I am a 35-year-old male. I have a problem in my skin, especially, on joints. I have had already consulted a dermatologist and she suggested consulting a rheumatologist based on the symptoms. Due to COVID-19, I could not consult but now it is spreading very fast. Could you please help?
I also have vitamin D deficiency and taking D-rise and Lobate S ointment.
I have gone through your query and reports. (attachment removed to protect patient identity).
Your vitamin D is significantly low for which you are already on the supplement.
I want to ask you about skin problem and joint pains. Since the prescription was not fully loaded, I could not figure out the exact diagnosis of what the dermatologist has said. Did they mention about psoriasis? As psoriasis and joint pains can be related. If you could attach a picture of the skin lesion, it may be helpful.
Is there any early morning stiffness in the joints? Any backpain or neck pain? Any one in the family with a history of skin problem?
Do let me know these answers and picture of your skin lesion to guide you further.
Thank you doctor,
Yes, I do have stiffness when I woke up in the morning. I do not have pain as such on joints, but I do have on the back neck and in ribs when I am bending my body. My mother and my grandfather have skin issues. I am attaching doctor's prescriptions and photos of my skin problem. Doctor suggested me to consult a rheumatologist.
I have gone through the pictures and prescriptions of the dermatologist. (attachment removed to protect patient identity). It does seem you have psoriasis with a strong family history.
So at times, psoriasis affects the skin only but in 30 percent cases, it can affect the joints as well which will involve the spine or the other joints like knees, ankles hand joints. So eventually if it is progressing, you need to start medications for the same.
For now, the safest bet is to start tablet Nucoxia 90 mg daily for 10 days and then 60 mg daily for 10 days.
Drug of choice for psoriasis remains Methotrexate, but I can only start after seeing the complete blood picture, liver function test, and serum creatinine. So once you have those you can revert to me, but if possible meet a rheumatologist in person.
You should start doing exercise 30 minutes daily. It will help with spine movements. As such due to lockdown, you cannot go out, but see whatever is possible in home environment.
I hope this helps.
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.. gone through your query and reviewed the attached photograph. (attachment removed to protect patient identity).
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