To confirm diagnosis, do I see a rheumatologist or dermatologist?

I have severe pain, arthritis, psoriasis, and scleroderma (diagnosed 20 years ago). Do I go to rheumatologist or dermatologist? My psoriasis was so bad in my hands I wore gloves as they cracked and bled constantly.
Finally, I tried light treatment and got some relief. I also see a pain mgmt. doctor for fibromyalgia and sometimes my flare-ups are so painful I can’t touch my skin. Also, my finger joints are inflamed, growing “spurs” and unbendable. Pain doctor said they are just growths – nothing you can do. My flareups? He gives me prednisone. WHO should I start with for definite confirmation and treatment? Doctors are extremely hard to find – I also have scleroderma and I would have to travel 2-3 hours to see a clinic to START!


Community Answers
  • Jax53
    6 months ago

    I had a team, which consisted of Dermatology, Rheumatology, Occupational Therapists, and physio. It was this team that is supposed to help me, Cope.

  • Rebecca moderator
    6 months ago

    I’m so sorry they didn’t give you the care that you needed and deserved, Jax53.

  • jewelrycats author
    8 months ago

    I have appointment at Cleveland Clinic in Weston, FL for Rheumatologist and Gastro NP as my problems have gotten severe due to misdiagnosing and non-communication between doctors. They are talking surgery for stitching my esophagus to stomach and I have severe constipation. Am taking Trulance but not much change.

    My biggest fear is the cost of these medications! I have fixed income on disability only.

    I’m hoping something can be done for the pain in my fingers especially! Leaky gut diet made me go out and I’m taking small steps. It seems all my autoimmune diseases got worse at the same time. Scleraderma, PsA, heart failure, esophagus, fingers deforming with nodules and exhaustion.

    Reading your articles and Q and Anwers are a great source of information! Happy to have found this sight!!

  • VickiN moderator
    9 months ago

    Hi @jewelrycats, a Rheumatologist is who will typically diagnose/manage your Psoriatic Arthritis, and a Dermatologist is who will typically diagnose/manage your Psoriasis. Pain management is super important, but most Rheumys will also want to treat the underlying inflammation and monitor your bloodwork/imaging.
    Hope that was helpful!
    -Victoria, Community Moderator

  • Leanne Donaldson
    9 months ago

    Hello @Jewelrycats,
    Wow, it sure sounds like psoriasis has given you quite a hard road to go. If I were you, I would certainly seek “official” diagnosis from a rheumatologist. With a history of psoriasis, I hope for your sake that it isn’t a difficult process. Plus, many of the medications used to treat the arthritis part of PsA also help with the psoriasis as well. A rheumatologist would be able to evaluate the best course of treatment for both as well as have the ability to evaluate your joints or joint damage which a dermatologist isn’t an expert in.
    How is your psoriasis doing now? Is it under control or are you still struggling? I know for me, prednisone helps with the pain, but the relief is only temporary and also tends to make my psoriasis worse. Finding a good rheumatologist (one who really listens and is knowledgeable) is extremely important, as is the relationship with him/her. Don’t be afraid to get a second opinion either. I am so sorry that you have experiencing this, please let me know how the search for a doctor, and your symptoms, are going. There are several articles available on diagnosing PsA as well as finding a good rheumatologist.

    https://psoriatic-arthritis.com/living/healthcare-team-work-you/
    https://psoriatic-arthritis.com/living/what-to-expect-rheumatologists-office/

    -Leanne, Community Moderator

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