Fingertip problems

[Guest guest]

An update on my problems with peeling skin on the fingers. Several

people have described similar problems and indicate that their

doctors are puzzled about whether it's related to the PA.

For what it's worth, my rheumy thinks what she's seeing on my

fingers is definitely PA. This time she could see the eruptions in

all the various stages, since it just started a week ago tomorrow.

Here's how it goes.

1) My fingers swell up, just from the last crease out to the end of

the finger. At the same time, they turn a funny color red and get

hot and the skin is shiny. Usually, this happens to one finger at a

time, but progresses rapidly. Left thumb, right thumb, right index

finger, left index finger, etc. Symmetric. The skins feels very

tight and not numb, but thick as though you are feeling things

through layers of cloth or rubber gloves. The fingertips might

throb, especially at night.

2) If I'm paying real close attention, I will then notice aftr a day

or two of this that a small area of skin - smaller than a pencil

eraser and round or oval in shape - begins to " pucker. " It may turn

a slightly yellowish or brownish orange color. This area of skin

feels hard, rather than dry - there IS a difference! This starts

with the first finger that swelled and progresses in the same

order.

3) Then a small split occurs, like a paper cut. On my thumbs, this

happens not just to the tips but also near the other two joints.

Tips first, though. When it all first started it was just the tips.

And also at this point, it's usually my whole thumb and not just the

last segment that swells in step 1.

4) The skin around the split begins to erode in an ever-increasing

spot. The skin under the peeled spot is very red and angry-

looking. It starts to bleed. Touching things is excruciating.

Multiple hard spots and splits will eventually occur on the same

fingers. When it all started, it only spread over the whole

fingertip, but now I find that it is creeping down the finger and

around the sides.

Now that I'm paying closer attention, I notice that even before step

1, I start to have just very slight redness around my cuticles of

all my nails. Not painful, just red and a little puffy, with

sometimes a tiny piece of hanging skin on one or two of them.

Also, the pitting and ridging in my nails gets worse as the cycle

progresses. After the last flare my nails had returned almost to

normal - smooth and pretty. The ridging may have started even

before the swelling. By the time the first split occurs, there is

pitting as well.

Today the rheumy was able to see every single stage of that

process. Her comment, " This is definitely psoriatic arthritis! "

Hope this may help someone...