Treatment of refractory psoriatic arthritis.

Psoriatic arthritis occurs in approximately 5% of patients with psoriasis and can lead to significant morbidity. Treatment options for refractory psoriatic arthritis can be divided into (1) medications used in the treatment of other rheumatic diseases and (2) experimental agents. This article reviews available therapeutic agents for psoriatic arthritis and outlines an approach to treatment. The use of physiotherapy and surgery and the management of arthritis mutilans are also reviewed.