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The National Psoriasis Foundation's Dr. Tell Me Blog is written by experts in dermatology, rheumatology, mental health and wellness as a way to deliver the latest information on psoriasis and psoriatic arthritis care.

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Biologics for Older Patients

How do biologics affect patients 65 years or older? They do just as well in contrast to some of the older treatments such as methotrexate and cyclosporine, which were very problematic in older patients and had side effects that were really difficult in older patients. The biologics are much better tolerated and have many fewer [...]



Heat or Cold for Psoriatic Arthritis Pain Relief

Is heat or cold recommended for pain relief? I find heat much better but some say that increases the inflammation and I should use cold. I find cold makes me ache more. Can you advise? I would go with what you’re using. If it’s comfortable, I don’t see any reason not to recommend the heat…. Read more »



Skin Sores and Back Arthritis

I have a collection of psoriasis sores on the lower back portion of my back and that is where the pain generally is. Can it be due to the sores that my back hurts so much? It might, but it might not. Sorry to hedge, but it depends. If you have very severe psoriasis with… Read more »



Psoriasis, Psoriatic Arthritis and Gastrointestinal Symptoms

Do you see patients that come in with psoriasis and psoriatic arthritis and GI issues, and can you give examples of some of the symptoms? I do, I’ve had patients that have had colitis or microscopic colitis associated with psoriatic arthritis. Anybody that I am seeing for psoriatic arthritis I’ll usually screen for any of… Read more »



Physical Therapy to Help Walking

Does physical therapy help someone to walk better? I am almost waddling now because of the pain I’m in. It might. It may not though. If you’re waddling because you have severe involvement of the hips, you’re already on maximal therapy and there’s already damage, then unfortunately it might be one of those cases where… Read more »



Splints for Fingers with Psoriatic Arthritis

Do splints help prevent problems with the finger joints? Splints can be helpful in correcting deformities. If someone is already starting to exhibit some deformities, an occupational therapist can fit them with splints that might prevent it from getting worse, especially if they are being treated at the same time. Howard Blumstein, M.D. Rheumatology Associates… Read more »



Long-Term Effects and Progression of Psoriatic Arthritis

Will this disease continue to progress even though I am on a biologic? How fast does this disease progress and if you are treating, can you stop the long-term effects of psoriatic arthritis? Good news, bad news. The good news is that most people that are on a biologic, in particular, won’t see much progression…. Read more »



Psoriatic Arthritis Effect on Tendons and Ligaments

Why is there pain not only of the joints but throughout the body? Can psoriatic arthritis affect only the muscle tendons and not the joints? I’ll answer the second one first. It definitely can just affect tendons or ligaments, it doesn’t have to affect joints. If you had someone who had a tendonopathy that was… Read more »



Differences Between Psoriatic Arthritis and Osteoarthritis

How can I tell the difference between my psoriatic arthritis and my osteoarthritis, and does it really matter? I would say it definitely matters because if you have active psoriatic arthritis, there are going to be medications that your doctor might want you to take. You can actually get into big trouble if you are… Read more »



Joint Pain Improved But Skin Symptoms Worsening

I have been on Humira for three years. My psoriasis is worsening but my joint pain is under control. I am tempted to stay on Humira because I would rather have unsightly skin but little joint pain. Does this sound typical or reasonable? Let’s start with the second question, does this sound reasonable? Well, absolutely,… Read more »



Psoriatic Arthritis and Repetitive Exercise

Do repetitive exercises, like typing for hours for example, help or hurt stiff joints? In general, any type of excessive, repetitive motion is not going to be helpful, because it leads to repetitive use injuries. If you are talking about really sitting there and banging away for hours and hours, that probably wouldn’t be the… Read more »



Psoriatic Arthritis and Exercise

I experience stiffness and pain getting worse an hour or so after exercising. What would this suggest? In general, exercise is good for inflammation and if you’re talking about someone who has a purely inflammatory arthritis — so no other comorbidities, no osteoarthritis, no fibromyalgia — exercise makes it better. I would say across the… Read more »



Psoriatic Arthritis in the Hip

I believe I have psoriatic arthritis in my hips. Is this a common area to hear sufferers complain about? The first question I always ask if someone talks about their hips is what do they mean? True hip pain is groin pain, it always occurs in the groin. Most people when they refer to their… Read more »



Psoriatic Arthritis and Joint Injuries

How does psoriatic arthritis affect your joints after injury? And does it cause a longer healing time due to an injury? If you have an injured joint, that’s a joint that’s already susceptible to inflammation and more likely to have more problems in the future. As far as recovery from an injury, in general when… Read more »



Psoriatic arthritis in different locations

Does psoriatic arthritis hit different areas of the body at different times? The answer is yes. You can certainly see a person who starts developing symptoms in one particular area, say a hand, and that might last months or even a year and then move to another area. We don’t know why yet, just as… Read more »



Removing dead skin cells

Is it better to scrape off the dead skin or leave it? Other people have asked about the use of the Ped Egg, which I believe is a scraper kind of tool you can use to slough off that dead skin. So would that be appropriate for someone with this type of psoriasis? Absolutely not…. Read more »



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