My Dermatologist Told Me to See An Arthritis Doctor... I Have Psoriasis and My Joints Hurt

Psoriatic arthritis is a distinct disease, different from rheumatoid arthritis and ankylosing spondylitis- another common type of arthritis- but sharing similar features to each. The disability and functional impairment in psoriatic arthritis can be as severe as that occurring from rheumatoid arthritis.

Typically, a patient will have had psoriasis for a number of years before the arthritis develops. A small proportion of patient will develop the arthritis concurrently with the skin disease and an even smaller percentage will develop the skin disease after the joint disease.

Psoriatic arthritis may affect most joints in an oligoarticular pattern, meaning a few scattered joints are affected and the joint inflammation does not have the symmetrical pattern seen in rheumatoid arthritis. Enthesitis, which is inflammation of the tendons that attach to bone, is common in psoriatic arthritis. “Sausage digits” – swelling of the fingers and toes so that they look like little sausages is frequent. Nail changes are also common. These include "pitting" and separation of the nail from the nailbed. Some patients will develop carpal tunnel syndrome because of inflammation in the wrist. Inflammation of the eyes is a serious complication, as is involvement of the aortic valve of the heart.

Joint deformity is frequent and affects 40% of patients with the disease. Psoriatic arthritis has a significant impact on quality of life. The skin disease is a tremendous burden and often leads to depression.

The inflammatory process that causes both the skin disease as well as the joint disease is driven by elevated levels of a substance called tumor necrosis factor, or TNF.

A patient with psoriasis who complains of joint pain, swelling, morning stiffness, and fatigue should raise a high level of suspicion for the diagnosis of psoriatic arthritis.

Laboratory testing will show evidence of inflammation and imaging procedures such as magnetic resonance imaging (MRI) can help confirm the diagnosis.

Treatments that improve the skin disease do not necessarily improve joint symptoms and vice versa.

Treatment goals include symptomatic relief and control of disease progression.

Non-steroidal anti-inflammatory drugs are helpful for relieving some symptoms. However the majority of patients with psoriatic arthritis will require a combination of methotrexate and anti-TNF biologic therapy. Anti-TNF therapies have provided a significant advance in the treatment of both the skin as well the joint disease in patients with psoriatic arthritis.

Dr. Wei (pronounced “way”) is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: Types of Arthritis

Self-Help Natural Skin Care Basics From Dermatologists

Going to a dermatologist is always prudent whenever you have a severe, puzzling or persistent condition, but, regardless of what other treatment is recommended, there are a few self-help basics that will go a long way when it comes to preventing and treating skin conditions. Healthy skin starts with a good basic natural skin care program of the type recommended by most dermatologists. Here are a few helpful hints:

1. Reduce the temperature of your bath and shower water. Although it?s hard to imagine that sitting in a bathtub could dehydrate you, extremely hot water does dry the skin and cause moisture loss.

2. Switch to natural skin care soaps and cleansing products, and use less of them. Even the gentlest cleansers can cause dry skin.

3. Eat well. Cut down on sugar and processed foods, and eat plenty of fresh fruits and vegetables. Good nutrition is a basic in natural skin care. What?s happening inside our bodies is directly reflected in our skin.

4. Take vitamins. It?s hard to get everything we need from our diets these days. Vitamins A, B, C, D E, and K are particularly beneficial to the skin. Trace minerals, antioxidants and essential fatty acids are also vital.

5. Exercise. It improves and maintains circulation so your skin is well-nourished and healthy.

6. Wash you hair only as often as needed, and use natural products. The chemicals in hair products cause a number of scalp conditions, and when your hair brushes against your face the chemicals cause facial skin conditions as well.

7. Wear sunscreen. There are several natural products available that don?t contain harsh chemicals.

8. Cut down on cosmetics and use natural cosmetics whenever possible. If you?re currently using foundation, you may be able to avoid it by implementing natural skin care basics that will give you healthier, glowing skin.

9. Use a shielding lotion. It protects your skin against the harsh, harmful chemicals and pollutants in our environment, and in the products we use. Hundreds of doctors now recommend them.

If you?re still having skin problems after implementing these suggestions, see a dermatologist to help diagnose and treat your condition. However, you may be surprised at just how far you can get with at-home basic natural skin care. Give it a shot!

Author, Gloria MacTaggart, is a freelance writer who contributes articles on skin care for The National Skin Care Institute. For more information, visit http://www.skincarenet.org.

 

Finding A Dermatologist That Cares

Finding a good dermatologist that cares about you and your acne problem can be tough sometimes. When you have blemishes, your self-esteem may be at its lowest point, you may feel self-conscious about the way you look, and you may even not want to leave the house.

Strangely enough, when you find yourself suffering from acne, reaching out to a stranger may be one of the best things you can do for yourself. That stranger is a dermatologist, a trained skin specialist who has probably seen it all, and who can give you valuable advice about your skin, and prescribe an appropriate treatment.

If you are thinking about visiting a skin physician for the first time, you are probably feeling apprehensive. This is absolutely normal. After all, you (or your health insurance) are going to pay a stranger to pick and prod at your face. You will be showing off a part of your body that you probably spend most of the time trying to hide. But the effort and perhaps slight embarrassment is well worth the reward - a new chance at radiant, healthy-looking skin.

