Skin and joints therapy.
- Initial Therapy with NSAID and analgesics
- DMARDs (Disease-modifying antirheumatic drugs): Methotrexate can produce a better result. It may also help skin psoriasis. Other drug of choice is sulfasalazine. However, both of them cannot halt the progression of erosive joint disease.
- Other: cyclosporine, retinoic acid derivatives (acitretin – teratogenic!) , and psoralens plus ultraviolet A light (PUVA) for skin lesions.
- Anti-TNF (etanercept, infliximab, adalimumab, and golimumab) treatment should be the choice for those who with active synovitis and does not respond to standard DMARDs (Methotrexate)
- Since Hydroxychloroquine causes skin problem, it is avoided.