Inflammatory Arthritis, With A Side Helping of Psoriasis

About a decade ago, I started noticing early signs of a disease called ankylosing spondylitis, or AS - a mouthful, I know. AS is a type of inflammatory arthritis that causes my SI joint spine to fuse together and my joints to become inflamed.

It also affects my eyes and some internal organs. And, because science is amazing, I also get a side-helping of free psoriasis.

The connection between psoriasis and AS

In fact, one of the extra-articular manifestations of ankylosing spondylitis (AS) and other spondylarthritis conditions are conditions that affect the skin — plaque psoriasis being one of them. It affects around 9% of people with AS.

When I started noticing symptoms, I was about 25 years old when they suspected AS, and at that time I was blessed with an unfliching sense of invincibility and health privilege.

"How could anything 'real' be wrong with me?" I thought.

Why are they looking at my nails?

When I was first seen by specialists a decade ago, they tested my blood, my spinal flexibility, and my lungs. And my nails. I wondered, "why are they looking at my nails?"

I had no idea that arthritis — which I'd always thought was a vague 'pain' issue that was no big deal or annoying for elderly people — could affect your skin, eyes, or nails.

It made no sense to me. It was a reductive and ignorant way of thinking. Fast forward 10 years and here I am: A health journalist with experience researching a multitude of diseases and a patient advocate writing also about my own.

Embarassing moments with nail psoriasis

But back to my skin and my nails: My psoriasis wasn't always apparent to me. Because my AS was so obviously the issue, and because it was so all-consuming, my skin issues took a backseat. I had these little red spots on my shins for years. And these itchy patches on my lower scalp.

I also had deep ridges in my nails, known as pitting. I am not diagnosed with psoriatic arthritis, though. It's psoriasis. Whenever I'd get a manicure, I felt embarrassed. The manicurist would take my hands in hers and look at me with confused eyes. "What did you do," or "what happened?!" they tend to say.

When I respond "it's a disease," they look at me like they'll catch it. So, I quickly learned to say, "It's just a weird bone thing."

The connection of autoimmune diseases

The fact is, I shouldn't be ashamed to say anything, and I shouldn't call my body weird. It's just that in those moments — when I'm not advocating or writing or talking to peers in the chronic illness communities — I want to be a person.

I don't want to educate or inform others about inflammation and the way the body manifests diseases in strange places. When the first coat of nail polish goes on, I can still see the ridge. Then the second and it becomes slightly less visible. By the third, my nails are mostly normal looking — and my little secret is hidden.

Except when it's not. I am fortunate to have mild psoriasis patches from time to time. They are mostly in sync with my AS flare-ups and they come and go with stress.

It's time that I speak up about it, not only because so few people understand how autoimmune issues are grouped together, but because I don't want to be ashamed of my pitted nails, itchy skin, or my hobbly walk during arthritic flare days.