Q: If your inflammation from psoriatic arthritis is not under control, are you more likely to have severe effects from COVID if you were to contract it?
A: (Dr. Ritchlin) We don't have evidence to support this association. Nonetheless, control of arthritis is vital to maintain high quality of life and function. It is essential for patients to be vaccinated so that patients who do have active psoriatic arthritis don't have to deal with the significant challenges of COVID-19 infection.
Q: I’m interested to know if the Covid vaccine could cause a flair of symptoms of Psoriasis?
A: (Dr. Ritchlin) Case reports in the literature document worsening psoriasis following COVID-19. In my experience, these flares are extremely rare. Specifically related to your question, I have not seen patients or reports that document onset of psoriasis or psoriatic arthritis following vaccination. Of course the challenge is to determine if the vaccine was causal in the development of psoriasis of psoriatic arthritis or if the relationship is due to chance.
Q: By the end of April, everyone in our home will be fully vaccinated. We are hosting an exchange student from Germany for the next school year. There is no chance she can be vaccinated prior to her arrival. Her mother is reluctant to allow her to get vaccinated here in the US. She is 16 years old. We are in Michigan and rates are very high right now for Covid. With both my son (age 22) and myself having both PsO and PsA and on a biologic, how concerned should we be to have her in our home without being vaccinated?
A: (Dr. Gelfand) This is a very difficult question to answer with any degree of certainty. The best I can say is that if I was hosting an exchange student who was 16 in my home I would expect that person to get the Pfizer vaccine (which is available to people 16 or older).
Q: In terms of booster, is there some kind of lab test to see if your still immune yet as times goes by? Like with the hepatitis shots as an example.
A: (Dr. Weinstein) Unfortunately we don’t yet know if there is a “cutoff” of antibody level that is protective. Not all infections have a cutoff like hepatitis that we know is protective, because of complex immune responses that involve more than just antibodies but other immune cells as well. So as of now, there is no lab work that will determine if a booster is needed, but this may change as the science evolves.
A: (Dr. Gelfand) Unfortunately we don’t know if such testing can guide clinical decisions for the COVID19 vaccine. The CDC currently recommends AGAINST getting a antibody test to see if an immune response was mounted to a vaccine.
Q: Is the LITE study open to those with at home UVB units?
A: (Dr. Gelfand) Yes- the LITE study is open to people who have a home phototherapy machine however we would send you a commercially available machine for 12 weeks as part of the study if randomized to that arm.
Q: Regarding the LITE study, what if people have psoriasis on the soles of the feet? Could they still be considered?
A: (Dr. Gelfand) Unfortunately no - palms and soles psoriasis requires a different type of phototherapy and is not as easy to do at home.
Q: What would be the right first step to see if my recently discovered psoriatic arthritis has caused any cardiovascular issues that I could monitor/improve?
A: (Dr. Gelfand) Re: CV risk - knowing your blood pressure, cholesterol and blood sugar is the first step. A heart healthy lifestyle (diet and exercise) are important too, https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/aha-diet-and-lifestyle-recommendations . Talk with your PMD or your dermatologist or rheumatologist re: heart health. Depending on risk factors some patients are recommend for statins (cholesterol medications) others are recommended for a special test called a coronary calcium score (a type of special CT scan). The good news is that by managing traditional CV risk factors we can dramatically lower risk of CV disease.