This is such a nice photo. I had to share it with you.
Classic psoriatic rash.
He presented with various aches and pains, including a most frustrating chronic tennis elbow (lateral epicondylitis) affecting his cricket. A little dry scalp, somewhat scaly. And this rash, at the umbilicus. A classic, often "hidden" site.
I use this as a reminder that the diagnosis of Psoriatic Arthritis needs a high index of suspicion and then a hunt for clues.
In the last few months, I've written the following posts to try and raise awareness:
- The Arthritis that affects Nails, Tendons (Entheses) & Skin (link)
- Psoriatic Arthritis: it's easy to miss (link)
- The Nails giveth the Diagnosis (link)
- Which PsA Questionnaires do you think a dermatology clinic will use? (link)
- Psoriatic Arthritis for Dermatologists: A Rheumatology Perspective (link)
- Tennis Elbow: sometimes it means more (link)
Phew! That's a lot of reminders.
This blog's also read, as you would expect, by our BJC Health team, and I'm writing this post with our physiotherapists and exercise physiologists in mind. I'm positive they, like their colleagues outside our clinic, are seeing patients presenting to them for tendon and/or entheseal (entheses = area where tendons connect to bone) problems. Sometimes, there is an underlying disease.
I'm working on helping us not miss this difficult-to-make diagnosis.