Had my first visit with a rhuematologist today. He thinks I have either

> psoriatic arthritis or RA, and ordered more blood tests to be sure. Can

> psoriatic arthritis be successfully treated with AP? Is psoriatic

arthritis

> caused by micoplasm? (The Scammell book has only one reference to

psoriatic

> arthritis on p. 28.)

>

> Thanks,

> Peyton

>

>

>

>

>

> To unsubscribe, email: rheumatic-unsubscribeegroups

>

>

[Guest guest]

HI Peyton,

On our web page at rheumatic.org/medhist.htm you will find three

medical histories of people with psoriatic arthritis - one used diet

alone and the others used antibiotic therapy. You will find their

details and contacts on the pages.

Chris.

On 10/01/2005, at 12:08 AM, TracingMyRoots wrote:

>

> Does AP work for psoriatic arthritis? The Scammel book has only one

> reference to psoriatic arthritis & that information does not pertain

> to AP

> treatment.

>

> I'd like to hear from other women who have been using AP for psoriatic

> arthritis. How long have you been on AP? Do you use Minocin? What

> dose

> have you found effective for you? Any other info you'd like to share

> with

> me? Thanks!

>

> Peyton

> tracingmyroots@...

>

>

>

>

> To unsubscribe, email: rheumatic-unsubscribeegroups

>

>

[Guest guest]

I agree Kathy F...maybe the golfer had Reactive Arthritis where

antibiotics would be able to " cure " him...which isn't really a cure,

rather he is just in remission enough to go back to normal

functioning.

>

> 56 year old male. I've heard of only one case where there was a

cure

> for PA. A professional golfer who I have been in touch with was

able

> to " push out " , as he puts it, the PA by using a combination of

> methotrexate with antibiotics. My doc is unwilling. I am getting

> ready to fly across country to use his doc. Any thoughts on this?

>

> [Editor's Note: There is no cure for PA, however, many, many

people enjoy a significant relief of symptoms for long periods of

time. You don't say what kind of doctor you are seeing. If you have

PA, you MUST get yourself under the care of a rheumatologist who is

extremely familiar with our disease. Secondly, you don't say which

part of this regimen your doctor won't agree to - the methotrexate,

the antibiotics or both. Antibiotics have definitely NOT been shown

to improve the symptoms of our disease so I am not sure why the

golfer is on it. I do know, however, that if you overtake

antibiotics, they may not work when you really need them to.

Virtually all rheumatologists would allow you to go on

methotrexate. You also don't say what other medications and

treatments you have tried. We are all different and what works for

one person will not necessarily work for another. I don't see any

reason to fly across country unless you have tried all known

medications in our PA arsenal (methotrexate, sulfasalazine, Arava,

Enbrel, Humira, Remicade, etc.) and have failed on them and unless

you have been to all rheumatologists within 500 miles. Just my

thoughts. Kathy F.]

>

[Guest guest]

I was at my rhuemy's office this past week and I asked

him specifically about antibiotic treatment for PA.

Is it quackery? Is it an option?

He told me that antibiotic treatment has been

successful with some patients with PA. However the

treatment comes with great risk of inducing Lupus or

MS, therefore it isn't something that is often done.

For me it is not an option as I am allergic to

tetracycline and most of the antibiotics used for that

regimen are in that family.

Sandi

________________________________________________________________________________\

____

Sponsored Link

Degrees online in as fast as 1 Yr

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http://.degrees.info

[Guest guest]

it is probably minocycline and it works for some people . It is also a

treatment for scleroderma and the doctors have had excellent results with the

scleraderma . however when I took it and I took it for several years It did

very little for me . If you dod try it make sure you get the real drug not the

generic. cathy from ma

[Guest guest]

I agree with the editor's note... I don't see why your doctor would say no to

any of these other helpful drugs... Going out of Country may not do any help,

its your choice of course, but try either asking again or a NEW doctor... No one

says you cant try another doctor...

Love and Peace Always,

Shaun and Barb

[Guest guest]

My son has psoriatic. It still falls under JIA. I'm glad your daughter

is doing well.

You can go to psoriasis.org to find out more info on psoriatic

arthritis. They have a good kids section on psoriasis, too.

