Arthritis?

[ben438]

I have had arthritis and muscles aches for almost 1 year now. I have been told by doctors that I have everything from reactive arthritis to ankylosing spondylitis to fibromyalgia. Needless to say very frustrating.

I have symptoms from all three. My question is about these small red and brown spots that appeared on my feet a couple months ago. They have now turned flakey and scaly.

(Now this is where it gets strange) I have a friend who swears we have the same condition. (this is usually about the time when the doctors stop listening. But I think he might be on to something.) So he has had completely different doctors than I and his diagnosis: a combination of reactive arthritis (rieter's syndrome) and very rare psoriatic arthritis.

I have never had psoriasis before in my life but the scaly skin with red patches now on my ankle and elbows sure looks like it.

Is it possible that we are both affected by the same bacteria/pathogen?

Do Bacteria cause psoriasis?

Have you heard of red or brown spots associated with ankolosying spondylitis or reactive arthritis?

It is important to note that the skin complications are not what is ailing me most but perhaps they can shed light on the greater issue as I am positive they are related.

Please help with any information you can. Including common sense therapy - i.e. exercise.

Also if you can give me pointers as to how to present myself in my doctors/rhumytlogist's office so that i don't get to specific as to be confusing yet reveal all the pertinent information. Is it unwise to mention other people at all?

Most Appreciative,
Ben

[Alan Rockoff, MD]

I understand your frustration at not getting a specific diagnosis.  The fact remains, however, that especially in areas like the skin and joints, diagnoses are often imprecise and blend into each other.

Psoriasis is not caused by a bacteria and is not contagious.  Neither are any of the other conditions you name.

Even if you have psoriasis, and perhaps you do, the treatment of the arthritis would not be different.  I am, however, far from an expert on arthritis, psoriatic or otherwise.  I take care of the skin, and leave the joints to my rheumatologist colleagues.  Still, the fact that there are new biological therapies for psoriatic arthritis, designed to stimulate the immune system, makes revisitng the question in light of your new scaly spots worthwhile.

You have to be careful when other people tell you they have "the same thing."  People do often say this, but how would they know?  And how woulod it change anything, even if it turns out you both have the same diagnosis?

If your skin findings are new, I would have a dermatologist look at them, biopsy or otherwise test them if necessary, and make as precise a skin diagnosis as possible--psoriais, Reiter's, or whatever.  Armed with that information, you can then look into newer treatments for psoriatic arthritis, if that's what's going on.

Best.

Dr. Rockoff