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About Tattoos and Giving P to One’s Kids
from John F.

My name is John I've been a P sufferer for 10 years. I work as a graphic designer with many hours in front of the computer without a break. I have plaque lesions on my elbows, knees and underarms. Heavy Scalp plaques at times. I'm currently on daily Dovonex to knees and elbows, coal tar shampoo 3 times a week and Trimovate for groin and underarms. I'd like to cut out the Trimovate being the only steroidal application I use at present.

I did suffer from a heavy annual strep throat as a child then had no infections until 2 years ago when the annual affliction re-appeared. Reading some of your archives on this topic has made me reconsider tonsillectomy. My sister has recently had, for the first time ever, a guttate full body outbreak after a difficult childbirth experience.  Hers seems to be on the wane after PUVA treatment.

I do have a couple of questions if you or anyone else has time...

I am considering a tattoo but slightly apprehensive about Koebner phenomenon. I did have a scar after a cycle accident that turned p'iatic but has subsequently cleared up.  Advise about the tat?

I have two children, both girls aged 1 and 3 (angels the pair of them). What are their chances of avoiding P?

Love the site especially the glossary!  A perfect example of the "content is king" principle. –John F.


Ed’s Response:  Thanks for writing, John.  Let me mention at the onset that, as a web site producer, I’ve always feared receiving a communiqué that starts “I’m a graphic designer.”  FlakeHQ is an avocation for me, but in my professional life I am a REAL media producer who works with graphic designers.  Those GDs who work with me never hesitate to tell me that I am NOT a graphic designer and I would be well-advised not to let anybody mistake me for one.  A few of these GD colleagues of mine have actually glimpsed FlakeHQ and politely changed the subject.  As GDs go, you should receive some sort of award for diplomacy.  Your last line will be dear to me forever:  “A perfect example of the ‘content is king’ principle.”  Meanwhile, if readers want to see what a well-designed web site looks like, go here:  (John works for Cobra Beer.)

Now, to your questions, John.  In general, I think most derms and fellow flakers would tell you a tattoo isn’t a good idea.  This is probably because the Koebner Phenomenon is a very individualized proclivity and if you can’t define how likely you are to “Koebnerize,” it’s best to assume the worst.  But, generalizations aside, if you’ve searched on “tattoo” here you’ve already heard from flakers who have had no problems with tattoos.  You’ve had some experience with Koebner as a result of the cycling injury, so you know you do manifest the phenomenon.  You have two throws of the dice:  first, will a tattoo Koebnerize on you?  Two, how long would a lesion at the tat site last?  I can’t roll for you, John.  But I’d say, “If it were me, I’d buy a new watchband.”  (Or, beings that I’m from Kentucky, perhaps I’d buy a new belt buckle.  Point being, no tats for me.)

With regard to your daughters’ chances of becoming flakers, we know (because you’ve told us) that the disease appears to be a genetic proclivity in your family; however, half your daughters’ DNA is coming from outside the family (a safe assumption?).  Current thinking is that a combination of genes cause the disease and, on top of these genes, certain environmental conditions must “trigger” the disease to manifest.  All of this suggests that simple probability for your daughters weighs slightly heavier in favor of them remaining flake-free.  Having said that, no one would be too surprised if one or both of them flaked to some degree.  Your precise question was, “What are their chances of avoiding P?”  The precise answer would be slight.  If they are not wired genetically to get the disease they won’t.  If the wiring does exist in them, they might get the disease (depending on what triggers them and whether or not they pull those triggers).  The irony there is that most people don’t know what triggers their P.  Those that do know, only learn AFTER it happens. 

Good luck to you and your daughters.  If I were still an imbiber, I’d be looking for an ice-cold Cobra about now.  -Ed

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