Opinions?

So my skin is very raw and cracked on my hands. I am already on Remicade
And see a rheumatologist every four months he comes to town. I am seeing my
family Doc on friday and was wondering if you guys thought I should
ask to see a dermatologist as well?

I am just frustrated with it all. I have
deleted dairy, pecans, lettuce, eggs, cranberries from my diet. ( I had food allergy testing done).
I use creams, lotions and a steroid cream. Omega 3 oil and bit d, b and on and on.
I am just wondering if anyone sees both a Rheumy and a dermatologist both? And does it
Help or confuse matters??

I'd say that seeing a dermatologist would be a good idea. They have more knowledge about the P side of things than most rheumys do.

I don't personally see a dermatologist because my P isn't that bad (my PsA is incredibly bad/aggressive, though). I do see a rheumy, an endocrinologist and a gastroenterologist....if you want to talk about confusing. ;)

I'm not sure I can be of very much help, but have you tried using only soap free wash? My p was never that bad, but has been really helped with using only soap free body wash and hand wash.

Soap and water are the enemy it seems, especially if the soap is harsh. I try to wear gloves when washing and cleaning up. Coconut oil, plus some prescription creams do help. I saw a dermatologist years ago and stockpiled the creams and ointments. I'd just have my pcp write the scrips now and save the specialist co-pay since the meds havent changed. However, if you've never seen one, it sure could help. I agree with Nym about the rheumy not knowing much about the dermatological side. Plus the derm. would instruct you on usage, for instance you should not use the steroid constantly.

Was on mtx but made me very sick and joints got worse.
The worst is on my hands which crack and bleed and burn constantly.
Wish I knew his to upload a pic. I would love a decent cream/ lotion that would help with pain and burning.
Just kind of frustrated.

tkrlady said:

About 3 yrs ago, i got peelings on palms of hand, silvery type…and soles of feet…was on enbrel then…

first stop skin dr…no diagnose, lots of steroid creams, rheummy was waiting on skin doc opinion

switched skin, doc, and in 3 seconds she made diagnose of pustular psoriasis…very difficult to get rid of

also switched rheummies, who made a fast diagnose too…and says u might still have RA, but u got PSA now.

she put me on remicade 15 months ago…What dose are u on?..i am up to 900 mg

I saw her last week, thought Orencia might be better, she says her PSA patients do well on remicade!

Are u on mtx?..i am

Peelings come and go, but they are better, and not bleeding…

Hardest thing is peeling after a shower, or washing hands…tried all kinds of soaps lotions…it’s a stubborn psoriasis

good luck!

Hi, Kristen

I'd say, ask to see a dermatologist. I'm assuming you don't have one who's local, and the dermie probably only comes to town every 4 months or so like the rheumie. Make acquaintance, so that if you are in a really difficult situation you and your family doc are set up to consult long distance if it ever becomes necessary.

Seeing the dermatologist at this point is a matter is a matter of strategy. Living where you do, with waiting times and only periodic access means you need to position yourself.

Another thought: you're a nurse. Could you be reacting to handwashes and santitizers?

Seenie

The gel sanitizers commonly being used in health Care today ARE causing a problem, which they are predicting to be as big of a problem when we were using latex gloves. Just attended a seminar (our company supplies a lot of it to various healthcare facilities) where they were suggesting alternatives. Also the description of you hands does suggest a sensitivity to either doning powder (powdered gloves) or latex. If you are using any vinyl or Nitrile gloves, they even though they are powder free often have a doning powder used during the manufacture,

This problem with your hands should be reported to your Supervisor immediatly so that a paper trail can be establish if it is a work place sensitivity. If nothing else your infectious control committee ahould have alternative for you. This problem can really blow up in a bad way

Beyond that you should never use the Steroid cream for more than two weeks and without a 2 - 4 week break between bursts or you will develop resistance ( which would also effect any oral steroids during a flare)

In between times I have found EMU oil to be the best. (not blended lotions)