What we've been told, and remember that each child is different, is

that psoriatic arthritis is not the type of arthritis that necessarily

causes severe damage. However, it is one of the most stubborn to treat

because when psoriasis is active, so is the arthritis. But there are

medications that can treat both the psoriasis and arthritis at the

same time. My son started enbrel which is supposed to help both. We're

still waiting for it to kick in, but it's still early yet.

Also, usually this type of arthritis is concentrated in the hips and

spine. Keep an eye on the psoriasis. This can come on quickly. My son

had it on his scalp for about 6 months before a spot appeared on his

chest. Within two months, it had spread over most of his body. The

trick is to catch it early. See a dermatologist who can prescribe

creams or oitments if the arthritis medication does not help with the

psoriasis too.

Thankfully, my son's psoriasis it's a lot more managable now. Still

working on the arthritis, but getting closer. Like I mentioned, it's

stubborn, but not devistating.

(son Andy, 8)

On 3/21/07, Cheri <ckswirl@...> wrote:

>

>

>

>

>

>

> My daughter was diagnosed with Pauciarticular JRA about a month and half

> ago. She had another visit with the Rheumy yesterday and they have changed

> her diagnosis to Psoriatic arthritis. I really can't seem to find alot of

> info out there. Is this still JRA / JIA or are we out of that " window " now?

> Does anyone have any experience with this?

>

> She's actually doing wonderfully. She had injections about 3 or 4 weeks ago

> and has been great ever since. We noticed a small red patch on the back of

> her neck and the Dr. confirmed it was Psoriasis. She's got a dermatologist

> appointment the end of April.

>

> Thanks for any input.

>

> Cheri and Libby (4, psoriatic arthritis)

>

>

[Guest guest]

Here is one more. It is a couple of years old, but the basic info is

still sound.

Psoriatic Arthritis

Psoriatic Arthritis

WebMD Medical Reference

http://my.webmd.com/

While many people consider psoriasis a skin disease, its primary cause

is a malfunctioning immune system. Thus, many of its worst effects can

come from psoriatic arthritis, a swelling of the joints that develops in

some people with psoriasis. Psoriatic arthritis causes the symptoms of

other types of arthritis -- stiff, painful and swollen joints -- and it

can be serious. Untreated, psoriatic arthritis can cause bone loss and

deformation of the joints.

Estimates for the number of people with psoriatic arthritis vary. Some

studies say about 7% to 8% of people with psoriasis have arthritis,

while the National Psoriasis Foundation's recent survey indicates about

23%.

While psoriatic arthritis is most common in adults between the ages of

30 and 50, it can develop in anyone, including children. Psoriatic

arthritis only affects people who have psoriasis, but even so, diagnosis

is often difficult. The symptoms of psoriatic arthritis often appear

years after the first signs of psoriasis on the skin. Sometimes the

arthritis symptoms develop before any lesions on the skin.

Because a long time can pass between the appearance of these very

different symptoms, psoriatic arthritis can be hard to catch. Bruce E.

Strober, MD, PhD, suspects that psoriatic arthritis may be a chronically

under-treated condition because people who have it just don't connect

the symptoms.

" A lot of people, even a lot of dermatologists, don't link up joint pain

with skin disease, " says Strober, who is co-director of the Psoriasis

and Psoriatic Arthritis Center at New York University. " But if you're

not treating the arthritis, you're not addressing one of psoriasis's

most debilitating aspects. "

What Is Psoriatic Arthritis?

Just like the symptoms of psoriasis, the pain and swelling of psoriatic

arthritis are caused by an overactive immune system, which enflames the

tissues around the joint. Typically, symptoms will flare-up and recede

periodically.

There are actually five different kinds of psoriatic arthritis:

* Symmetric arthritis is the most common type of psoriatic

arthritis, making up about 50% of all cases. It's symmetric because the

symptoms occur on both sides of the body. Symptoms are similar to

rheumatoid arthritis, and symmetric arthritis can cause permanent damage

to the joints.

* Asymmetric arthritis, the second most common type of psoriatic

arthritis, is typically milder and only causes symptoms on one side of

the body. A smaller number of joints may be affected, perhaps as few as

one to three, and the inflamed joints may be red. Asymmetric arthritis

can also result in swollen hands and feet.

