Lucky–that’s a funny word in regard to PsA! 
Mine was the creepy sneaky ache and pain, and I’ve always felt ‘lucky’ my PsA didn’t hit me like truck!
I guess no matter how it starts out, it eventually feels like a truck–or a freight train–sort of like ‘this is going to kill me if I don’t do something about it!’
That makes me wonder…my psoriasis hit me like a truck in my early 20s, but my PsA came on gradually years later…I’m wondering if most people with little or no psoriasis are typically the ones whose PsA comes on faster and more severe?
Okay folks, I need your expert opinions. The skin biopsy from my inactive leg rash remnants came back as “nonspecific spongiotic dermatitis”. My rheumatologist is telling me that this rules out psoriasis. But I’m confused, because pustular psoriasis is a form of spongiotic dermatitis, is it not? The term nonspecific makes it very broad. Can a biopsy done on an inactive rash (inactive for ~2 weeks) even be trusted to begin with? Or am I grasping for straws here? Waiting to see the report itself in the mail… feeling like I just took two steps backwards towards a diagnosis.
Spongiotic dermatitis refers to an ACUTE condition (usually eczema) its a descriptive term rather than a diagnostic one. Pustular psoriasis can be described as Spongiotic dermatitis but not often. In that case it would be spongiotic psoriasiform dermatitis. the adjective spongiotic comes from Spongiosis which is intercellular edema (abnormal accumulation of fluid) in the epidermis. All the diagnosis you have means is that what you have is not psoriasis. It doesn’t mean your next skin flare isn’t the P.
I wouldn’t say you took 2 steps back quite yet. Spongiotic dermatitis is for sure an inflammatory condition unlike most eczema. I’d be concerned if your Rheumy totally blows this off. You are going to be prone to Spongiotic dermatitis if you do have P. In the meantime POLL your relatives (especially first degree) At least one of them should have had P if you do.
In any event Nothing precludes you from having Seronegative Arthropathy which is treated the same anyway. Many here carry that DX anyway. AND if you don’t have P and can get treated, BRAVO, thats two steps forward. You really don’t want P (as I sit here with both arms a bloody (seriously - actually blood for our Brits) mess
Thank you for the clarification. I don’t want to have psoriasis, per se… I don’t want to have this skin condition at all, whatever it is. It has been recurrent since 2011, present/active about 80% of the time since the onset. It has made my life miserable during the times when it is at it’s worst and has prevented me from doing things–there were days when I wouldn’t leave the house because it hurt to move my legs and ankles because of the rash. The timing also coincided with the onset of severe fatigue. And when a rash developed on my hand, I developed nail pitting on the most infected finger. Psoriasis just makes sense as an explanation, beyond just physical appearance. I can even recall having a rash on my forearm in front of my elbow on and off as a kid, and psoriasis would explain that too.
My legs have had generalized itchiness for a little while and small bumps everywhere, with the scaly rash only in one spot and not very active (and not taking on the typical appearance that it has had in the past). Maybe it is something different at the moment. I don’t really know.
My cousin had an autoimmune condition that caused painful blistering on her skin. I just don’t know what it was diagnosed as. I’ve been avoiding asking my aunt, as my cousin passed away a few years ago and it’s still a sensitive subject. But she’s the only one in my family that I know of who had a skin condition. Edit: I just found her former pinterest page, which mentions “Erythema Multiforme”.
I finally actually got to see the report from my foot X-rays. The X-ray interpreter did note:
“There are some mild narrowings of the interphalangeal joints proximally of the second, third and fourth digits.”
Is that a normal finding and not something to be concerned with? Funny, because those toes listed are my toes that hurt the most (and that won’t bend anymore on my left foot). Pinky toe never hurts, the big toe sometimes gets sharp shooting pains, but those three middle toes are regularly painful.
Here’s some information on joint space narrowing - https://www.healthline.com/health/joint-space-narrowing#diagnosis2
I know that my own x-rays and imaging show joint space narrowing in many of my joints, large and small. So some of my baseline imaging already showed changes. Note that it can be age and overuse related as well, but the age piece isn’t really an issue for you, huh?
Again, joint space narrowing can impact joint range of motion.
Thank you for the info. I’m mostly curious how common of a finding it is on nonsymptomatic young people, but I’m not finding much info online for that. I guess most healthy young people don’t get foot X-rays too often.
Overuse damage is certainly a possibility. My former job had me doing some very intensive off trail hiking for a few years. Had occasional arch pain and on off over the years, but widespread foot pain involving my toes is new as of July.