你的PSA域是什么？

银屑病关节炎是一种独特的条件。与其他形式的关节炎不同，靶向关节，PSA也与肌腱，韧带，皮肤和钉子的变化有关。此外，它有一个变色龙特征，在那里它可以在一个人与另一个人的一个人身上采取大幅不同的外观。

This, at times, makes PsA a more complicated condition to treat. However, doctors have found that splitting the disease into five different基于位置的类型- 最近，最近，进入六个不同的域名 - 可以帮助更有效地针对每个患者的需求。域名，其归类为PSA如何在身体中表现出来，并且更多地包含疾病的细微差别，而不是类型的细微差别，对于精确定位治疗策略可能是特别重要的。

“Treatment isn’t a one-size-fits-all approach, but the domain and severity of the condition—along with other factors such as age and comorbidities—are mainly what dictate what treatment we’ll choose,” says Delamo I. Bekele, M.D., a rheumatologist at the Mayo Clinic in Rochester, MN. “Sometimes, domains also overlap, so that’s an additional consideration that will affect which treatment we choose.”

这是每个域的破录，以及它们对您的治疗方案可能的意义：

关节

这是什么：If your PsA mainly affects your joints—elbows, wrists, knees, ankles—but not your spine, it’s classified as peripheral arthritis.

如何治疗它：The first line of defense, for minor cases, are anti-inflammatories (think ibuprofen or naproxen). After that, your doc may try steroid injections directly to the affected site. For moderate or severe cases, there are disease-modifying antirheumatic drugs (DMARDs) taken orally or via injection. “The only thing that we don’t recommend for peripheral PsA are oral steroids, because those haven’t been found to be very effective for treating the joints,” says Dr. Bekele.

Spine

这是什么：Known as spondylitis or axial disease, this type of inflammation of the spine is less common, occurring in about 10% of patients, says Dr. Bekele. Although rare, “sometimes back pain can be the first symptom of psoriatic arthritis.”

如何治疗它：如果你的条件温和,你的医生可能会start you off with daily OTC anti-inflammatories. “Unlike with a standard headache where you’d take an anti-inflammatory as needed, with inflammation of the spine you need to take it consistently, and daily, to be effective,” says Dr. Bekele. Physical therapy is also typically part of the treatment plan. If those prove ineffective, your doc will skip over the disease-modifying medications—“those do not work for spine involvement,” says Dr. Bekele—and will instead turn to biologics, which are disease-modifying antirheumatic drugs that are injected.

Skin and Nails

这是什么：What we most commonly think of with the name “psoriasis,” skin psoriasis is an inflammation of the skin and is characterized by a red, scaly rash typically on the elbows, knees, scalp and lower back. “Nail psoriasis usually coincides with skin psoriasis,” says Dr. Bekele, and includes pitting, crumbling, or spotting of the nails.

如何治疗它：Get your dermatologist involved, suggests Dr. Bekele. “In addition to systemic medications that your rheumatologist will prescribe, there are also treatments that are driven by dermatology,” he says. Depending on severity, your derm may prescribe topical lotions, corticosteroids and, more rarely, ultraviolet therapy for extreme cases.

肌腱和韧带

这是什么：You may not often think of enthesis—or even know what it is, for that matter!—until it acts up. Enthesis is where the tendons and ligaments attach to your bones, and inflammation of the area is called enthesitis. “It’s common to see psoriatic arthritis in the Achilles tendon or the plantar fascia on the bottom of the feet,” says Woodstock, New York-based podiatrist Doug Tumen, D.P.M., author ofAsk the Foot Doctor. Other commonly affected areas are the hips and elbows.

如何治疗它：“Enthesitis can be quite difficult to treat, but there are various options we use depending on how severe the symptoms are and also what part of the body is affected,” says Dr. Bekele. If your symptoms are mild, your doc will likely start you off with non-steroidal anti-inflammatories (NSAIDs) like ibuprofen or naproxen. For moderate or severe cases, disease-modifying medications like methotrexate are the next line of defense, followed by biologics. Localized steroidal injections can also work well for hips or elbows.

Toes and Fingers

这是什么：“It’s called dactylitis, otherwise known as ‘sausage toe or finger,’ and it’s very common in psoriatic arthritis,” says Dr. Tumen. “Anytime I see a painful swollen toe, usually the third or fourth [the one next to the pinkie toe], I’m immediately going to suspect that it’s PsA,” he adds.

如何治疗它：对于轻度病例，典型的方案是用抗炎症开始。然而，贝卡尔博士说，秃头炎可以慢响应治疗，所以你的MD可能会跳过疾病改性的抗胃酸药物，并直接去生物制剂以治疗它。

While PsA is a special, complicated disease, it can also be a manageable condition. “If you have a mild case, in time we can withdraw therapy or even stop it, but even if we can’t, at least we now have a better understanding of the different variables of the condition, so we can target therapy appropriately,” says Dr. Bekele.