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Ask the Expert: Dr. Vivian Bykerk, Rheumatologist, Answers Your Questions on Psoriatic Arthritis

man has pain in wrist

Q1. What’s the difference between psoriatic arthritis and rheumatoid arthritis?

Both are forms of inflammatory arthritis and often are treated with similar medications. Patients with psoriatic arthritis often have a rash of psoriasis present at the same time but blood tests are negative. Patients with psoriatic arthritis often have complete swelling of a finger or toe (called dactylitis).

Q2. Is there anything to help with psoriatic arthritis flares?

Non-steroidal anti-inflammatory drugs help to manage the pain. Disease modifying drugs such as sulfasalazine, methotrexate and leflunomide and biologic therapies that block TNF (etanercept, adalimumab, infliximab, golimumab and likely certolizumab) are all proven to help this. Talk with your physician about treatment.

Q3. I have deformed nails from psoriatic arthritis where it’s thickened and discolored. Is there a treatment that will help my nails grow normally again?

Often treating the psoriatic arthritis helps the nails grow normally again.

Q4. I have psoriatic arthritis and get extremely fatigued. What can I do for my fatigue?

Treating the psoriatic arthritis with effective medication can help. It is also important to control weight and eat a balanced diet. Consult with your physician.

Q5. I’m newly diagnosed with psoriatic arthritis and have a swollen finger. Will the psoriatic arthritis affect more fingers?

Left untreated it can go on to affect other joints and fingers. It is important to see a rheumatologist to help you with the right treatment strategy.

Bykerk Vivian1Dr. Vivian Bykerk is a Rheumatologist at Hospital for Special Surgery. She has an active clinical practice and works with patients with autoimmune diseases causing joint and spine inflammation including rheumatoid arthritis, psoriatic arthritis, and spondyloarthropathies. She is also the director of a team of specialists at the Inflammatory Arthritis Center of Excellence at Hospital for Special Surgery.


Next week Dr. Scott Ellis, Foot and Ankle Surgeon, will answer questions on toe and foot deformities. Write your questions below or email socialmediacontact@hss.edu.


The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.