Know Your Psoriatic Arthritis: Is It a Flare or Infection?

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.