Not sure I spelled that right but I have a ??? I ran into a friend yesterday.
She was covered in psoriasis. It was from head to toe and the tops of her
hands were like hamburger. She said she had had it for about a year just
after having a bad case of strep. She is now permanently hoarse from the
continual strep throat as I guess the strep infections have damaged her
vocal cords. She also said she has joint pain and bad stiffness in the
morning. She said all her doctor will do is prescribe creams for the skin
but she said it has done nothing for her. I was shocked to see her in this
shape. She is 22 years old. It broke my heart. Is this how psoratic
arthritis starts? I would like to know more about this. I told her to insist
on being tested for autoimmune disease. Are there any specific tests that
will confirm psoratic arthritis or is it just standard RA testing? Any one
have this? I know you can get reactive arthritis from strep, but I'm not
sure I understand the psoriasis connection.
Lori, I'm really sorry to read this about your friend. In this day and age there are treatments for this horrendous form of arthritis and for the plaques associated with it.
I had psoriatic arthritis before I developed plaques. The PA is much worse than the RA. Much more painful and destructive in my case. I didn't develop psoriatic lesions until a year after I was diagnosed with PA. I still don't have the textbood looking plaques but a red type of lesion.
She needs to be evaluated by a rheumy and have Xrays of the stiff and painful joints. In the fingers there is a specific bone deformity that is inherent to only PA. I think it's called the cup and pencil deformity. It's late and I'm not thinking well. That's how I was diagnosed. My rheumy was suspicious. Many of the biologics and dmards are used for PA also. Sometimes you get the plaques and not PA, other times you develop PA and never get plaques, and then you can have both RA and psoriatic plaques. It's like RA and each case is very different and ranges from mild to extremely severe.
I have laser treatments to the 2 plaques that I have. One is on my shin about where the end of the knee replacement scar will be. I need to have it cleared up before the replacement on that knee in September. So far the laser treatment is working and it looks much better and is decreasing in size. The other one is on my elbow and it's just about entirely disappeared. My rheumy does the laser treatments and so does one of the dermatologist in this area. She could also have UV treatment. It's deplorable that they haven't treated her more aggressively and referred her for a full workup. As bad as psoriasis and PA are if it were me I'd be more worried about having a drug resistant strep that's left my vocal cords damaged.
PM me if you want any further info. I'm going to bed....really tired. Lindy
Hi Lori,
I'm sorry to hear about your friend - it must be tough if the Dr's aren't being much help... I wanted to say a few things, I have PA and, like all of us, I've done some research! Firstly psoriasis is an auto-immune disease in itself and some of the treatments we have for RA and PA are used to treat psoriasis. PA can appear before or after the skin condition. You can have joint pain (PA) or skin involvement (psoriasis) or both (PA). Not everyone with psoriasis will get PA. It is common for the first appearance of the disease to be after a major infection or virus. It is difficult in some people to diagnose PA as bloods and x-rays are often normal so it's a case of eliminating other diseases. The joint involvement can take one or more of several forms - someone has posted a link to the John's Hopkins ask the expert site and you can find more info there. One of the most important things is that anyone diagnosed with one of the forms most likely to result should be treated early and aggressively. Your friend needs to see a Rheumatologist if she hasn't already.
The last thing I'll say is that my Auntie has severe psoriasis (but not PA) and when it's flaring really bad she feels shocking, can't get out of bed, flu-like joint pain etc. That's not arthritis, just the physical effects of the massive effort her body's making to produce all the extra skin cells that cause the plaques. SHe doesn't get that kind of symptom at any other time. If you want to ask anything else, please do... If it was my friend I would be encouraging her to keep a diary of symptoms etc to take to the Dr to get a referral to a Rheumatologist. That's how I got them to take notice. I showed them a diary with how long I was stiff for each day, which joints hurt when and for how long. I took photo's of my hands and feet when normal and when swollen because the swelling I get is quite subtle and could be mistaken for simple chubbiness!
I hope this helps.
KT
Thanks guys. I am just so shocked that a medical professional would notLori,
I started with the psoriasis when I was about thirteen, and it progressed into the PSA. I am still having trouble controlling both. I was diagnosed in late Feb. and started MTX in March. I have now taken my second shot of Humira, and just noticed another flare of the psoriasis this morning. She does need to see a Rhummy, because it is ichy you can develop a severe infection. Call her today and tell her there is life after this and she needs to get it under control. My dad(untreated) died of this disease in Sept. at 61. Way, too young!
Love and peace,
Michelle
If she can't get in to see a rhematologist, she should see a really good dermatologist at least. Before going to a rheumy, I went to a dermatologist (an awesome one!). I started getting some kind of antibiotic injections that cleared up the psoriasis almost right away. Since starting MTX, I haven't had to go back to the dermatologist, cuz that keeps my psoriasis under control. But that's something to think about. My Derm is Dr. Gold, one of the leading in the country. But he's in Nashville, TN.