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Pitted nails reveal psoriatic arthritis




 

 

DEAR DR. ROACH: I am a 77-year-old male. I had to stop playing golf about two years ago due to joint pain. I had psoriasis from age 15 until I was 40. I am retired from the Navy and had to be hospitalized twice during my time in service due to my skin. Why it disappeared at age 40, I don’t know. Is it possible that I could have psoriatic arthritis? One doctor I saw said that I had to have psoriasis in order to get it. I saw that you said that sometimes the arthritis shows up before the skin lesions. Can it show up after you have quit having the lesions? — Anon.

ANSWER: Indeed, psoriatic arthritis can show up years after psoriasis starts and when there are no skin lesions. Often, pits in the nails or other nail changes are seen in those with psoriatic arthritis.

However, having psoriasis doesn’t protect you from other types of arthritis, such as osteoarthritis or rheumatoid arthritis. Since psoriatic arthritis is so destructive, you should see an expert, perhaps a rheumatologist.

The arthritis booklet discusses rheumatoid arthritis, osteoarthritis and lupus. Readers can order a copy by writing: Dr. Roach — No. 301W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.

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DEAR DR. ROACH: About 10 months ago, my husband noticed a small “bleb” on the skin near his right hip area. He used “tag away” and alcohol swabs daily; however, the area is a giant 2- inch- diameter “blotch” with an open sore in the middle. He insists that it is almost gone. I am afraid that it is skin cancer, very serious and that it needs to be checked out by a dermatologist. How do I get him to go? — P.K.F.

ANSWER: Please tell him that I think it sounds like it might be skin cancer, such as a squamous cell carcinoma, and that he should see a dermatologist immediately. Some people have an immense capacity for convincing themselves that nothing is wrong. The sooner he gets an evaluation, the better.

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DEAR DR. ROACH: I am a veteran and have had digestive problems (GERD and gastritis) since I came back from Vietnam in 1968. How closely related are these disorders? — J.R.O. ANSWER: GERD ( gastroesophageal reflux disease) is very, very common, and refers to the passage of food and acid backward — from the stomach into the esoph- agus. The general cause of GERD is a relative weakness in the lower esophageal sphincter, the muscular, valvelike structure at the bottom of the esophagus. Gastritis is an inflammation of the lining of the stomach.

Both of these terms often are used imprecisely, as a guess at what might be causing nonspecific stomach pains. With such a prolonged course, it would be wise to make sure of your diagnosis, as your symptoms actually might be caused a different condition, such as an ulcer or infection by the bacteria H. pylori, which would require different treatment.

Readers may emai l questions to ToYourGood- Health@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to P.O. Box 536475, Orlando, FL 32853-6475.

©2014 North America Synd.


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