Infection

[bevlin]

I've had RA for about fourteen years and have been taking Methotraxate for most of that time. am doing well and have continued to work as a childminder. I'm not often Ill ( considering the many runny noses/coughs that I deal with on a daily basis!) but on the last two occasions that I have had a cold I find it hangs about for three to four weeks with me feeling more and more unwell and ends up with me getting an infection. Yesterday I went to the GP because my finger was swollen and so painful with pus around the fingernail. I thought it might have been a splinter but it was because my immune system is impaired apparently. Nice doctor lanced my finger and squeezed yucky stuff out and I feel so much better today. Does this happen to anyone else?

[allanah]

No that sounds really nasty. But I get very troublesome boils that show me when my immune system is down X.

Hope you feel better soon xx

[nomoreheels]

I'm also on MTX & on the rare occasion I have a cold it always takes longer than it used to. It generally ends up on my chest but my GP is good & now knows the routine, I ring her & she sends a script for antibiotics to my chemist.

Whilst it's nowhere near as bad as your finger my thumb nail has started coming away from the nail bed just on the one side but it's reached the middle now. I take great care of my nails & always keep my hands clean so I'm a bit perturbed about this as it's never happened before except when I trapped my finger in the car door (twice) & lost the nail completely both times. I mentioned it to my Practice nurse last week when I was having my bloods done & she gave me a sample pot & asked me to put a clipping in it & she'll have it sent for analysis. She thinks it may be a fungal infection but I'm wondering if it's anything RD related.

I hope your finger heals soon & doesn't cause any more problems.

[bevlin in reply to nomoreheels]

Funnily enough I do have trouble with my mails.mthey split and break very easily. I often end up with a nail ripped right across the nail bed. I don't bother with nail varnish any more as have to keep them so short. Wonder if it's to do with the MEDS?

[nomoreheels in reply to bevlin]

Could be. Although I don't let them grow long they started splitting up on the nail bed about 5 years ago. I asked my Consultant if it could be my meds & she said possibly they'd become porous so to use varnish to help protect them which I've done ever since usually just clear as part of a French manicure. I found an treatment that works well for me which has solved the problem. It's just this is something I've not had before so will wait & see what the results says.

[flow4 in reply to nomoreheels]

NMH, there is *certainly* a link between nail changes and inflammatory disease. The connection is well-known in PsA - nail changes are in fact a diagnostic criteria. In a nutshell, nails are directly connected to the skeleton and so can reveal changes that are also going on in your bones. Sometimes a nail change is just a sign of one-off trauma (like when you bash a finger), but sometimes it is a symptom of joint disease, and there is some evidence that changes in your nail(s) may be a specific sign of damage within the same particular finger(s) or toe(s) (see second link below).

What you describe is called onycholysis, and can be fungal, but given your existing IA diagnosis, you should mention it to your rheumy I think. If you have had any skin rashes too, mention these: it may lead to a dx of PsA.

This is a clearly-written overview: psoriasis.org/advance/nail-...

There is more detailed info here: enthesis.info/pathology/pso...

[nomoreheels in reply to flow4]

Thanks Flow. As usual I'm not aware I banged it but can't be sure! I had read about onycholysis when I first noticed it but my nail is otherwise normal unlike the majority of images, that is except for the separation from the edge to the middle of the nail & about half way down. I've keep it short so I just hope the clipping will be enough to test?

I don't have skin problems generally nowadays but as I child I had an eczema of sorts in my crease behind my knee & ears oddly enough, I grew out of that but do get stress eczema, just the odd patch which reacts to the Cemalyt prescribed by my GP in Spain.

I do think you've hit on relevant points & though I've not discussed it with a Rheumy yet my latest DEXA scan results threw up some questions which may be relevant so whatever the results of the clipping I'll definitely mention it at my appointment next month.

Actually, I noticed a while ago one nail (index finger r hand) was growing flat on one side but that grew out & just checked each nail again & the next fingernail (middle) is doing the same, at the same side. Odd but could be relevant.

Thanks for the links, I've read the second one & will go through the other later.

Apols Bevlin for hijacking your post.

[Pands]

Hi, I find that every little scratch especially on my hands takes ages to heal. The scratch will go very red and then sore and then about 3 weeks later I am finally better. I am sure it is the meds delaying the repair mechanism.