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EMT Worries About Infection
from Mike H.

I must say that I enjoyed your website.  I find it very hard sometimes to deal with having psoriasis.  I first noticed it when I was 14 and it started as a small patch in my scalp.  I thought it was dandruff.  The rest, they say, is history.  I am now 28 and have it on probably 75% of my body. 

I have tried many different treatments and some worked for awhile and others didn't.  I am a fire fighter/paramedic and have had a couple of scares when strangers’ body fluids got on my P.  Fortunately I have never contracted anything. 

Sure, I could change professions, but I can't see that happening.  Anyways I look forward to visiting your site again soon and thanks for the comic relief.

-Mike H.

*****

Ed’s Response:  You’re welcome, Mike.  Glad you found us; glad you’ll come back.

I can certainly appreciate your scares.  While flakers know their lesions will crack and bleed at times, we generally don’t know how susceptible any lesion — even an apparently whole one — may be to infection.  I recall a number of slide photos and artistic representations of psoriatic skin from cut-away edge views:  The topmost layer of dead skin cells is extra thick and the cells look assembled by some drunk brick layer.  Though this can feel like a tough callus sometimes, how protective, really, is that pile of helter-skelter skin cells?  We know it tends to vent moisture more than normal skin.  If our own body moisture can get out so easily, how easy is it for other fluids to get in?

Well, perhaps not that easy.  We know that thick lesions are resistant to the topical lotions, creams and ointments we use to treat them ... so we scratch and in other ways eliminate the scale — and therein may lie the problem:  When the scale is pried off a flaming lesion, the younger inflamed skin left exposed is even more wound-like.

Conversely, we are taught that a P lesion is an area of skin fighting off an imagined pestilence by too-rapid regeneration of skin cells.  Isn’t this fight the same one we’d wage — but appropriately — if the area really were infected or otherwise traumatized?  The answer to that is, at least in some respects, yes.  Does that mean we’re prepared to defeat whatever might get in through the battleground lesions?  Perhaps not, especially if you consider a number of the medicines we use to counter the lesions also suppress our auto-immune system.  Does this mean even though our defensive forces may be actively engaged in the area of a lesion, they may not have much strength? ... Here I run out of answers and conjecture.

Your occupation and your concerns should be a wake-up call for all of us.  We are not wasting time to occasionally remind ourselves that our lesions are wounds.  We may be tough and able to function — we may disregard our lesions’ susceptibilities — but we may come to regret this.

Be careful!  -Ed

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