(January, 1999)

Another Misdiagnosis
from Andy P.

Ed: Hope this note finds you well and in good spirits. I have only recently found your site, and have had a lot of fun and felt relieved that I am not alone in this apparently flake free world!

I am 27 and only had relatively mild P until recently, when a case of tonsillitis and the need to take some anti-malaria tablets really kicked the P into action. Now I'm off to see a "derm" (I'm starting to pick up the jargon already!) next week for the first time. Don't know what she will have to tell me that I haven't already picked up from real life stories on your site.

Anyway, fingers crossed all will go well and I will become less flaky as time goes on. However, whatever happens from now on I feel I have entered a world where people will understand (not sympathize with) what I may go through in the future. Don't get me wrong—my friends are great about it and, as far as I can tell, they are not bothered by the shedding. However, its different to hear other people recounting situations and occasions that I am starting to relate to.

One that may be applicable for the "Don't Say this" section—I went to see my doctor last week after my P flared up, to which she said how bad it looked and recommended a few ointments to use. When I asked to be referred to a specialist she said that there was quite a lengthy waiting list and that it would probably have cleared up by the time I got an appointment! I have since changed my doctor and I am going to see a specialist next week!

Anyway, must go now—thanks for your efforts—they're appreciated -Andy P.

*****

Ed's Response: Your welcome, Andy. It's too bad that so many doctors appear to be in the dark about P. I wish that there were courses we could go to—like there are in business: Something like, The Complete Guide to Skin Diseases: For Non-Dermatologists (concept borrowed from The Complete Guide to Finance & Accounting for Nonfinancial Managers, [Steven Finkler, ©1983 Prentice-Hall].)

P must be difficult to diagnose for the first time. My experience suggests it requires an etiological and epidemiological history before it is correctly diagnosed. For awhile, I thought my current (6 years, now) dermatologist was a genius for diagnosing it right away, but in retrospect I figured out that was not the case. I told him what doctors before him had said and had me try, and I think he based his quick diagnosis on deduction: Well, if all those things didn't work, this and this and this are ruled out. So, what remains? P. Then, at first based only on deductive reason, he put me on a P regimen and, when that seemed to palliate but not "cure" the symptomology, his deduced conclusion was validated. In a sense, I'm a psoriatic because I match the definition and other things have been ruled out. That kind of makes the population of psoriatics the "F Troop" of skin abnormals, doesn't it?

Keep us apprized of your situation. It will be interesting to learn what approach to treatment ultimately helps you the most. -Ed

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