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Fever Pitch (7.15.2022)

Jul 15, 2022 7:49 am

Rheumatologists’ Comments

David S Knapp

| Jul 16, 2022 12:43 pm

Jack, as my wife fits your PsA/ sine psoriasis actually going back to teenage years, she has been treated with all the usual drugs. Intolerance to variety of biologics and MTX have limited treatment over the years. She had dramatic improvement with Otezla but again could not tolerate side effects. Fortunately, no structural joint damage is clinically evident as her Sx wax and wane with weather, activity, etc. I call it "Zig-Zag disease" based on migratory clinical involvement that comes and goes. Otherwise I would characterize here as a sero-negative rheumatoid variant, SNRA, inflammatory arthritis, or even a subset of JIA persisting into adulthood. Blame it on the weather, the biotome, activity-no real rhyme or reason for pauci-articular "cold" synovitis, enthesitis, nail issues and non-psoriatic skin rashes. The Plaquenil seems to offer the best treatment option overall. Thanks for covering this topic. She always remembers you from Hawaii meetings!!

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