May-Jun '08 | briefing | mail | interviews | articlespsorchat |  don't say this | flaker creativity | flakers' jargon | other places | archives | send mail | ed dewkesearch | acknowledgments | legal stuff | Flake: Confessions of a Psoriatic  | 2008 Ed Dewke

Would Our Children Inherit P?
from Alex L.

Hi there.  I discovered your site whilst surfing the net on a very unproductive day at work and would like to thank you for all the information and understanding I've gained from reading Flakehq.com!

My partner has psoriasis and doesn't always look after himself particularly well — struggles to maintain a regular skin care regimen — but he's been incredibly appreciative of my efforts to discover more about the condition.

It developed after an injury when he was around 17, and he has been to all sorts of doctors, dermatologists and other specialists but has never been fully clear of it, despite a wide array of creams and topical lotions. I had previously thought he was quite badly affected, but having read so many of the personal stories on your website, some of which touched me so deeply they made me cry, I have realized that he is nowhere near as seriously afflicted as he could be. He has it in his hair, over elbows and lower arms, some on back and chest, hips and particularly on his lower legs and nails. He is very uncomfortable and refuses to go swimming or to the beach, but has become increasingly more open about it with me, particularly since we've been living together.

I found you whilst trying to find some sort of herbal wonder drug but am sad to learn that no such miracle exists. However, after reading all the positive feedback on Kalawalla, we've decided to give that a go, so I'll write again and update with the progress.

I do have a question, which I would hesitate to ask my partner as he's a sensitive soul and I'd hate to upset or hurt him. He is keen to start a family, but I'm unsure if the condition is hereditary (not that that would necessarily preclude us having children, I'd just rather be forewarned and thus forearmed). My mother had it when she was much younger, but only very mildly, and centered on elbows and knees. Strangely, it disappeared around the time of my father's death and never reappeared (very decent of him to take it with him). I have never had any signs of it, but wonder if I could be a 'carrier'? Or if my own family history coupled with my partner's psoriasis could lead to an increased risk for our children?

Again, I'd like to reiterate that your site is an incredibly valuable resource, and I thank you for your work. I am delighted to have a greater insight into something that affects the man I love, and if the treatment we choose leads to any kind of remission, you'll be the first to know.

All the very best, -Alex L.

*****

Ed’s Response:  Thanks for writing Alex.  Your partner is lucky to have you.

Your question about P and heredity is a good one.  Evidence strongly suggests that heredity plays a large role in who ends up flaking.  A significant percentage of people with psoriasis can identify relatives with the condition.  Many suppose that the number of people who are “carriers,” as you call them, is far larger than the number of people actually exhibiting symptoms, and that those flakers who believe themselves alone in their families most likely have inherited genes that define the proclivity to flake, but because relatives’ were never “triggered,” the carriers remained invisible.

Some scientists are trying to sort out the genetic evidence that has been associated with P.  One of the possible advances that could derive from an understanding of this evidence is a DNA test that could predict psoriasis in potential offspring.  This might not yield a “yes/no” answer.  More likely it will yield a “percent probability,” or a “relative degree of risk.”  This is because of the “trigger” characteristics of the disease, which appear to depend on factors outside or at least in addition to DNA.  In other words, we might gain a sense of “probabilities” instead of “guarantees.”

On the other hand, having the technological capability of determining the “probability” of bequeathing psoriasis is only as valuable as the possibility of doing something about it.  It might be more frustrating than useful to be seventeen years old and wake up one morning with P lesions; then, when you tearfully ask your mother what’s happening she sighs, sucks in her lips and says, “Well.  We’re not surprised.  I told you when you were a baby this might happen.”

And I’ll leave you with this consideration:  Western medicine has acquired most of the effective knowledge about treating psoriasis through pharmacology in the past two decades.  Were it not for these advances, today I would be a severely disabled psoriatic — probably barely mobile from psoriatic arthritis and suffering from at least two kinds of skin P covering 30% or more of my skin.  Because of modern medicines available to me (I’m well insured through my employer) my psoriasis, today, is virtually unnoticeable.  Understandably, I have great faith in the future.  As I’m a grandfather seven times over by marriage, I’m not likely to be conceiving children anymore, but were that not the case, I don’t think the “heritability” of my psoriasis would stop me.

Best of luck to you and yours, Alex!  -Ed

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