It is nice once in a while to be able to laugh at ourselves, that can be Our best medicine 💊 😄

Hi, Terri. Mine was all self-diagnosed. I never saw a doctor. Psoriasis presents differently than eczema. So mine clearly had all the signatures of psoriasis, not eczema. Doctors also mainly rely on visual examination. There are no blood tests for psoriasis. I can do my own visual exam on myself and don't need a doctor doing that for me.

I never ended up with any real or significant joint pain; and no swelling in the joints. So practically speaking, I would not have had PsA. However, I did used to have a moderate problem with peripheral neuropathy pains, which happened mostly in the feet and toes, but would sometimes happen in the hands, the leg, the arm, and so on.

The peripheral neuropathy pains started several years ago, long before I ended up with skin psoriasis; and the pains were progressively getting worse year by year. I also used to have some episodes of very bad lower back pain that was nearly crippling at times.

But all that is 99% gone now. I really don't have anymore lower back pain; and the peripheral neuropathy pains are 98% gone. Once in awhile I will have a bit of peripheral neuropathy problems in the feet or toes, but very seldom anymore.

I don't know why my back pain just vanished, which first started in 2013 and got worse every year. And I don't know why the peripheral neuropathy pains are also basically gone. But I'm guessing it was still the fish oil (Omega-3), the same thing I credit with curing my psoriasis.

The point is that while I never had obvious joint problems or swelling, possibly I was headed in that direction before the fish oil saved me. I just don't know for sure...🐟🤔

Even though psoriasis is driven by T cells and immune signaling, doctors usually don’t run detailed “T-cell profiling” tests for routine care. There are a few reasons for this:

First, those tests (like advanced immune panels or cytokine assays) are expensive, specialized, and mostly used in research settings anyway. Insurance likely typically wouldn't cover them for standard psoriasis treatment.

Second, the results aren’t reliable enough to guide treatment. Psoriasis isn’t driven by one single immune pathway in every person. Different inflammatory signals can dominate in different people, and even in the same person over time; so one test snapshot doesn’t predict which drug will work best.

Third, blood tests don’t necessarily reflect what’s happening in the skin. The immune activity inside plaques can be very different from what shows up in circulation.

Because of this, treatment is still based mostly on symptoms, severity, past responses, and safety screening, rather than detailed immune testing. In practice, it’s still a trial-and-response process; or trial-and-error process maybe more accurare at least in some cases.

I've heard stories of people doing well on one drug, but inexplicably the doctor changes the medication, and it ends up wrecking the person's health. That would be a trial-and-error example.

It’s also worth noting that mainstream medicine focuses mainly on "blocking" downstream inflammation (like TNF, IL-17, or IL-23) with biologic drugs, rather than investigating what may be driving immune imbalance upstream, such as diet, metabolic health, chronic inflammation, or lifestyle factors. Those areas are still under-researched and under-emphasized in standard care.

So while immune testing exists in theory, it isn’t practical or predictive enough yet to be used routinely for choosing psoriasis medications. And arguably there's no money in such testing to be made by the drug companies anyway, who are doing just fine financially as it is by selling drugs that cost $30,000 to $100,000 a year or more...🤑

Oh my Goodness Jim, all this girl does is Complain, complain, & then, do it again, hehe.