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ademas
07-19-2006, 09:26 PM
Just a quick introduction and a quick question.

I'm a 47 year-old male from Seattle, WA.

For about 20 years I've dealt with some minor nail pitting, and then about 6-7 years ago it became much worse. My doctor assumed it was a nail fungus, and put me on Lamisil. It did nothing, and I stopped treatment after 6 months.

A couple of years later, I switched health care plans and revisited the problem of my nails with my new doctor. He immediately went for the elbows, and noticed I had a patch of flaky skin about the size of a quarter on my right elbow. So...there it was. A psoriasis (and psoriatic nails) diagnosis.

He gave me some topicals (a steroid cream) and later dovonex, and for a number of years I've plugged along, treating my nails twice a day...occluding at night. It helped the appearance slightly, but only because of the moisturizing effect. If I ever skipped a day, they looked as bad as usual.

Well, the last 12-18 months, things have taken an ugly turn. My toenails became involved, and it has quickly spread to all toenails, and 3 toes on each foot are swollen and painful, and have the "mini-sausage" look. I'm also experiencing a lot of pain in my achilles tendons, particularly if I've moved around a lot the day prior. I'm also having some issues with balance, particularly when walking up or down stairs, or when stopping to change the direction I'm going--but this might be due to the way that I'm walking, due to stiffness, and to avoid pain.

My first appointment with the RA is tomorrow. I've been to two dermatologists, and neither could help me due to the fact that I can't take immunosuppressants. I don't really know that the RA will be able to do much for me either, and therein lies my question.

Is there an effective treatment for psoriatic arthritis that isn't an immunosuppressant?

Any suggestions?

Thank you.

MikeK
07-19-2006, 09:47 PM
Hi Ademas,

Welcome to the Board. :cool: Nice to meet you. I'm sorry to hear that you're going through such a rough time. :( Good luck at the doctor tomorrow!

I'm going to give you a link to a "must read" post by JesseLou. She discusses the questions that must be asked and the tests that must be ordered whenever PA is suspected. Here's the link: http://www.psoriasis.org/forum/showthread.php?p=74786&highlight=question#post74786.

You asked:Is there an effective treatment for psoriatic arthritis that isn't an immunosuppressant?I'm not sure if it's an immunosuppressant (it's something that you need to discuss with your doctor) but I do know that some people manage to control their psoriatic arthritis by using the anti-malarial medication, Plaquenil. (It doesn't work for everyone, it can take several months before it works, and the potential side effects range from unpleasant to awful. (Not everyone experiences side effects.) Here's a link to some additional information (the discussion is geared to rheumatoid arthritis but Plaquenil can also be prescribed for psoriatic arthritis): http://www.healthsquare.com/newrx/pla1337.htm.

Since you live in Seattle, you might want to seriously consider attending the NPF's annual conference. It's going to be held the first weekend in August (Aug. 4-6) in Portland, OR. Some of the most knowledgeable doctors (both dermatologist and rheumalogists) in the country usually speak at the conference (this will be my third conference) and you'll be able to pose questions to them during question and answer sessions at the end of almost every workshop. Here's a link to some additional information about the conference: http://www.psoriasis.org/events/conference/.

I hope this helps.

Good luck!

Keep us posted!

Mike

RichJ
07-19-2006, 09:50 PM
hi Ademas,
sorry i can't help much but welcome to the p family. you have met some of the wonderful people on here and will find alot of great info. welcome and nice to meet you. i wish i could help

have a good night all

richard

wildflowerAnn
07-20-2006, 05:16 PM
Hello Ademis,
Sorry to hear that you have psoriasis and arthritis. Welcome to the message boards. Hope your doctor appointment goes well tomorrow.
Ann

cjg
07-22-2006, 06:22 PM
Hi and welcome! I don't know the answers to your questions, but just wanted to say hello.

mamaooch
07-23-2006, 04:46 AM
Sorry I can't answer your question. I have severe pa and mild pppp and I take MTX along with Remicade. Someone will come along soon and help you get the answers you need.

Have a good day!
Cindy

Welcome to the boards!

kkellogg
07-23-2006, 05:23 AM
Hi Ademas:

Welcome to the boards... I'm glad you found us. You have gotten some great advice. The link that Mike posted is indeed a must read. I would even print Jesselou's post and bring it with you. I'm so glad you are getting to the doctor. I hope you get some relief soon. And yes, since you are so close, it would be great if you could get to the conference in August. Hang in there and keep us posted.

Krista

scratchydee
07-23-2006, 05:51 AM
Hello ademas,

Welcome to the boards. I am sure you will get some great advice and support here.
I can be of no help with the arthritis but I get the pitting in my nails from p. The one thing that helps me is eating lots of fruits and veggies. At least 5 servings a day. It is like night and day when I do this. I don't know why this helps but it does.
I hope your appt went well. Good Luck!