Does anyone have any good data on this ? I have Googled till my Googler is sore and I always forget this question when I see the rheum doc !
I assume it happens on a case-by-case basis, like most aspects of this disease. Maybe it won't bother you for years, maybe not at all. I doubt they've studied that specific question- it's rather rare for the arthritis to happen before the skin problems.
I also don't have the skin problems but have been diagnosed with arthritis.
My new Doc said she had a patient who developed it 10 years after the arthritis. Not sure if she had the nail ps also. I have the nail ps and have had only a small patch on my leg that went away within 3 weeks and have had scalp ps too. I’d agree that it’s probably case by case.
You may never have it mimi, you are recieving treatment. the P for most is the easiest controled.
Incidentally without a biopsy, you can't say whether or not its P. I had nothing for years, turned out what was suppsedly a hemroid was not. Nail involvement is P. There are dozens of forms types of P that manifest in different ways as simple as a zit from very minor to major.
Fascinating ! I do have some nail dystrophy, and maybe some inverse "down there" but I have never shown it to my doc, LOL.
I realized last week what an amazing doc I really do have. I was so bummed out before my appointment, afraid that I would "ugly cry" or have a meltdown in his office, and I apologized in advance for anything I might do or say. Thankfully, I did not melt down.
Sometimes it feels so hopeless. I am working out and though I am stronger, I do not feel better. I will keep working out because I know I need to keep strong and keep moving. As far as the PAIN, nothing has worked for me except prednisone!
The PAIN, for me, is the worst part. I am also trying to imagine what it would be like to have severe skin involvement and I just can't comprehend what some of you all must go through with all of it, My doc listened and he and he spent over an hour with me and really gave me some hope again. Simponi Aria will be my next experiment, pending off label approval by my insurance company. We also talked about apremilast, but neither of us are wild about the idea of it, since it is so new.
I started having joint problems in 2001, my two large toe nails have been thick and discolored since my late teens. My psoriasis showed up last April, palmar plantar psoriasis on my hands and left foot, also around the time the flares started to increase to every other week. Thankfully starting treatment cleared it up and it hasn't come back. I have always had dry skin and a couple of times little patches of what was then diagnosed as eczema. After seeing the dermatologist I was told it could have been psoriasis.
please explain the hemroid part. Sorry if the seems strange or if it's to personal. It never occurred to me my issue there could be related to this
tntlamb said:
You may never have it mimi, you are recieving treatment. the P for most is the easiest controled.
Incidentally without a biopsy, you can't say whether or not its P. I had nothing for years, turned out what was suppsedly a hemroid was not. Nail involvement is P. There are dozens of forms types of P that manifest in different ways as simple as a zit from very minor to major.
It wan't hemorrhoids. I'd finally had it and went to a surgeon to get them lopped off who informed me it was either bad hygiene or psoriasis. Seenie has a funny story very similar. Fortunately for me a skin culture confirmed psoriasis. The buttocks crease is another common sight for the P. A number of cases of Pruritus ani (also known as anusitis) whuich seems the same, is often just eczema but is increasingly being found to really be the result leakage from small fistulae caused by psoriasis or even early Chron's disease. There are several others here with similar experiences but the topic doesn't come up often so its been very hard to get to the bottom of......
did it cause other issues besides itching, like bleeding
Lamb, OMG, LOL. Where can I read Seenie's tale ?
Oh yes bleeding for sure robyn Get it checked and make sure they CULTURE.
one more thing to add to my list. It never seems to end. I need to get blood work done because of internal bleeding - again. And my blood pressure has dropped - again, Oh yeah, and my eyes
tntlamb said:
Oh yes bleeding for sure robyn Get it checked and make sure they CULTURE.
Is it a culture or a biopsy ? I don't want anyone cutting or scraping anything south of the border.
A not-so-great but sometimes wise dermatologist described psoriasis to me as "The Great Pretender." Sometimes they can distinguish it from other things on biopsy, but it seems unlikely they'd be able to with inverse because it lacks the thick scaling of psoriasis on other surfaces. Oftentimes psoriasis looks like a silvery scale, classic plaque psoriasis, and that's when they can get a really good look. Even then, though, you're depending on the person reading the biopsy to know what they're looking at.
Mimi, its a little snappy thing sorta like an auto injector, the do both with the same sample usually. As rosen said, its still a crap shoot depending on who does the work, but you want both done, yeast infections love to grow in P.
Not to change the subject but there is some on going work where they are identifying t cell interkleukins in the samples (from anywhere not just south.) The story is they should be able to use this to match biologicals (the new generation)
$h¡+ !! was my first thought about this Lamb: A number of cases of Pruritus ani (also known as anusitis) whuich seems the same, is often just eczema but is increasingly being found to really be the result leakage from small fistulae caused by psoriasis or even early Chron’s disease.
