PsA foot question

ouchpotato

Hi everyone

While I am waiting for my apt with the rheumy, I wanted to ask about PsA, in particular with regards to the feet.

My GP suspects AS, because of the spine and SI joint problems, but I am wondering about PsA since reading about foot involvement. I have no psoriasis anywhere else on my body, but my left foot is in a bit of a state and it crossed my mind that maybe it is psoriasis.

The toenails have become thick, yellow/white and under the nail there seem to be several other layers which make the nail stand away from the toe. I have been in a pain flare recently, and during this time the nails have become much more damaged quite rapidly.
Almost the whole of the sole of the same foot is covered in dry flaky skin, and the heel is hard and cracked to the point of bleeding and very sore (I do take care of my feet, and use a ped egg and moisturise but after a couple of days it is just as bad). It is only on one foot. My feet ache a lot of the time and some of the toes are very painful.

I did treat the nail problem with anti fungal cream when it was only one nail but to no avail so I am assuming it is not a fungal infection.

Not looking for a diagnosis, just some thoughts on this.

Hope everyone is having a good day.

x

dreamdaisy

PsA traditionally begins in the smaller joints, the fingers and toes being the prime candidates for that. Mine began with my left knee, then my right and my sacro-iliacs. It took a few years for my toes to join in, but they have.

I have nail trouble with some thickening etc, but not too much. I do have them falling off every now and again (usually after they split right down the middle) which is sore but not too bad. It may be worth asking your GP whether this trouble on your left foot is psoriatic in nature, the skin on the inside of my ankles is dry, flaky and ocassionaly scaly (psoriasis is to do with the skin renewing itself too quickly) so he may be able to give you something to help (I use double-base gel, it's lovely and soothing). DD

DebbieT

Hi,

Without seeing some sexy pics of yellow toe nails n scaley feet it's obviously hard to say, not being a Dermatologist doesn't help either but ..... It sounds SOOooooo much like my nail psoriasis & plaque psoriasis on the soles of my feet id be very surprised if ure told it's not that!!!

Nail involvement alone is enough, even 1 single psoriasis lesion is all they may need to make a concrete diagnosis. I would think they may biopsy like with Anna tho. If you both think psoriasis is likely I would suggest getting a dermatology referral asap. The plaques on ure soles should be reasonably easy to treat. My heels came off in one clump, it was gross but my feet felt a lot lighter

I've had many years to get my head around psoriasis, less around the psoriatic arthritis. There are treatments available for both, methotrexate for instance & the anti tnf's.

I wish you much luck. I hope you get a firm diagnosis.xxx

Boomer13

Hi ouchpotato;

Like you, my dr.s suspected AS but recently I had a small lesion (a few cm) appear on my foot, biopsied, came back as psoriasis. I've had relatively few skin issues but have had the arthritis for seven years with terrible foot & toe pain. I can't comment on the nails as mine are clear.

I can tell you my previous GP would never have biopsied the skin, so maybe you'll have to push a little? Would be worth it, though, for you to find out whether it's ps or not.

Apologies if you're reading this after reading all of my other whiny posts already!!

Hope you get answers, it does help to know.

Anna

ouchpotato

Thanks for your replies.

Will the rheumatologist look at this, as in the whole picture, when I see her? It's just that it's impossible to get a gp apt at the moment for at least 2 weeks, unless you are literally at death's door. My rheumy apt is 2 weeks today so will prob see her earlier than a gp anyway.

It's horrible having 'gammy' feet in this weather, I want to wear pretty sandals but the nails are so horrid, it makes me self conscious. And a very odd thing (or maybe not) I noticed is that the tops of the toes on the left foot are all wrinkled, almost as if I have just got out of the bath, but it's right at the tips. The body sure is a weird thing.

dreamdaisy

She'll look at it if you show her and she may then refer you to dermatology. I turn to my Crocs on the very hot days, they cover the feet but let them breathe. DD

DebbieT

I wear crocs too, even in winter Nail varnish can still be used, I think it detracts from the ugliness of my nails but I'm quite hardened to wot others think now, I won't hide away just to make others feel better!!

I think ure Rheumy will look at the over all picture & if they think psoriasis is a possibility they'll definitely take that into consideration.xx

mike26

hi ouchpotato
yes mine are in simmular to you ,
i first thought i had nail fungus infection
some time ago now saw my doctor and he also prescribed
me with a anti fungal solution.
now i think it was probably PsA.
all my toe joints have PsA my nails are like youres
scored lines down them soft and horrid looking.
my ankles and feet are badly swollen and sometimes hard
to walk with them(more like a hobble) :roll:
I to find my crocs more comfatable (1 size larger than my feet)
probaly not now tho my feet are swollen . :oops:
the skin problems are not to bad for me tho.
its the PsA side of it thats a
hope gets better for you.
mike26 :roll: