Hello, , I saw your message to ddavis (and photo) and was wondering if you've heard of Raynaud’s Phenomenon? I'm not a doctor and am certainly not diagnosing you, but I know a lot of our community members with PsA also experience Raynaud's as well, which impacts blood flow to extremities. Of course, I would imagine if you've had conversations with your doctors that they already would've looked into this, but, if they haven't, it might be worth asking about. I'm also including a link to an article with more information on the condition, https://psoriatic-arthritis.com/clinical/raynauds-phenomenon. -- Warmly, Christine (Team Member)