* Distal interphalangeal predominant (DIP), a less common form of

psoriatic arthritis, affects the joints close to the fingernails and

toenails. The nails are often affected by the condition as well.

* Spondylitis can make movement painful, especially in the neck and

back. It can also cause inflammation of the spinal column.

* Arthritis mutilans is a frequently debilitating and destructive form

of psoriatic arthritis. It often affects the hands and feet -- and

sometimes the back and neck -- and it can result in permanent deformity.

Symptoms of Psoriatic Arthritis

The symptoms of psoriatic arthritis are similar to those of other kinds

of arthritis. They include:

* Stiffness in the joints

* Pain or swelling in the joints

* Irritation and redness of the eye

Of course, the usual symptoms of psoriasis -- such as red, scaly patches

of skin -- may make diagnosis of psoriatic arthritis easier.

In order to identify psoriatic arthritis, your doctor will perform a

physical examination. Your doctor may also order blood tests, joint

fluid tests, and X-rays in order to examine the affected areas and rule

out other diseases.

Treatments for Psoriatic Arthritis

While some of the treatments for psoriasis will also help psoriatic

arthritis, others - such as phototherapy -- will not. If you have

psoriatic arthritis, you should be getting a treatment that works on

both the joint pain and the skin lesions caused by the condition. Some

common treatments include:

* Nonsteroidal anti-inflammatory drugs (NSAIDs). These are a common

class of painkiller medications that are typically the first choice for

treating psoriatic arthritis. They include a number of over-the-counter

pain medications, such as aspirin and ibuprofen (Motrin, Advil).

Although you may think of drugs like Advil as harmless, you

should talk to your doctor before using them to treat your arthritis.

Chronic usage can be dangerous and cause gastrointestinal problems.

-2 inhibitors, which include prescription drugs such as Celebrex and

Vioxx and Bextra, are a special type of NSAIDs that are sometimes used

to treat psoriatic arthritis. Side effects may include nausea and

headache.

* Disease modifying antirheumatic drugs (DMARDs). The DMARDs are

more powerful drugs that are used for cases of psoriatic arthritis that

don't respond to milder medications. Some of the drugs in this class are

also used for systemic therapy of psoriasis, such as methotrexate

(Rheumatrex and Amethopterin) and cyclosporine (Neoral or Sandimmune),

both powerful drugs that help fight psoriasis by suppressing the immune

system. They may also cause serious side effects and raise the risk of

infection. Imuran is another drug that suppresses immune function and is

sometimes prescribed for psoriatic arthritis. It can have serious

effects on the bone marrow.

Another DMARD is Azulfidine, which is easier for many patients to

tolerate than cyclosporine or methotrexate. Side effects include

vomiting and nausea. Certain drugs used to prevent malaria, such as

Plaquenil, can help with the symptoms of rheumatoid arthritis, and they

are sometimes prescribed for psoriatic arthritis as well. However, in

some people, anti-malarial drugs can cause psoriasis to flare up.

Your doctor may also recommend a short prescription of oral

steroids to help clear acute joint pain, although steroids cannot be

used safely for long periods of time. Stopping treatment with steroids

suddenly can also cause a flare-up of symptoms. Sometimes, doctors

recommend using gold salts, such as Myochrysine and Solganal, although

their serious side effects have made them less popular in recent years.

* Biologic therapy. The newest tool in treating psoriasis is

biologic medications, which are used both to treat psoriasis and

psoriatic arthritis. So far, only one drug has been approved to treat

psoriatic arthritis -- Enbrel -- but more will be soon. The evidence so

far shows that they may be safer than many systemic medications. Other

biologic treatments include Remicade and Amevive. They work by targeting

the immune system response that causes the symptoms of psoriasis,

preventing the joints from becoming inflamed. One drawback to the

biologic medications is that they have to be injected or administered

intravenously. Biologic medications may also make the immune system more

susceptible to infections.

* Other treatments. Guided physical therapy, which can improve

strength and flexibility, is often helpful for people with psoriatic

arthritis. Using hot and cold packs can also make a difference because

cold can numb pain and heat can relax muscles. You should also try to

eat a balanced diet high in fruits and vegetables, maintain a healthy

weight and get regular exercise, if possible. Do what you can to reduce

stress, perhaps by practicing relaxation techniques.

