Communications (December, 1997)

Fungus and P
by Claudia

Ed: Great website. I am 48 and have been afflicted with P for my entire adult life. I have a tremendous amount of sympathy for fellow sufferers, and am always willing to spread my P wisdom when I can.

For many years I suffered incredibly with cracks and pustules on my hands. There were times that I had to completely bandage them because of the weeping. I was truly handicapped. I have been clear of P on my hands for over 10 years now. I had done all the standard derm treatments, shots, pills, creams, x-ray and UVA treatments, but the one that worked was Neutrogena hand cream. Every night I put Neutrogena hand cream thickly on my hands, sometime I wore white gloves, sometimes plastic gloves, sometimes no gloves at all. It cleared up completely in about 3 months and I have been able to control infrequent flair-ups. I think it is the glycerine that does the job. It really worked for me and a couple of people that I have suggested it to.

Scalp P is my biggest problem, I thought I had found the cure with Skin Cap. Skin Cap cleared up a 25 year case of scalp P in 3-4 days. It was like magic. I was very depressed when I tried to order it again and found out it was no longer for sale. Skin Cap contains Zinc Pyrithione which "helps in this way to exert an anti-bacterial and anti-fungal action mainly of the Pityrosporum ovale and Pityrosporum orbiculare." I am very interested in the fungal aspects of P; have you done any research in that area.

Thanks! -Claudia

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Ed's Reply:

I have to occlude my hands regularly, too (I use "food-handler's gloves"). I've never garnered significant results from occluding a simple moisturizer (like glycerine) but when I use a corticosteroid ointment I usually see improvement after three or four nights.

Early on in my own case I considered the "fungal aspects of P." Foot lesions and bad toenails are often confused with fungus. I think, though, that the medical community has pretty well ruled out microbes as a root cause of psoriasis. For one, microbes are pretty easy to get rid of (a lot easier than psoriasis lesions). I believe the microbes in fungus are also easy to identify. So, I don't pay much attention to psoriasis products that boast anti-fungal action.

But, as we now know, zinc pyrithione isn't the product in Skin Cap that produced such miraculous results. It was clobetasol propionate, a corticosteroid, in a rather potent dose. It shouldn't have been in an OTC product in the U.S. You can get the whole low-down (pun intended) from the National Psoriasis Foundation. The awful irony in your case—as I mentioned in another communication here this month—is that clobetasol propionate (commercially available as the prescribed Temovate) is considered by my derm to be too potent for safe use on the scalp.

Discuss your situation with a derm. Perhaps, since your scalp P did respond well to Skin Cap, he might suggest you try a milder corticosteroid, perhaps occluded at night. -Ed

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