Some infections can mimic symptoms of a PsA flare.
When you have an autoimmune condition like psoriatic arthritis (PsA), much of treatment revolves around achieving remission from symptoms and preventing and managing flares. When flare symptoms spring up, it’s tempting to jump into action and start treating the PsA flare.
There’s just one problem: It might not even be a flare at all.
The first thing you should do when you think you recognize a flare of PsA symptoms is see your doctor, says Nicola Berman, MD, rheumatologist at Lenox Hill Hospital in New York City. “Viral conditions can mimic disease flares,” says Dr. Berman, “and if missed, this can be potentially fatal if you’re immunosuppressed.”
Because PsA is linked to a hyperactive immune system, many of the treatments of PsA work by suppressing part or all of the immune system. As a result, people with PsA on these treatments may be more vulnerable to viral, bacterial, or fungal infections.
“With immunosuppressed patients and with psoriasis, you have open skin wounds. Sometimes if you scratch them enough, you can develop skin infections,” says Dr. Berman.
If your rheumatologist decides that your symptoms are actually caused by a disease flare, they can then assess what went wrong in your treatment and whether any changes should be made in your PsA regimen. It’s possible that you’re not using the right PsA treatment for you, and an alternative option could better prevent flares.
“If you’re experiencing any symptoms that are out of the ordinary for a disease flare, or if you’re questioning any of your symptoms, it’s very necessary to just touch base with your doctor and go over it with them,” says Dr. Berman.
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Someone with psoriatic arthritis will
generally see their dermatologist and
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rheumatologist quite regularly.
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They should also seek medical
advice when they develop a flare.
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Firstly to find out whether it is a flare
because viral conditions can mimic
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disease flares and
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if missed this can be potentially
fatal if you're immunosuppressed.
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It might not just be a viral condition
it could be a bacterial infection or
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it could be something else entirely.
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And it's important that you
get the necessary tests and
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get worked up appropriately
in these settings.
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Someone can develop joint pain and
fevers and whether or
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not it's a disease flare or a viral
syndrome is very hard to tease out.
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The problem with not seeking help could
be that you have the wrong diagnosis and
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that it might not be a flare.
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So with immunosuppressed patients and
with psoriasis, you have open skin wounds
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sometimes if you scratch them enough and
you can develop skin infections.
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And there's a lot of need to pay
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close attention to this developing
on biologic therapy, too.
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A rheumatologist can accurately assess
whether or not this is a disease flare,
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whether this requires admission,
whether this requires
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a change in their baseline biologic or
disease-modifying anti-rheumatic drug.
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So if you're experiencing any symptoms
that are out of the ordinary for
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a disease flare, or
if you're questioning any of your systems,
00:01:32,814 --> 00:01:37,189
it's very necessary to just touch base
with your doctor and go over it with them.
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Psoriatic arthritis self care. Atlanta, GA: Arthritis Foundation. (Accessed on May 28, 2019 at https://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/self-care.php.)
What is psoriatic arthritis? Atlanta, GA: Arthritis Foundation. (Accessed on May 28, 2019 at https://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/what-is-psoriatic-arthritis.php)