Need Help Psoriatic Arthritis Without Psoriasis


I need help. The VA (United States Veterans Administration) does not believe that I can have Psoriatic Arthritis (PsA) without Psoriasis. Nor do they believe that PsA can be triggered by trauma. Without going into detail (as I can not) I was injured in Guantanamo Bay Cuba while working in Camp Delta (the Al-Qaeda prison). I can not find any other trigger of my PsA, and I have to prove to the VA that my PsA comes from that traumatic injury to justify my right to a claim. PsA has me to a state now that I can no longer work as a Corrections Officer and without the VA I have nothing to fall back on. If you can find or know of information that could be of help to me please email me at ■■■■■■■■■■■■■■■■■■■■■■■ . I am doing a lot of research, but there just does not seem to be a lot of case studies, or information out there for me to support my case.

Thank you in advance for any help that you may give.

Tony Moss

Lansing, MI, USA

Hi, Tony, welcome to the group.

VA doesn't believe you, but you seem to have a PsA diagnosis. Who provided you with that diagnosis? A rheumatologist, I presume? Would the rheumy not be willing to justify this?

I cannot recall where, but I have seen information that says a very small number of PsA sufferers have the arthritis before skin symptoms appear. Do you have any toenail "fungus"? That is the only evidence of psoriasis that I have.

Here is an organization which may be able to help you. They have a lot of information, and it looks like you can contact them as well:

Hope this helps.


Hi Tony,

This breaks my heart. I cracked my skull when I was 7, then one month later had rheumatic fever, and have been living with PsA ever since, though I wasn’t actually diagnosed till I was 21. So I attribute my onset to trauma and illness but it was never proved.

Do you have pitting in your nails? Or any sort of markers in your nails? This is the only sign of Psoriasis I have.

I am appalled at the response you’re getting, and I’m going to do some asking around in the greater Arthritis community, and see if we can find you some help. I’m wondering if a lawyer wouldn’t be out of the question? I’ll let you know what I find by emailing you.

-Hurt Blogger

Hi Hurtblogger,

I know how frustrating the VA can be; my DH has to deal with them. I found these articles by searching Google. I tried to look for medical, peer-reviewed research articles. Peer-reviewed articles are harder to argue with, and may be likely to carry more weight for your argument. Just type "psoriatic arthritis trauma" into Google. There are many responses; unfortunately, most are available at a price. You might be able to find them in a library, where you could photocopy them for your own use. You can also use the Google Scholar search engine to hunt for more research-based, peer-reviewed articles.

Good luck!


Thank you everyone for your help. I am working with my doctor as well spending a lot of time doing research. I am sure that this info will help. I am trying to over whelmingly provide proof of not only PsA, but the reasons for it.

Tony, I'm sorry you're having to do this -- justifying / explaining your PsA to the powers -- as you have more than enough to deal with. Having PsA is not easy, we all know that all too well, and then to have to do battle as well! Thank you for posting here, though: I'm finding the links that Byrd provided very very interesting.

Just curious: do you have even one nail that isn't "right"?

Good luck with this. Please drop by again to share your knowledge and to let us know how you are doing.


Hi Tony! I did NOT have any skin problems until 2 1/2 years AFTER my diagnosis. I went to the doctor with horrible bone pain in 2005. I had a life threatening food poisoning incident in 2004 and about 6 months later started having pain in my bones that did not go away with Advil or Tylenol. My rhuem. has gone so far to say that the incident of food poisoning and the effects of antibotics most likely wiped my immune system out and you cannot start over once that happens. It is important for you to know, that NO ONE in my family history has ever had this or psorisis. I started having skin lesions AFTER contracting strep throat (which put me in the hospital for 2 weeks). Upon arriving home, my hands and feet broke out with little “pimple” type bumps. The dermotologist diagnosed “Pustalar psorisis” which went totally out of control and I was “raw” not just in my hands and feet but also throughout my body. I was on Humira/methotrexate at the time of this complication. My doctors put me on Remicade/methotrexate and it has taken about 3 years to get to where I am now. That being very few skin lesions and hands breaking out about one week prior to receiving Remicade. I do not know is this helps your situation, but I do believe that for some patients, this disease can be brought on by some kind of trauma to the immune system. Good luck to you and I hope the VA will come around to protect the life you have…Thank you for your service to our country!

Remember, skin symptoms often do not show up sometimes for years after the onset of joint problems. Also, lesions can hide (under hair, in skin folds). Keep looking in obscure places. Look at your toe nails even! But keep in mind, they may not show up for a very very long time. And, in the early stages, some docs are reluctant to call it psoriasis. They start of with “grease spot,” “eczema,” and a hundred other things before they believe in psoriasis. I know it isn’t easy, But hang in there and keep doing your research. Do try Google Scholar. If you find an article there you think you are interested in, take it to a library–better a library at a teaching hospital if you have one near-- and ask them to help you find it. It takes time, but it’s worth it!