* Assistive devices. If your arthritis is making it difficult for you to

do everyday things -- buttoning your shirt, opening a bottle, or getting

up from a chair -- ask your doctor about assistive devices -- tools or

gadgets that make common tasks easier for people with debilitating

arthritis.

Although you may be tempted to try alternative medications to soothe the

pain caused by psoriatic arthritis, remember that none have been proven

effective in treating the condition. Because some alternative approaches

-- including herbs, supplements, and therapeutic techniques -- can

actually be dangerous or interact with other medications, it's important

to check with your doctor before using them.

Psoriatic arthritis can be profoundly upsetting and potentially

disabling. But regular treatment can often slow or even prevent its

worst symptoms from developing. The key is to see a doctor early, since

damage to the joints and bone can happen quickly. Never ignore chronic

aches and pains in your joints, especially if you have already been

diagnosed with psoriasis.

[Guest guest]

Virginia,

My daughter’s nails are beautiful~~

no ridges, no pitting. Her onset of arthritis was nearly 12 years before the

onset of psoriasis. She’s now classified as “undifferentiated

arthritis” because her symptoms and disease pattern don’t fit

perfectly in the poly category or in the psoriatic category, but rather are a

mixture.

I know that’s not a huge amount of

help for you, but at least you know there are others out there who don’t

follow the textbooks!

Liz

From: [mailto: ] On Behalf Of P Woods

Sent: Thursday, October 18, 2007

1:06 PM

Subject: psoriatic arthritis

Hi to all of you all that are dealing with psoriatic arthritis-

I need some advice. Our son (11years) I've mentioned

before. He was diagnosed with pauci in 2003. Since then he's been

on naproxen, then added mtx and enbrel and then changed to : ketoprofen,

arava, remicade. He has only had documented swelling in his left

knee. He does have swelling at times on his fingers between the joints-

not in the joints themselvese and in his right knee, but the drs have not seen

this. He hurts all over- especially back, hips, shoulders, and

knees. His labs are always totally normal. He is also very

hypermobile- so some achiness can come from that. He's been to PT and OT

off and on. Currently they are dropping the remicade and telling us to

make sure he swims at least twice a week. They would like more data as to

what's going on as his pain level does not match his labs or his exam.

They've wondered if some of it's hypermobility, some JRA, and some of it an

amplified pain disorder. I've often thought that he did have some type of

spondy arthritis just because of where and how he hurts. In the last

month we've noticed his big toenails have horizontal lumpy ridges , now all ten

toenails are yellowish, some have ridges some not. The ped rhuemy, the

regular gen practioner and the dermatologist have all looked at his

nails. They all said they didn't know. The derm got out a book and

we looked at pictures, but it doesn't fit any specific category. They are

growing some nails to rule out a fungus, but don't really think that's

it. They all said it could be the beginnings of psoriasis, but there is

no pitting. He never seems to fit exactly in any category and a diagnosis

of psoriatic arthritis would make all of his symptoms fit except that he has no

skin involvement. In Dr Lehman's book, he says that in kids you can

have the arthritis first and the psoriasis later. I realize that only

time will tell a lot of things about this, but am curious if any of you have

ever run into this? Do you have any suggestions? It's just now

been about 7 weeks since his last remicade and he's hurting pretty badly

all over- limping and walking up on his toes some. He does not

have any visible swelling. He's stiff in the morning for about

2 hours instead of about 30 minutes.

Thanks for listening

Virginia

[Guest guest]

a friend of us had very good results with ldn for psoriatic

arthritis.she takes also psorinovo here in holland which helps

metabolisme.i would encourage you to check thyroid.she has more

energy,no joints pain,she could put again the feet in her shoes,the

psoiasis is better and she could avoid the methotrexate.

>

> Developed this condition 18 years ago during a time of acute stress,

> avoided conventional medicine until last year when I reluctantly

agreed

> to try methotrexate. I would like to come off this medicine asap.

Can

> anyone advise me on the benefits of LDN for this disease?

>

[Guest guest]

I just started-- about 5 days on LDNaltrexone, and think I'm feeling a

difference. I've avoided the methotrexate and worse as of now.