When seeking out a specialist, make a list of what you are looking for. What do you like about your family physician? Are you most concerned about someone who is sensitive to your concerns and has good chair-side manner? Are you more worried about having someone with flexible hours who can accommodate your hectic schedule? For some, the most important thing is having a very knowledgeable doctor with reputation and extensive training. Still others seek out dermatologists because they specialize in certain skin conditions.

Whatever your specific needs and interests, a good doctor will treat all his or her patients with respect, patience, sensitivity, and courtesy.

Well-trained professionals will be able to answer all your questions and provide you with several treatment options. Before your first visit, take the time to prepare a list of questions. You should find someone you feel comfortable talking to, and be able to carry out an open dialogue with. If you have any questions about your medication, treatment options, or anything else, don't hesitate to ask. Most like their patients to be prepared and to demonstrate a vested interest in their treatment plan.

If you find your dermatologist difficult to talk to, consider finding a new doctor. You should never feel rushed, ignored, or unable to ask questions. One thing most patients avoid doing is revealing their anxiety about visiting a dermatologist. It can actually be to your benefit to let your doctor know about your nerves. This can help them become more sensitive to your concerns, and will probably result in a better visit for both of you.

If you have decided to take that important step of finding a good acne skin care expert, here are a few tips for finding the best one in your area. If the cost of treatment is paramount to you, consult your health insurance to see if they cover dermatology, and whether you are restricted to a specific network of physicians and try to make an appointment as early as possible - waiting lists are common.

What are the qualifications of a well-trained dermatologist? They must be a medical doctor that is certified by the American Academy of Dermatology (AAD) and trained in dermatology. Some will have graduated from an accredited medical school, and have completed between three to five years of specialized training. This certification requires that they pass oral examinations and a comprehensive written exam.

Other things to look for - membership in the American Academy of Dermatology. Members receive mandatory continuing education classes, they are peer reviewed, and must remain in continual good standing to remain members.

You should also try to find a skin doctor with experience. The one with many years experience is more apt to make an accurate diagnosis and find appropriate treatment. If you are seeking help for a somewhat rare skin disorder, you will want to find an authority with extensive research and training experience with that disorder.

Also, ask your family doctor or friends for their opinion. Not that it always works, but, you just might find a great Dermatologist that way.

Ken Black is the owner of www.skin-care-reviews.com, a site devoted to skin care issues, including Acne Product Reviews. Visit and browse our site today.

Dermatologist: The Most Qualified Physician for Skin Problems

The skin is the largest and most visible organ of the body. It reflects the health of the body and acts as a barrier against injury and bacteria. Sadly, at one time or another, nearly everyone has some type of skin disease that only a skin doctor can absolutely give the scientific explanation for those skin problems. Dermatologist is a medical doctor specializing on the study of the skin, diseases of the skin and the relationship of cutaneous lesions to systemic disease. Dermatologist is a medical doctor trained to usually combine several activities like seeing patients in public hospitals and/or in private practices, acting as consultants to other specialists, teaching and delving into clinical or basic research.

The dermatologist must have expertise in basic sciences including pathology, biochemistry, physics, physiology, microbiology and endocrinology. Because skin diseases are often associated with internal conditions, dermatologist must also be familiar with all the other medical specialties because of their consultant work. Dermatologist likewise perform skin surgery in several situations like preventing or providing early control of disease such as skin cancer; improve skins appearance by removing growths, discolorations or damage caused by ageing; and to establish a definite diagnosis.

There are several responsibilities that dermatologist has including examining patients, performing biopsies and other diagnostic techniques of dermatology, interpreting test results and evaluating examination findings before prescribing treatments, including x-ray therapy, physical therapy and medication. Dermatological services are as well managed by dermatologist like formulating plans and procedures for dermatological services, scheduling operation of diagnostic and treatment facilities, and assigning nurses, physical therapists, x-ray therapists and other medical technicians. The dermatologist advises on the types and quantity of dermatological supplies and equipment, coordinate dermatological services with other medical activities.

There are however several types of health care providers who can take care of your skin conditions aside from dermatologist. The first thing that you need to know about picking a skin specialist is the probability that you are really badly in need to see a specialist as sometimes your condition may not need the specialist. Therefore, it is important that you know when you really need to see a dermatologist. Some conditions are exclusively treated by a dermatologist especially with severe forms of common diseases such as acne, rosacea and atopic dermatitis. Most skin cancers are treated by dermatologist, sometimes in conjunction with a surgeon. There is also the dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the bodys immune system.

Getting a referral from your physician is a great help and of high importance in finding the right dermatologist who will be working with you. It is important that you are assured that the dermatologist has the right credentials for the medical procedure(s) that your skin demands. You may have to do some preliminary check that will enable you to be prepared and educated prior to your consultation. Such steps are critical as it will help you achieve a successful outcome. You have to have a give-and-take dialogue assuring that you and your dermatologist have the same vision of what you want the end result to be as well as your expectations are realistic. The communication between you and the skin doctor is of most importance as you are considering things about your skin or associated problems.

Michael Sanford

For more infoormation on acne skin care please visit http://www.no-more-acne.org