Uh Oh!

[Fred]

My question is though, if this is likely arthritis in my feet and hands, will this elevate my chances of being proscribed fumaderm or Cosentyx or will it take my treatment down a different path?

As you are in the UK.

Fumaderm: No if it psoriatic arthritis, and depending on where you live Fumaderm is a no for psoriasis too. It's a postcode lottery as to if Fumaderm will be prescribed, but it won't be prescribed for psoriatic arthritis.

Cosentyx: No for any reason. It is still a new treatment and not many people are on it. To get any of the Bio treatments you will have to fail on the oral treatments first, but even then Cosentyx will not be given first.

As this is your first consultation with a dermatologist in the UK I would say you will be offered Methotrexate.

This is my own opinion and you could be very lucky, but I doubt it.

Have a read at these threads it may help:

NICE issues new guidance for GPs treating psoriasis

NICE Quality Standards for Psoriasis