I'll let you know how it goes. I'm investigating the availability of the

Dutch medicine, psorinovo, as well, as I have a daughter in

Holland who can do leg work for me. If I find a prescriber I'll share. Carol

[Guest guest]

Hi,

cutting and pasting earlier posts on psoriasis and ldn:

>Subject: Re: [low dose naltrexone] Psoriasis>I have had psoriasis for over 25 years and NOTHING helped! Once I started the LDN (3mgs) daily - within a couple of weeks the plaques were 90% gone (a little skin discoloration in the areas where the plaques were) But needless to say I WAS SO HAPPY to be able to wear sleeveless shirts and not feel so ugly and insecure.>>I hope this helped,>C.

======

we have a friend with this disorder. she was on psorinovo, a medicine that is given in holland and improved on that to an extent. after that she started on 4,5mg LDN and improved much. her pains were gone. her energylevels are back to normal. the swelling in her toes went and she could get back in her shoes. her toe nails didn't come back thusfar. best wishes,m.==============

Took me 3 months for all joint pain gone, and 4 months for all of my psoriasis to clear up. Had this since i had lyme, everything else cleared up except that, then the LDN, took care of that.

===========

our frienf with psoriatic arthritis had very good results ,more energy,could put her feet back in shoes,no pain in the joints.she is from hooland so here they use also a medecine with the name psorinovo.about psoriasis if it does not disappear you may want to look at the treatment of dr simoncini.

=================

Ingrid

[low dose naltrexone] psoriatic arthritisDeveloped this condition 18 years ago during a time of acute stress, avoided conventional medicine until last year when I reluctantly agreed to try methotrexate. I would like to come off this medicine asap. Can anyone advise me on the benefits of LDN for this disease? ------------------------------------

[Guest guest]

vinnylid:  Thanks for your update.  I'm wondering if - at any point in this

process - your doctor suggests x-rays to determine whether or not there is

any change in your joints to ensure that damage isn't being done even though the

antibiotic protocol is controlling your pain?  I'm really interested in

following what happens under this regime. 

 Joanna Hoelscher

[Guest guest]

I'll second Joanna's interest and query.

....Brent

<<I'm wondering if - at any point in this process - your doctor suggests

x-rays to determine whether or not there is any change in your joints to

ensure that damage isn't being done even though the antibiotic protocol

is controlling your pain? I'm really interested in following what

happens under this regime. " Joanna Hoelscher>>

[Guest guest]

Joanna,

At this point I am free of static pain, with some restriction in my

shoulder range of motion. I plan to do x-rays in May when I start

Medicare. When I am using 100mg twice daily Minocycline and 50mg

Diclofenac I would not know I have a disease. I am trying the pulse

Mioncycline now on M,W,F and only needing the Diclofenac once a week.

I'm trying to get my own immune system to pick up the fight. I have the

skin Psoriasis under control using dietary supplements such as fish

oil, borage, and flax seed oils. I mix the flax and borage oil in

cottage cheese as suggested in the Budwig Protocol (Not found in

http://www.ncbi.nlm.nih.gov/pubmed/)

vinnylid

[Guest guest]

When Andy gets scalp psoriasis, it looks like dandruff that is stuck to his

scalp. It looks a lot like cradle cap.

Check out this link. It might help you:

http://www.psoriasis.org/about/psoriasis/scalp/

On Wed, Apr 29, 2009 at 6:34 PM, Crawford <swcrawford3@...>wrote:

>

>

> For those of you with kids with Psoriatic Arthritis, what does it look like

> on their scalps? I noticed that Abby was scratching her head tonight and my

> first thought was that she had lice. Then when I looked at her head I

> noticed a patch that was about 1-2 inches in diameter with several small

> dark spots. It looks like she has an area covered with very tiny freckles. I

> know this is pretty new because I fix her hair all the time and have never

> noticed it. I know that they have ridges on their nails but I'm not sure

> what those look like. I did notice that her cuticles seem to be up pretty

> far. She looks like she is in need of a manicure.lol. I don't know if I am

> worrying for nothing or what. Any advice would be greatly appreciated.

>

> & Abby (2-pauci)

>

>

>