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Ed’s Pregnancy Theory(?) Reprised (Oh My!)
from Sherry S.

Ed, I'm one of many who cleared during pregnancy and flared worse than ever within two weeks after delivery, the whole thing being more than 30 years ago but still fresh in my mind.  Your hypothesis sounds right to me:

I think it has to do with hormonal influences on the immune system during pregnancy. This has occurred to me only since starting a cyclosporine regimen for my flaking. Cyclo is a drug principally used to suppress tissue rejection after organ transplants. In other words, it quiets the body’s natural biochemical response to foreign tissue. While a fetus may not be exactly "foreign tissue" in a mother’s body, it is something extraordinary, something not there solely for the benefit of the mother. So, I’m wondering if the pregnant body doesn’t "shut down" or at least modify the immune system so it doesn’t turn against the fetus? If this or something like this does occur, perhaps that aspect of the immune system that causes psoriasis is also suppressed during pregnancy. -Ed (from Any Clues from Remission During Pregnancy?)

As for the TIM (topical immunomodulator) I'm using now, Protopic, well, it isn't eradicating the spots I'm using it on (I have too many to apply twice a day to all), but after a month the plaques are thinner.  When I press on a spot, the skin turns white for longer before reddening again.  Mostly in Protopic's favor is that it's a non-stinky ointment (unlike coal-tar derivatives I've used for years), so I'll continue with it at least another month or until I see my derm and she proposes something else.

I often wonder about coffee, and I've read your suppositions about it.  It was banned (along with chocolate, citrus, chicken, shellfish, onions, garlic, and alcohol — but the last doesn't matter, since I don't drink) when I tried acupuncture and swallowed herb pills with each of my spartan meals — this was back in 1993.  My P cleared, but could I live that way for the rest of my life!?  It was one of so many variables that I chose to discard its power, but still ... I wonder.

Anyway, I do think your theory about what happens during pregnancy is worth considering by those that run the research, so I hope you've made sure they've seen it.

Best to you, -Sherry S.


Ed’s Response:  Thanks for remembering my theory, Sherry.  The research getting underway now in southern California should reveal whatever there is to be revealed.  However, NPF’s coverage of the issue, referenced in the link in the preceding sentence, does give me pause.  To recap, 35% of the pregnancy cases surveyed confirmed P improvement, 18% reported worsening of P and 46% reported no change.  Almost half the subjects said pregnancy had no effect on their P at all.  Though disappointing for “us theorists,” this isn’t really surprising.  46% of the pregnant flakers aren’t talking one way or another, because they haven’t anything to talk about.  The women whose letters are archived at FlakeHQ have something to talk about — improvement or worsening.  My preoccupation with some reason for improvement is not a significant scientific motivation — or, at least, that’s what I infer from a twenty-five year old experience in a college behavioral science lab.

We were considering experiments wherein dogs were “conditioned” by being shocked when they went after food located on top of certain electrified floors.  If I recall the experiment (which we were reading about, not conducting) the subject was the affect on conditioning of variable negative reinforcement rates.  If you didn’t always shock the dogs when they went after this food, how many shocks over how many occasions would it take to condition the dog not to go after the food at all?  What caught my attention (and became my downfall preoccupation) was the handful of dogs who never did learn to avoid the food.  It was a small percent.  Statistically insignificant.  Still, I wondered, Why were they different?  Were they less intelligent?  Able to endure more pain?  More intelligent? Were they doggie ascetics with powers of transcendence over physical discomfort (yeah ... I thought like that in college)?

During the course of this study we were required to write several short papers.  I forget what the assignments were, but they all related to the shocked dogs experiment.  In each paper I expounded new reasons why I thought we ought not ignore the handful of untrainable dogs.  As I remember it, my papers were graded progressively lower.  The professor berated me for not paying attention to what was significant.

If it’s accurate that about 35% of pregnant flakers will experience improvement, that’s a little over 1 in 3 — statistically more interesting than my handful of unshockable canines.  Yet perhaps not enough to point to anything too fundamental about the physiology of pregnancy.  I will be surprised if my theory proves true.  If hormonal actions of pregnancy effect the immune system in a way that stops P, I would expect it to work more than 35% of the time.  To  me, odds like “1 in 3” suggest either a much more basic, or the opposite, a much further removed causal relationship is at work.  The most basic (we think) is probably genetic predisposition.  Now they’re thinking several genes working interrelatedly may be the root cause of P.  Maybe the 1 out of 3 women who improves during pregnancy has a specific gene interrelatedness the other 2 do not. 

If I say another word I’ll gag on my own ignorance.  (I’m turning a little blue around the gills already, I’m sure you’ve noticed.)

Regardless of my theory or the ambiguity of the statistics, I’m glad the study is being undertaken.  Pregnant women exude miracles and mysteries of all kinds and it would please me greatly to learn, on top of everything else, the cure for my condition derives from them as well.  -Ed

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