Health Boards
Thu-29-10-2015, 23:37 PM
Welcome David! You'll find a lot of information here and a lot of friendly people who are always willing to offer advice, give an opinion or just sympathize!
Fred mentioned that I might know a bit about what's available in the U.S. I can only tell you what my dermatologist's steps are in treating psoriasis. First, topical and UV treatment and then oral meds. He mentioned biologics but also said that those are after exhausting other treatments. That seems to be the standard just about everywhere from what I can tell, but of course individual patients may jump further ahead in treatment depending on the severity.
I do have a rheumatologist but I do not have psoriatic arthritis. During my last appointment with him my psoriasis was flaring a bit. He mentioned putting me on Methotrexate (he said most insurance companies will require it but not all will) and then going on Stelara. I mention this as my psoriasis wasn't as bad as the first time I saw a dermatologist who wanted to start out with topicals so different doctors will take different approaches.
Basically it will all depend on the doctor plus as you know insurance varies greatly here and that can also affect what a doctor would choose to start someone on.
What is REALLY great about this forum (among a lot of other great things!) is that you can get informed and that can help a great deal when working with a doctor if you should decide to go on a treatment. I know that should I need to get more aggressive on treatment again that I could go through my dermatologist (probably would put me back on Acitretin) or my rheumatologist who sounds like he would want to take a different approach.
Fred mentioned that I might know a bit about what's available in the U.S. I can only tell you what my dermatologist's steps are in treating psoriasis. First, topical and UV treatment and then oral meds. He mentioned biologics but also said that those are after exhausting other treatments. That seems to be the standard just about everywhere from what I can tell, but of course individual patients may jump further ahead in treatment depending on the severity.
I do have a rheumatologist but I do not have psoriatic arthritis. During my last appointment with him my psoriasis was flaring a bit. He mentioned putting me on Methotrexate (he said most insurance companies will require it but not all will) and then going on Stelara. I mention this as my psoriasis wasn't as bad as the first time I saw a dermatologist who wanted to start out with topicals so different doctors will take different approaches.
Basically it will all depend on the doctor plus as you know insurance varies greatly here and that can also affect what a doctor would choose to start someone on.
What is REALLY great about this forum (among a lot of other great things!) is that you can get informed and that can help a great deal when working with a doctor if you should decide to go on a treatment. I know that should I need to get more aggressive on treatment again that I could go through my dermatologist (probably would put me back on Acitretin) or my rheumatologist who sounds like he would want to take a different approach.