To Your Good Health: Psoriatic arthritis diagnosis doesn't hinge on lesions

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.

A: 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. 301, 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.

Dear Dr. Roach: I'd much appreciate it if you could let me have your expert opinion. I'm a female, age 85, weigh 70 kilograms (154 pounds), am in good health, walk daily one or two hours and, until recently, had no locomotion problems. For the past six months or so, I have been experiencing difficulties getting up from a chair without using my arms for support -- and this seems to be rapidly deteriorating. Could Co Q-10 help, or anything at all?

-- S.L.

A: Rapidly progressing weakness is a reason to get evaluated immediately, and I would start with your own doctor or a neurologist. There are many nerve and muscle problems that can cause progressive weakness, and some of them are quite serious.

Co Q-10, a vitaminlike substance, has some usefulness for the muscle damage associated with statin drugs, and may be useful in mitochondrial diseases of the muscle. Vitamin D deficiency has been shown to be a common cause of weakness in the elderly, and replacement of vitamin D can improve strength. However, I recommend getting a diagnosis before trying a treatment, however benign.

Dear Dr. Roach: A diagnosis of "Cameron erosions of the esophagus" was made after my gastroscopy. I was not able to find that term at nlm.nih.gov/medlineplus. Have you ever heard of that condition?

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To Your Good Health: Psoriatic arthritis diagnosis doesn't hinge on lesions