Is lip biopsy necessary?

[powderpuff]

My rheumy has not performed a lip biopsy and I was wondering if it is necessary if SSA and SSB are positive. Actually, no diagnostic tests for dry eyes or mouth have been performed. The only examination performed was looked at my hands and wrists for swelling first and second visit. I thought this was a little strange as I expected a full examination. What are your thoughts? 

[anita]

If your SSA & SSB are positive, you should not need a lip biopsy.  If you have not had a schirmer's test, it's easy and will give you an idea of your eye dryness.  But a thorough eye exam should also be done.

[Cassi307]

I did not have a lip biopsy as my labs were strongly positive. It also took years before I was finally diagnosed and had been to my md with complaints of the same symptoms before someone put it together. I actually did not develop dry eyes until the time I was diagnosed. So, it is not always necessary for a diagnosis.
Be careful of the dry eyes. It is not a minor symptom for me. I have been on Plaquenil for over a month and am having a decrease in stiffness and joint pain but I have been battling blurred vision due to dry eyes. Go see an ophthamologist's for an eval.

[powderpuff]

Thank goodness, I was afraid to have one  . I'm a chicken when it comes to cutting inside the mouth.

My rheumy says my symptoms are minor although I've informed him I cannot eat without something to drink and my tongue is fissured and dry. Even while I was talking to him my throat was so dry I became hoarse and started to cough. I can not eat anything with any acid anymore without my tongue hurting.  My eyes feel like I have sand in them most days and natural tears do not help anymore. I am going to pick up the restasis tomorrow because I'm pretty desperate to get some relief even though no referral to the ophthalmologist. My rheumy has ignored my calls to speak about the meds and referrals so I will ask my PCP to refer me and treat me as much as she can.
I'm a little afraid the Plaquenil will ruin my vision as I've had stabbing, sharp pains in my eyes.

I appreciate everyone's input.
PP

[jazzlover]

I wouldn't do it even if my blood tests were negative.

[Cassi307]

Powderpuff read up on Plaquenil. There are some good threads about it here. Just use the search bar. My eye problems are not limited to dryness. Only a good eye exam will tell you what is going on with your eyes. Does your insurance require a referral by your primary?

[powderpuff]

Powderpuff read up on Plaquenil. There are some good threads about it here. Just use the search bar. My eye problems are not limited to dryness. Only a good eye exam will tell you what is going on with your eyes. Does your insurance require a referral by your primary?

Unfortunately, yes. I hope my PCP will not have a problem referring me.

[Styx]

If you have positive SSA and SSB, I would not bother with a lip biopsy. Have them do a schirmer test and measurement of salivary flow, etc. instead.

If I were a doctor, I would assume a positive SSB patient has Sjogren's until I have considerable evidence otherwise.

Styx