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Allergies and Psoriasis? It Might be Simpler than You Think
from Jean K.

Ed: I think you might be overstating the case of allergies and psoriasis [Briefing, Mar-Apr 2010]. It sounds as though you want to tie them together. Why can’t allergies just trigger a psoriasis flare? Or why can’t a psoriasis flare trigger some allergies?

Maybe it’s the fact that many think both psoriasis and allergies are immune system disorders.  Is food poisoning and irritable bowel syndrome two sides of the same disease because they both are in the digestive system? Like the digestive system, I think lots of things might be caused by the immune system but still be unrelated.

It seems to me that medicine advances by accident or by very detailed examination of the chain of events that ends up with disease. If studying the pathogenesis of allergies leads backwards down a chain of events that doesn’t clarify psoriasis, so be it. If studying psoriasis leads backwards down a chain of events that doesn’t clarify allergies, so be it. If those two explorations don’t satisfy your yearning to connect the two, there is always the ambiguity of triggers to fall back on. Who knows why anything triggers an allergy or psoriasis? We know so little about triggers, why couldn’t the fact that you get seasonal allergies followed by psoriasis flares indicate those allergies trigger the psoriasis?

I’m not trying to be a smart aleck, Ed; I’m just trying to simplify your argument. –Jean K.


Ed’s Response: I’m going to share your email with my rheumatologist, Jean. I think you and she are making the same argument. But your version I understand. Thank you very much.

You are reminding me of something I learned in high school science classes (but evidently forgot later), that if more than one alternative hypothesis can be convincingly argued, pursue the easiest first. Your hypothesized trigger connection between allergy and psoriasis is certainly "easier" than my argument, which doesn't even propose a hypothesis, just more or less wishes for one.  -Ed

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