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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19331
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I suffer from psoriatic arthritis, that causes pain and swelling

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I suffer from psoriatic arthritis, that causes pain and swelling in my ankles, toes, knees, elbows and finger joints - as well as several tendons/soft tissues in my legs. Last night for the first time I noticed what looked like a blue/grey vein on the underside of my big toe, that appeared enlarged, swollen (slightly raised) and was very painful to the touch, with occasional stabbing pains when left alone. This morning the "vein" has gone, but I have what looks like a purple bruise (its not redy or very dark in colour) to the right of where the vein was last night (on the side of my toe).
Is this something related to my arthritis? Should I be worried and get checked out asap?
Hello from JustAnswer. This could be related to the psoriatic arthritis, as psoriatic arthritis does increase the risk of inflammation of veins in the foot, including the development of clots within the vein. However, this does not sound like something for which you need to get checked out quickly. When we speak of inflamed veins and blood clots, there is a significant difference between venous disease affecting the small veins that are superficial in the extremities and can be seen under the skin and similar disease affecting the large deep veins, particularly the deep veins at or above the knee. When you hear of people with blood clots in an inflamed vein that requires urgent treatment, this is only referring to disease affecting the large deep veins. Bllod clots in these large deep veins are the clots that can break off and travel to the lungs. Venous disease that affects th superficial veins, even the superficial veins in the thigh, does not carry the same risk, and we do not treat superficial disease aggressively. Superficial disease is frequently transient or will respond to simple interventions. In your case, the vein on the underside of the toe would be a superficial vein, and the tenderness is indicative that it was inflamed However, the fact that the prominent vein is already gone is a good sign that this is already healing spontaneously. If there are no other symptoms, there is no reason to perform any other interventions. If there is some residual soreness, then the use of mist heat to ease inflammation is usually all that needs to be done. If I can provide and additional information, please let me know.
Customer: replied 2 years ago.
Thank you - that's reassuring to know. Inflammation of veins in the foot, is not something I'd been alerted to by my own Dr. Is this something that will start to occur more often as the disease progresses? Is it tied into inflammation of the soft tissue/tendons etc that I'm seeing? Inflammation of anything other than the joints seems to stump most of the UK Doctors I see - but I can't believe its a rare occurrence?
Not necessarily. Superficial phlebitis can happen in anyone. It is not real common, but it is not rare. It is slightly more of a risk in someone with psoriatic arthritis. It is not a common problem in someone with psoriatic arthritis and a single episode does not cause a significantly greater risk than the underlying disease process. It is due to inflammation in and around the vein, but is only indirectly related to the musculoskeletal inflammation from psoriatic arthritis.
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