How a Rheumatologist and Dermatologist Work Together

Psoriatic disease is an autoimmune disorder that involves inflammation throughout your body. It’s also an umbrella term for two conditions: psoriasis and psoriatic arthritis (PsA).

Psoriasis generally affects the skin and causes plaques or lesions to appear. PsA primarily affects the joints, causing pain and stiffness. People with psoriatic disease may also experience issues with other organs and tissues, and they have a higher chance of developing heart disease or diabetes .

About 30 percent of people living with psoriasis also develop PsA. You may develop PsA without having psoriasis, but it’s not common.

When treating PsA, a person will often have a team of doctors and specialists. This team typically includes a dermatologist and a rheumatologist. When these healthcare professionals work together, diagnosis and treatment practices may be more effective.

Dermatologists often work with people living with psoriasis. With around 30 percent of people living with psoriasis later developing PsA, dermatologists are often the first to recognize PsA symptoms in their patients.

If you’re already living with psoriasis and working with a dermatologist, they’ll likely ask you about symptoms related to PsA. If they identify PsA, they can start to administer treatment specifically for PsA.

Early treatment is important to help prevent arthritis from getting worse and causing joint damage. About 40 to 60 percent of people living with PsA will develop joint deformity, which leads to reduced quality of life.

Rheumatologists specialize in diseases that affect the joints and muscles. A rheumatologist can provide an initial diagnosis of PsA or develop a treatment plan following a dermatologist’s diagnosis.

A rheumatologist can help you develop a comprehensive treatment plan that works for your needs. They will often be the doctor you see for managing your medication, reporting any issues, and other aspects of your PsA care.

Diagnosing PsA can be difficult, but it’s important to diagnose the condition as soon as possible for more successful treatment outcomes. Early treatment can help prevent permanent joint damage.

The best results may occur when the rheumatologists and dermatologists work together to diagnose the condition. According to a 2021 studyclose collaboration between the two doctors can help speed up the diagnosis of PsA.

Diagnosis typically involves ruling out other conditions, which can be difficult because PsA has overlapping symptoms with other types of arthritis. Currently, there’s no standard practice for diagnosing PsA.

Symptoms a dermatologist or rheumatologist may look for when diagnosing PsA include:

  • pain and swelling in the joints
  • inflammation and stiffness that improves with activity and worsens with rest
  • enthesitis, or swelling and pain in the tendons around the joints
  • nail psoriasis
  • dactylitis, or swelling of the toes and fingers

According to a 2021 study conducted in China, one factor that affects a rheumatologist’s ability to diagnose PsA effectively is whether they work full time or part time. These findings may not apply the same way in the United States, but they provide helpful insight into the need for rheumatologists to have experience with and be involved in the diagnosis.

Psoriasis often presents before PsA. Due to the likelihood of comorbidity of the two conditions, your dermatologist may be more open to a PsA diagnosis if you have psoriasis and develop joint pain.

Treatment outcomes for PsA may also improve when a rheumatologist and dermatologist work together.

Often, treatments for psoriasis and PsA overlap. This means some of the systemic treatments used to treat one can also help treat the other. Systemic treatments can include biologics and oral medications.

When working with both doctors, a person with PsA will need to communicate which treatment each doctor provides. A dermatologist may work by prescribing skin care treatments, while the rheumatologist may work more on treating the overall disease and joint pain.

Treatments for psoriatic disease include:

  • systemic medications, such as biologics
  • phototherapy
  • creams and ointments
  • complementary and alternative medicines, such as yoga and acupuncture

Systemic medications often help for PsA, because they target overall inflammation. Your rheumatologist may recommend additional treatment, such as pain medications like nonsteroidal anti-inflammatory drugs (NSAIDs).

When a person with PsA seeks care from both a dermatologist and rheumatologist working together, a diagnosis may come earlier, and treatment outcomes may improve. Earlier diagnosis can help slow disease progression and help prevent joint damage.

Dermatologists often work with people living with psoriasis, and rheumatologists specialize in diseases affecting the joints and muscles. About 30 percent of people living with psoriasis develop PsA.

Speak with your doctors about whether working together would help in developing a comprehensive treatment plan and improving your PsA.

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