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Hello everyone. I'm hoping to get a bit of advice/input on whether or not what I'm experiencing might by psoriasis and psoriatic arthritis, because overall doctors have not exactly been helpful. Since 2011 I've had rashes on and off (I'd say present 85% of that time). The rash is red, extremely itchy, and flaky, but not silverish like I see in photographs of psoriasis. It usually occurs in circular blotches on my lower legs, from my knees to my ankles, but has also occured on my lower back, my armpits, and the back of my neck around hairline. Doctors (GPs, not dermatologists) have misdiagnosed it as poison oak contact dermatitis (I no longer work around poison oak but the rash persists), scabies, and the most recent diagnosis is eczema. Changing soaps, laundry detergents, etc doesn't help, and I use all natural products anyway that are free of many chemicals, dyes, and perfumes. Prednisone, cortecosteroid shots, and triamcinolone make the rash go away, but it's very short-lived and the rash is typically back within a few days of stopping use. When my rash gets really bad, a lymph node in the back of my neck swells up and becomes tender. Even when the rash disappears for a while, the skin on my legs is still itchy (sometimes my scalp is too). Does this sound like psoriasis? Does it need to have that silver scale to it?
In addition to the rash, I've been dealing with severe fatigue since late 2013, dry eyes (to the point of blurred vision), joint pain on and off since early 2014, and lower back/sarcoiliac area pain since early 2015. Lately the joint pain has gotten worse, has become mostly symmetrical, and is affecting multiple joints at a time. The joints affected are my knees, ankles, elbows, wrists, sometimes shoulder & neck, and possibly my hips (I can't actually tell if it's back pain or hip pain). However, I rarely have any indication of swelling in my joints--occasionally they are tender or sometimes my toes swell, but that's about it.
I finally found a doctor the other week who actually listened to me, so we ran some blood work for ANA-IFA, ESR, and CRP. ANA-IFA came back positive with a titer of 1:160 and speckled pattern. ESR and CRP were normal (I was also taking 15mg meloxicam at the time and am not sure if that would have impacted the inflammation results). Following the positive ANA, the doctor ordered an autoimmune cascade, sent off to a commercial lab. The lab ran an ANA-EIA analysis, and the result came back negative (0.2), so they didn't complete any further tests in the cascade. My doctor has decided based entirely on the second test result that I don't have an autoimmune disease and that everything is in my head (I have a history of social anxiety, so most doctors tend to stereotype me and just lecture me on seeing a counselor). I know this is not in my head--something is wrong with me and I have no reason to be making this up (I hate attention and I dislike going to see doctors). It's impacting my life, my relationship (my fiance doesn't seem to believe me either), and my work.
I think the second test was faulty (scientific literature suggests that ANA-EIA tests my have a hard time picking up antinuclear antibodies with a speckled pattern, and literature also suggests that commercial lab test can be highly variable and unreliable; IFA is also supposedly the gold standard). Right now an autoimmune disease is the best lead I have on figuring out what is wrong--I fit the symptoms and think that RA, PsA, or MCTD are possibilities.
Does anyone have psoriatic arthritis or rheumatoid arthritis without visisble swelling of your joints? Do you think my age--27--might affect how much inflammation there might be? Do you think my symptoms fit psoriasis and/or psoriatic arthritis? Thanks.
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