Skill Checkup: 49-Year-Old Woman With Psoriatic Arthritis and Swollen and Tender Peripheral Joints Despite Treatment

Marina Magrey, MD


March 20, 2023

The Skill Checkup series provides a quick, case-style interactive quiz highlighting key guidelines- and evidence-based information to inform clinical practice.

A 49-year-old woman in the United States had a 12-year history of psoriasis. Two years ago, she developed joint pain, stiffness, and swelling and was diagnosed with psoriatic arthritis. She makes her living as an artist, and her symptoms have impeded her productivity. A tumor necrosis factor alpha (TNF-alpha) inhibitor was initiated at the time of diagnosis. She had an initial response to therapy that has waned over time. Current disease activity includes three swollen and five tender peripheral joints and psoriasis affecting 4% body surface area (BSA). Her height is 5 ft 6 in (168 m) and her weight is 161 lb (73 kg).


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