This may post or not. Haven’t got a clue. Newly diagnosed with PsA in December 2025. Looking over last year makes me happy indeed to have moved on to April 2026. Until November 2025, I’d been treated for seronegative RA since 2019. The usual string of trial-and-error medications from methotrexate up to and including biologics Rinvoq, Humira and Actemra. Actemra was doing absolutely nothing.
Meanwhile, I’d had clear signs of psoriasis on and off for a decade. I know that now. Nail psoriasis on toenails, plaque on both heels and inverse psoriasis appearing now and then in truly nasty spots you just don’t need or want it. Problem was, nobody identified any of this as psoriasis including me who valiantly treated everything as fungus none to successfully. But there you go.
Moving from Ottawa to Washington DC then Boston back to Ottawa from 2009- 2019 did mean I was jumping around from doctor to doctor with less than consistent rheumatologist in the picture dealing with joint inflammation and pain. Four, some better than others. My husband is Canadian Foreign Service. We move A LOT. It’s been our life.
Back in Ottawa, for good this time, I won the lottery of no rheumatologists in town and landed one who diagnosed and began treating RA and retired after a year. Next and current rheumatologist has been hit -or-miss and frankly more miss. When I began to have strange rashes, now I know as inverse psoriasis, these she dismissed as not side effects of any new RA meds I was taking - all from over the phone! So, I stopped mentioning the rashes at any in-person appointment. My heels were no more than dry skin I needed to moisturize more after I scraped off layers of thick white build-up after each shower.
In November, for whatever reason, untreated PsA too long???, the mysterious rashes, thick heel layer of something??? all enflamed sent me to my family doctor. She mentioned the word psoriasis for the first time as that’s what it looked like to her. Plaque on my heels and soles. Inverse about everywhere it could be. And things were about to get worse.
She pulled off an appointment with a dermatologist in 2 weeks, something of a miracle here. Prescribed desonide, steroid cream to apply in the meantime, with refills. That inverse psoriasis spreads like wildfire. During that week of waiting, I consulted Dr. Google on all things psoriasis. This was all new to me. A whole world awaited out there.
It didn’t take me too long to connect all the psoriasis symptoms I’d had over the years, inverse, plaque and who knew about nail psoriasis? I’d had that baby for years. It’s horrible. The podiatrist in Boston who ripped out my big toenail talked about something hereditary. And, yes, my father had grungy toenails too.
If you throw in all the RA-like joint pain and the old knee replacement plus the recent shoulder replacement, seems like a good bet I’d had psoriatic arthritis for a decade at least. No wonder the drugs for RA didn’t work. And there was so much more about RA I never quite thought applied to me.
When lesions between my toes bleed all over the bathroom floor one night, I called for a follow-up with my family doctor. This was getting ridiculous. The other inverse psoriasis areas were spreading too, itchy and oozing. She saw me the next day for a summit conference and a look-see. We had a great working relationship, so I broached the subject that by educating myself on psoriatic arthritis, I was beginning to think that might be the overall issue, not RA and psoriasis.
What did my rheumatologist say, she asked. Nothing as I hadn’t seen her in ages. And she didn’t see patients between appointments any too happily. Plus, she had told me ages ago that she “didn’t do rashes”. Rashes were the family doctor problems. One email later, and by the end of this appointment, I had a next day visit with my rheumatologist. A miracle. No idea what was in that email, but it did the trick.
My rheumatologist was notably surprised at the war zone of my skin. Yes, clearly inverse psoriasis run amok. Genital psoriasis to be precise and other areas, every skin fold and toes. And plaque psoriasis on feet. Immediately changed my diagnosis from seronegative RA to PsA. That was that. Start using Taltz and she had some sample injectors on hand to get me started right away until prescription started.
Wasn’t it great my family doctor had already organized a dermatologist? Sure was, I thought. My rheumatologist was thrilled when she didn’t have to organize anything. And my family doctor was already prescribing steroid cream to rub all over everything so she didn’t have to. How handy!
That was December 1. Officially PsA. We headed home, my husband driving. I don’t drive as I have vision in only my right eye, so no longer drive. Seems like a wise idea. Did first injection of Taltz and everybody waited for that dermatologist appointment. No one could possibly imagine what was about to happen next.
- I’ll wait to see what Dr Kaul’s has to say before I start telling my GP she’s wrong!