Psoriasis Perhaps Causing Arthritic Joint Pain - A Connection? I

Posted on Sat, 15 Aug 2020

Question: Psoriasis perhaps causing arthritic joint pain - a connection? I was previously on biologic injections and methotrexate injections last year, followed by 10 mg methotrexate tablets 1 x week as a maintenance does. This cleared up my psoriasis very well but I stopped about 8 months ago in Dec 2019 for various reasons and since the rise of COVID-19 in March I have not wanted to re-start due to fear the treatments will weaken my immune system at this critical time. I am in the vulnerable category being 71 with underlying health conditions.

However I am wondering if the return of my psoriasis which I have noticed over the past month has also seen the symptom of painful joints, especially my right knee and shoulder but also the left knee at times (see previous question posted 18 July). Is there a possible connection? Should I resume my methotrexate treatment and up to what level would not comprise my overall immune system? Thank you

Follow up: Dr. Heang Chan Raksmey (0 minute later)

Psoriasis perhaps causing arthritic joint pain - a connection? I was previously on biologic injections and methotrexate injections last year, followed by 10 mg methotrexate tablets 1 x week as a maintenance does. This cleared up my psoriasis very well but I stopped about 8 months ago in Dec 2019 for various reasons and since the rise of COVID-19 in March I have not wanted to re-start due to fear the treatments will weaken my immune system at this critical time. I am in the vulnerable category being 71 with underlying health conditions.

However I am wondering if the return of my psoriasis which I have noticed over the past month has also seen the symptom of painful joints, especially my right knee and shoulder but also the left knee at times (see previous question posted 18 July). Is there a possible connection? Should I resume my methotrexate treatment and up to what level would not comprise my overall immune system? Thank you

Answered by Dr. Heang Chan Raksmey (1 hour later)

Brief Answer:
Psoriasis can happen in the joint as well (psoriatic arthritis). The treatment for psoriatic arthritis is usually long term.

Detailed Answer:
Hello and thank you for your question XXXXXXX Hope I can be of help for you today.

Through reading your query I would like to help you with this question. Psoriasis can happen in the joint as well (psoriatic arthritis). Is a condition that causes joint pain , swelling, and stiffness. It happens in patients who have a long term skin condition with psoriasis. There is no cure for psoriasis, but different treatments can help ease and control symptoms. If you have joint problems your doctor will do an exam on your joint and X-ray for your painful joints. They might order an imaging test called an MRI. Blood test and lab tests on a sample of fluid from a swollen joint to get a sample of fluid. The treatment for psoriatic arthritis is usually long term. That's because even after symptoms get better, they sometimes return later on. You should stay active to help your muscle strong and not stiff your joints. You should stay home because of Covid 19 anyway.

I hope that can help you, and please let me know if you have any clarification or question about that, and I would be welcome to discuss it with you further. I Hope you have good health.

Best regards,
Dr. Heang Chan Raksmey, General and Family Physician

Above answer was peer-reviewed by : Dr. Raju A.T

Answered by Dr. Heang Chan Raksmey (0 minute later)

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Heang Chan Raksmey (1 hour later)

Dear Dr Raksmey,

Excellent answer how to move forward - good detail and advice, so thanks.
One key question not yet answered: should I re-start Methotrexate at level as previously (injection then 10 mg a week) and risk weakening my immune system with COVID-19 virus a major health risk?

Regards,

David

Follow up: Dr. Heang Chan Raksmey (0 minute later)

Answered by Dr. Heang Chan Raksmey (3 hours later)

Brief Answer:
If your joint is concern and you have diagnosis for your doctor that you are having psoriatic arthritis, you may need to restart Methotrexate.

Detailed Answer:
Hello,

Thank you for your question. If your joint is concern and you have diagnosis for your doctor that you are having psoriatic arthritis, you may need to restart Methotrexate. If you start to use Methotrexate your immune will be suppress so you are in high risk if you contaminate covid 19 so you should follow the covid 19 prevention protocol from the government.

Hope I have answered your query. If you do not have any clarifications, you can close the discussion and rate the answer. Wish you have good health. Let me know if I can assist you further.

Best regards,
Dr. Heang Chan Raksmey, General and Family Physician

Above answer was peer-reviewed by : Dr. Kampana