I have several toenails that are lifting with thick buildup and debris underneath and two that are actually detaching. I also have horizontal ridging on almost every toenail. I've had the culture for fungus done and it came back negative but my dermatologist never mentioned that a biopsy for nail psoriasis could be done. There is such a test available correct? He doesn't want to diagnosis it as Psoriasis until he sees lesions on my skin elsewhere, but there aren't any.
I'm really needing to find out if this issue with my toenails is psoriasis because I've been having issues with muscle and joint pain for 18 months now and I'm really beginning to suspect Psoriatic Arthritis. I came down with a sudden sever case of Iritis/Episcleritis in June and have learned there are strong links between these eye conditions and inflammatory arthritis. I've also had three fingers and a couple of toes swell.
I think knowing for sure if this issue with my nails is Psoriasis or not will really help my rheumatologist in diagnosing me. I've searched the internet and I don't know if I'm using the wrong key words or what but I cannot find any info on nail cultures for Psoriasis. If anyone knows if it's possible to have nails tested for Psoriasis I'd sure appreciate knowing. Thank you! :-)
Before my psoriasis got really bad I asked a dermatologist about my icky toenails. He said it was most likely a fungus, but when it didn't grow he told me it was psoriasis. I DID have skin lesions, but I don't think there's much else it can be. If you are already seeing a rheumatologist, I'd just tell him what you suspect. Do your fingers ever look like little Vienna sausages? That's what my fingers looked like in the beginning and I've seen it used in every description of psoriatic arthritis. (I was so surprised when I saw it listed as a symptom because I kept saying to people "don't they look like little Vienna sausages?". Enough of that!) Once you can get an actual diagnosis, you can treat it. Good luck!
My family doctor wouldn't diagnose me with psoriatic arthritis because he said "it's too uncommon"!! Can you believe that? Then the rheumatologist diagnosed it before I had a chance to sit down. Good rheumatologist!
My rheumatologist does know about my toenails and is waiting to hear what my results from the culture are. I see her Monday to let her know. As for my fingers I don't get sausage swelling I get swelling/pain in the middle knuckle of my fingers that goes down toward my hand and I think this is something that is confusing things a little. My swelling doesn't scream "classic" Psoriatic Arthritis.
I have been diagnosed with psoriatic Arthritis and your symptoms are exactly the same as mine. I didn't need a biopsy to be done as it was plainly obvious by the state of my nails, or should I say lack of them as they were falling off.
I also have episodes of swelling on my fingers that are extremely painful and have to take a strong course of Prednisolone.
I am now on Methotrexate to stop the psoriosis spreading to my bones as it has already gone into my tissues surrounding my bones.
I get very bad muscle spasms and tightenings and very often get severe cramp.
Your joint pain in your knuckle sounds like Tendonitis which is also linked with Psoriatic Arthritis, I get this in my wrists and ankles and have injections into the joint every 3 months to relieve the pain.