Again, thank you everyone for your help. Some of the information I already had and some I didn't. The more minds that address an issue the more complete the results are. Between the information that you provided, the information that I was able to gather, and my advocacy group, I think that I will be able to prove my case, or force the VA to prove that my PsA is not related to trauma.

Thanks again.

I hope that I can return the favor to you guys one day. Stay strong, positive, and active. If we don't keep trying then we can never win against PsA.

Did you get my email about contacting your Congressional office? They can advocate on your behalf! Please keep us in the loop about how it’s going.

I just wanted to say that it was 8 YEARS AGO that I had what I now know to be P on my eyelids. So I’m saying that maybe you should go back ten years and see if there was ever a problem with your nails and also consider dandruff. Have you ever had it. Because chances are it was P. good luck. If we can be of assistance by writing our stories showing how many different ways and forms of P we all have to show the VA that there truly are sooooo many types and forms maybe it will help show that no two cases are alike and you don’t have to have P right now to have PsA. Say te word and I’ll share on the other forum im on. I’m an honorably discharged Navy Veteran…I’m sure there are lots more like us with this disease who would be more than willing to help. Military and civilian too.

Tony said:

Again, thank you everyone for your help. Some of the information I already had and some I didn’t. The more minds that address an issue the more complete the results are. Between the information that you provided, the information that I was able to gather, and my advocacy group, I think that I will be able to prove my case, or force the VA to prove that my PsA is not related to trauma.

Thanks again.

I hope that I can return the favor to you guys one day. Stay strong, positive, and active. If we don’t keep trying then we can never win against PsA.

Well the VA denied my claim. Go figure. However; they did acknowledge several things that I thought would be very hard to do. Such as, I do have PsA. It can come from trauma as an autoimmune issue. However; they cited that my rhummy stated that there was a spot of psoriasis on my leg. ( I do not have psoriasis) The VA used this as the sole reason for my denial. Since it wasn't psoriasis I will have a dermatologist address that in a letter this week. I will then take his letter to my rhummy, and we will work out another letter to the VA. After all that, I will file my appeal. I think that they will not have a choice but to approve me after this. Since I do not have psoriasis...It almost has to be a autoimmune response from trauma that I had while in service.

Please note that I submitted all of the studies I found online with my medical records. So thank you to all of you who helped me find more information. I gave them a lot to chew on when I filed my claim, and the VA did not do an exam since I had all of my medical records.

It seems that I now only have one hurdle left in front of me, and that is easily fixed. At least till the VA finds a new reason. Then I will be back to ask for help again.

May you all have a pain free day!


For an organization that is supposed to advocate for our veterans, well I guess that's another discussion board! I'm sorry you were denied, but I can't say I'm surprised. It's so adversarial. Hang in there, Tony, and try to stay positive. All you can do is try to whittle away at them a bit every day. Eventually, you will get there, but it takes time and lots of patience. Every male in my family (both sides) is/was service connected. I hate to say it, but yours is not the first story like this I've heard. I wish you the best of luck pursuing this, and if we can be of help, do let us know.

Hey Tony,
…i’m not sure about trauma raising PsA but stress for sure! And there are definitely ppl that have PsA with no lesions. I actually have no lesions. I did have lesions one time after a stressful period, my dad died. Then they went away. That was 25-30 yrs ago. I’ve never had them again. But right after that was when I starting hurting. Definitely stress induced. My husband told me last summer, I think you have PsA after going to a women’s conference. 2 weeks later, I got dactylitis. But some rheumatologists are skeptical! The ome I have now I don’t think even put PsA down on my chart and I’m on humira. I think …i’m so bad that it’s barely working. I was in pain clinic for years for my “neck pain” with no diagnosis. I’d change drs. Try Dr Alkhatib at henry ford in novi, mi. He’s very kind. I’l tell you though… don’t goto any other one in there. They suck. He’s awesome… got that? The other ones told me fibro…pissed me off. TRY ALKHATIB… He’s a super good listener.

I got psoriasis first, and I’ve always attributed that to the stress of quitting smoking. That was a very traumatic event for me. It’s probably irrelevant to Tony’s situation, but I’ve always been convinced that’s what triggered my psoriasis…on top of that, nobody in my family (or extended family for that matter) has psoriasis or PsA. My dad did have the fungus toenails and dry skin, but that was never diagnosed as psoriasis and he didn’t have any arthritis at all.
I wonder how Tony turned out since it’s now several years since this discussion started—I was thinking he should contact his state’s Attorney General’s office.

Hello, chiming in and saying yes you can have psa even though you do not have psoriasis. I have read that somewhere.