Current medical status: Diagnosed with PsA 1 year ago. Had 20 year history of mild plaque psoriasis on knees and elbows. Prior to arthritis symptons developed psoriasis of face and genitals. Arthritis progressed slowly after worsening of skin condition. Currently have dactylitis of 4 toes and 1 finger; enthesitis of right heel and left knee. Enthesitis of 1 vertebra.
Current medical treatment: Treated for 9 months with methotrexate, reaching dose of 20 mg once/wk subcutaneous. Seemed to provide significant improvement in joints, skin and nails. Paracetemol 650 tid, diclofenac 75 mg bid. Also take simvastatin 20 mg od and androgel (topical testosterone 1%) 5 g / day.


The Non-Steroidal Antiinflammatory drugs (NSAID) you have been taking decrease the pain by decreasing the inflammation. No other pain reliever can decrease the pain so efficiently and not decreasing the inflammation at the same time.


Unfortunately, all NSAIDs can cause hepatic symptoms including increased liver enzymes. Furthermore, Non-Steroidal Anti inflammatory drugs should be used with caution when administered concomitantly with methotrexate, because they can enhance the toxicity of methotrexate. Liver enzyme elevations are frequently seen after prolonged use of methotrexate. They are usually transient and asymptomatic.