New here...not diagnosed yet

Hi everyone, my name is Chris and I've been suffering with chronic pain for the last five years, although my first symptoms started when I was in my late 20s ( I just turned 45). I've never been diagnosed with psoriasis, although I have had a few episodes that have me wondering and a couple of spots on my feet right now that I believe could be a mild psoriasis. My main area of chronic pain is my lower back and right hip. I was diagnosed with sacroiliititis last year based solely on physical examination but this was not supported by x-rays of the area. In addition to some minor skin lesions over the years, I have also been plagued by chronic mouth ulcers and swelling in various body parts (shoulder, elbow, finger, toe, knees). This comes and goes with no real rhyme or reason. Right now I have swelling in my left pinky toe and it hurts to even touch the skin on it. The pinky is starting to look like a question mark. The pinky swelling arrived with its friends shoulder swelling, increased hip pain and, my favorite, unrelenting fatigue. I also have what appears to be some pitting on the nail of my left big toe. My primary MD thinks I may have PsA or seronegative RA, but I've been terrible about following up with him. I'm hoping he'll be able to squeeze me in for an appointment on Friday when I have off from work. Blood tests for lupus and RA have come back negative. ESR was in the normal range. CRP was not ordered. I've never had an MRI of my back or hip

I never seem to remember to show the doc my skin lesions while in the office, although I've mentioned them to him. They're pretty mild so I'm not sure he would be able to tell just by looking at them. I've been unable to find any pictures of mild psoriasis online so I'm wondering if I post a few pics of the areas I have presently if some of you could give an opinion. I should also mention that I've had a few episodes of nails lifting from nail bed without any precipitating injury and a few bouts of severe dandruff (which I'm now thinking may have been psoriasis since the flaky areas were mostly at the hairline at the back of my head). I appreciate any comments that you have for a potential newbie. Thanks!





Hey, Foobulous, welcome! Swelling toes, dandruff-like flakes, nails that aren't quite right, unrelenting fatigue, on-again-off-again joint pain and swelling, normal inflammatory markers ... I can certainly see why your doc is considering PsA as a possibility. Those pictures that you have are going to be really useful when you do get in to see the rheumatologist. We all know that your symptoms will pack up and leave town when the time for the appointment comes.

Have you read the article called "Rheumatology Appointments 101" in our Newbies' Guide? Make sure you do, before you get that appointment! And do follow up. Dealing with a possibly serious condition is not exactly a fun thing to do, but one of the things that we know for sure is that early diagnosis, and timely and aggressive treatment gives you the best chances of escaping damage, if this is PsA.

Meanwhile, hang in there, and feel free to hang out here!

I am new to this site also and looking back had many symptoms that Id never tied together until I became almost unable to function. My doctor told me that not all patients present with skin lesions first. I only get them in my scalp and never connected to pain … I did have very dry flakey and burning feet and even when moisturizer at night this would keep me awake. Hopefully you will get X-rays and answers and get in the right treatment for you. My understanding is that any damage caused prior to treatment may not be reversible but further damage and remaining functional can be achieved as you’ve likely seen by members. Though I still have fatigue, pain and difficulty sleeping the mtx and remicade have made slow but steady improvement and my function is much better. I am able to work now 12 hour shifts and had to take a leave as a year ago I could hardly move. Someone in this site reminded me to be a patient patient. No 2 of us are alike, and it may take time. I just joined this site and already hearing about others and things they do, especially things they do in their lives outside of being a chronic illness patient has really helped me as it was very difficult to accept that things may never be as they were…but often times as I’ve found they are better. Do you have a rheumatologist? Know we are all here to support you as a person not just a patient. The people on this site amaze me. They are strong, preserved to get a diagnosis, brave to share. And though I hope you do not share this diagnosis I can say you’ve come to the right place to learn the many ways all of the members of this club have embraced being a person and not just a patient…I hope you get some answers and some relief. I know it can be frustrating but do not give up…

Looks like mild psoriasis to me. And your big toenail looks yellowish too, along with those little spots. Your skin/nail symptoms, along with the SI and swollen joints and fatigue --isn't that a fun symptom??--sure look and sound like Psoriasis and PsA to me!