[Peabody]

I'm not diagnosed, but I know that my dr is considering lupus. So far my blood levels are all in the "normal" range, but I've had recurring bouts of cutaneous vasculitis on my feet and lower legs (w/ the small red dots (petichae) later turner brown/hyperpigmentation)) over the past 6 months, as well as a month of inflamed toe joints (several toes on each foot, first one foot then the other). I also am already a member of the autoimmune family (MS & psoriasis). Does the above sound like anyone else's entry into lupus?

 

[Lily]

Hi peabody,

I did have a lot of cutaneous issues when I first got sick, and I still get livedo reticularis, occassionally petichae and sometimes ecchymosis.

I haven't had problems with my toe joints, just about every other joint at one time or another though.

Have you been tested for Rheumatoid arthritis?

Another thing that screams out with the toe joints especially is something called Psoriatic Arthritis, especially as you have Psoriasis already. A certain percentage of Psoriasis patients end up getting this type of arthritis. As far as I know it doesnt present with an ANA - not sure. But it probably does show an elevated ESR and possibly CRP. Have those been tested? An experienced Rheumatologist should be able to distinguish between PA and RA, x-rays help a lot because both RA and Psoriatic Arthritis have quite distinctive features on film.

Is it your GP monitoring you or do you have a good Rheumatologist as that would be the best kind of doctor to help you sort out what might be going on.

love
Lily

 

[Peabody]

Thanks Lily. I did see a Rhuemy for my toes- unfortunately, by the time I got in to see him, most of the inflamation had subsided. Like you, I was suspecting psoriatic arthritis, but he seemed to think that it wasn't likely. However, he admitted that it would have been better to see me w/ active inflamation going on, and since I've been to the initial visit with him, I'd be able to get in quicker if it happened again. He said that if it IS psoriatic arthritis, he wouldn't be able to treat it very well b/c my MS meds wouldn't let me do the best stuff for PA. I'm not sure I talked too much about the cutaneous vasculitis with him when I went as I didn't have a name for the "red dot rash" at the time. My PCP is the one monitoring me for now on any "further developments"- but I did like the Rhuemy so if needed I have someone good to go back to.

 

[Lily]

Hi again,

Do you know exactly what blood tests they ran? It would be helpful to get a copy of them to see if you have been thoroughly evaluated. We can try and help you with that. "Normal" levels don't always mean normal levels, but some docs sit around waiting for something dramatic to happen before they jump in. I'm not saying your doc is one of those but experience here teaches us that it's good to know what was tested and what the results were. It's also helpful for you in the future to monitor any changes.

love
Lily