Final answer:
Initial treatment for psoriatic arthritis often begins with NSAIDs to reduce pain and inflammation. Depending on severity, DMARDs or TNF-α inhibitors may also be prescribed. A rheumatologist would determine the appropriate therapy based on the individual patient's symptoms and disease severity.
Step-by-step explanation:
You are caring for a patient with a history of psoriasis who is now showing musculoskeletal signs and symptoms with joint involvement. Although seropositivity can provide a definitive diagnosis of psoriatic arthritis, it is important to note that the initial treatment choice for management is typically based on the specific symptoms and the severity of the disease. Rheumatologists often employ a stepwise approach to therapy.
For the management of the musculoskeletal symptoms in psoriatic arthritis, the initial treatment might include nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation. Depending on the severity of the symptoms and whether there is moderate to severe joint involvement, disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, or tumor necrosis factor-alpha (TNF-α) inhibitors, like etanercept or adalimumab, could be considered. Uricosuric drugs are not typically used in the treatment of psoriatic arthritis but are rather used for conditions like gout.
Clinicians may also consider corticosteroids and other medications such as hydroxychloroquine, which is an anti-inflammatory drug used in other conditions like rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), and can be used as part of a combination therapy.