Jan-Feb '09 | briefing | mail | interviews | articlespsorchat |  don't say this | flaker creativity | flakers' jargon | spouses corner | other places | archives | send mail | ed dewkesearch | acknowledgments | legal stuff | Flake: Confessions of a Psoriatic  | 2009 FlakeHQ, Inc.

Diagnostic Fence Riding Isn’t Helping
from Tenisha M.

Hi Ed: Just wanted to say that I stumbled upon your website just now. I've suffered from eczema/psoriasis — I'm not actually sure which one, since I've been diagnosed with both! — for 15 years.

I've rubbed just about every hydrocortisone cream, ointment and steroid on my body that I can think of. What started on my hands when I was 18 has now consumed my entire body with the exception of my scalp, lower parts of my leg and feet after a particularly bad flare-up in recent weeks.

Like many of your readers, I'm at the end of my rope when it comes to my skin. I've tried homeopathic remedies, using everything from jock itch cream, diaper rash ointment and Noczema to Bag of Balm ointment. I've tried so many things I no longer know what works.

With the exception of a few spots on my forehead or small patches on my eyebrows or cheek, my eczema has never been on large parts of my face — until now.

I'm a dark-skinned African American and my skin is actually gray when it flares; nigh time is really bad and I wake up in the morning covered in white from dryness. Never before has my entire body been this inflamed. My arms, legs and trunk are covered. Really sad, because I get compliments on my smooth cocoa-colored skin, when not inflamed.

So I bit the bullet and went to the urgent care doctor yesterday and got a 5-day dose pack of prednisone. I held out as long as I could, but I have no choice about the steroids. I only went to the doctor because I literally look sick — gray, discolored skin that quickly and inevitably becomes dry again no matter how much Vaseline or lotions that I slather on it.

I know the steroids are bad for me, but it's been at least 2 years since I've had any, although that still doesn't make me feel better because I know what they do to the body.

And so that led me to your site, as I'm researching what to do. All I can say is that I threw away all the hyrdrocortisone and prednisone about 3-4 years ago and virtually eliminated eczema using borage oil, flaxseed oil and fish oil.

I was in heaven, until I moved from the harsh winter climate of Michigan to the pollen-rich climate of Georgia nearly three years ago. Who knew? My body did a 360, and I broke out everywhere.

After a particularly bad outbreak about three years ago, I finally went to an allergist, who told me I was allergic to dogs, corn, wheat, chicken and shellfish and there was nothing he — or my barebones insurance — could do. Later, my physician discovered during a routine blood test that I was only allergic to mold and corn.

I've avoided prednisone and all the steroid creams since then because, for me, they really no longer work.

I went to a Chinese herbalist a few months ago, but I haven't been able to stomach the herbal tea; maybe I'll try again. I've carefully avoided derms because they've generally just prescribed harsher and harsher steroids — and those just don't work for me.

But I do have an appointment with a derm this week — a last-ditch effort to do something while the prednisone is still in my system.

What this derm will tell me I can only guess, although I was referred to him by an eczema sufferer whose skin was particularly bad, but not as bad as mine. This derm in Georgia has patients from as far away as South Carolina, Florida and Alabama, so we'll see.

I found your site really inspiring and I'm debating writing a blog to document my experiences. (I'm a writer, so this is an easy decision, but I wonder about opening up to everyone on something so personal.)

I can definitely relate to your readers' experiences, although there are some unique differences when it comes to African Americans and eczema/psoriasis. My skin flakes off in brown dust, not white.

People of color with eczema usually have blotchy, extremely discolored skin. Eczema can make the skin of someone who is the complexion of say a Halle Berry turn into the color of a dark brown skinned Eddie Murphy. We don't typically get red blotches but darker blotches that turn brown, white or gray depending on the complexion. 

And the manic itching you describe makes people look at me like I'm a drug addict.

Luckily, I have a supportive husband. If there's a bright side to all of this, my skin clears up in the spring — although Georgia pollen is brutal in the spring — until winter returns. I wear short sleeves and tank tops, even though my arms are usually discolored from the winter's itch.

Now, I long for the days when the eczema was isolated on my body. Anywho, thanks for reading my long rant. It's helpful to relate to someone who knows what I'm going through. I'll let you know about my blog. I figure it'll be cathartic.

Thanks, -Tenisha M.

*****

Ed’s Response: Thanks for this, Tenisha. At the very least, hopefully your derm will weigh in on the eczema/psoriasis fence and thereby put you on a surer-paved road to relief. (A lot of eczema remedies are just a waste of time for flakers.)

And to compel the doctor to make a decision and not waffle, you might show him a copy of your email to us!

I understand why you are driven to prednisone's "quick fix" attributes. I was delighted with my response years ago to intralesion steroid injections, which are supposed to be a non-systemic application of the same type of medicine (see Intralesion Steroid Injections). Based on what you've written here, you certainly don't appear to be an "over-user" of oral prednisone.

If your derm does determine PSORIASIS, a lot of therapy/medication options come up that you haven't mentioned. You might want to ask him about the topicals that are NOT corticosteroids:

  • Tazorac

  • Dovonex

  • Protopic

  • Prescription strength topical tars

Or oral systemics:

  • Methotrexate

  • Cyclosporine

  • Soriatane

Or the biologics (self-administered injections, or office visit infusions)

  • Enbrel

  • Raptiva

  • Humira

  • Remicade

  • Amevive

(All of these are very expensive and impractical unless you have good prescription insurance, though the manufactures often do have assistance programs.)

Finally, I think a blog is a great idea.  Do let me know if you post one and I'll be sure and let FlakeHQ readers know how to find it.

Please stay in touch, Tenisha.  -Ed

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