Inflammation of the butt hole. Who would-a thought? I know my Doc checked for inverse psoriasis. Whenever I “feel” inflamed I tend to also have issues down there too.
I had skin symptoms for 20 years and then not all for the next 20. Mine seems to be above or below the skin.
When my skin problems went away I could see red spots under the skin at the joints that ultimately became psoriatic arthritis.
So after a 20 year skin hiatus mine showed up.
It seems that no one has the same situation or severity of both.
Hi mimiB,
I've had psoriasis for almost 40 years now....since it started in my early 20s (I always blamed it on the stress of quitting smoking cigarettes) it started out strong but then was managed pretty well up until my mid-50s (about 5 years ago). All hell broke loose--the psoriasis got worse in places--especially my lower legs, and that's when the psoriatic arthritis started flaring up really bad. This happened within months after I went through menopause. I can tell you, if I had a choice of the skin problems or the arthritis, I'd take the skin problems any day. They aren't painful. Sure, it's hard to deal with because it's embarrassing and I really never wear shorts or short sleeved tops. I never got sad or depressed when it was just the psoriasis, though. The pain of arthritis is really getting to me. It seems to be getting worse rapidly, and it is scary. I know it's not recommended, but I go tanning occasionally to help clear up my skin somewhat. I don't feel that anything I'm doing for the arthritis pain is working--however, I'm not doing much. I'm terrified of all the strong drugs--the biologics especially! I take a few aspirins and tylenol, but they're really worthless. I'm trying to find time to read the discussions on this site.....I think knowing how biologics are working for others will help me make a decision about trying them. First, though, I'm planning on changing my diet to avoid certain foods and increase certain other foods to see if that helps. I'm surprised your doctor gives you prednisone. I have BEGGED for it--my 89-yr-old mom has been on a small dose of prednisone for about 12 years for her polymialgia and she is the healthiest 89-yr old I've ever known! My doc tells me it will hurt me more than help! I have not heard of Simponi Aria, but I'll look into it.....do you get prednisone shots at the pain site or do you take tablets? I wonder if there are others who get prednisone on a long-term basis?
mimiB said:
Fascinating ! I do have some nail dystrophy, and maybe some inverse "down there" but I have never shown it to my doc, LOL.
I realized last week what an amazing doc I really do have. I was so bummed out before my appointment, afraid that I would "ugly cry" or have a meltdown in his office, and I apologized in advance for anything I might do or say. Thankfully, I did not melt down.
Sometimes it feels so hopeless. I am working out and though I am stronger, I do not feel better. I will keep working out because I know I need to keep strong and keep moving. As far as the PAIN, nothing has worked for me except prednisone!
The PAIN, for me, is the worst part. I am also trying to imagine what it would be like to have severe skin involvement and I just can't comprehend what some of you all must go through with all of it, My doc listened and he and he spent over an hour with me and really gave me some hope again. Simponi Aria will be my next experiment, pending off label approval by my insurance company. We also talked about apremilast, but neither of us are wild about the idea of it, since it is so new.
grandma J, I take it orally and also get the occasional 80 mg kenalog injection into my knee.
Steroids may be appropriate for "bridge therapy" or "stopgap" treatment until an effective DMARD or Biologic or combo is found and for extreme flares. Every patient is different and may respond to therapies with varying degrees of success depending on where they are in the disease process and their unique symptoms.
To me, the disease is scary and so are the meds. I know you have heard "fear the disease, not the meds" but frankly, both of them are scary to me. At some point, we have to face our fears of the disease AND the drugs and choose to fight. If we choose fear and passivity, the disease will win. In the beginning, I had the tendency to catastrophize and I think I was dealing with a pretty whopping dose of depression. Now, my motto is "strategize, don't catastrophize!" That means to become a warrior against this enemy and pull out every weapon of mass destruction I can wage in the fight.
For me, prednisone is an effective weapon in my arsenal, I have taken as little as 2.5 mg and as much as 30 mg per day, depending on what is going on. I simply cannot function without it right now. I would be bed ridden or wheelchair bound.
As it is, I am currently on 10mg of daily prednisone, and I can function pretty well, including a fairly intense cardio workout 3 times a week.
My goal is to get off of prednisone, completely, once I find a biologic that works. I have tried three and have not had success with any of them. I do take methotrexate, but it does not adequately manage my symptoms. My right knee has gone from normal to "bone on bone" in the last year and a half. My ankles and feet have major issues. I have had a lumbar fusion and now my cervical vertebrae are in similar shape. This stuff is nothing to mess with, so please fight it with everything you have.