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WARNING:  It wasn’t psoriasis
from Dan A.

Ed:  I have been reading your web site for a few years now.  It has been a source of encouragement at times when it seems like there was little hope for any improvement in my skin condition.  I have had a slowly worsening inflamed, flaky, itchy skin condition between my buttocks for about 10 years.  I showed this area to a doctor around 6 years ago.  I was immediately referred to a dermatologist.  My first derm did a biopsy and the diagnosis was psoriasis. 

The past 6 years I have tried every prescription topical that I am aware of with little improvement.  They only thing that seemed to help was steroid creams.  Dovonex, Anthralin and Tazorac were of no benefit.  A few years ago I tried Soriatane.  It actually seemed to help a little, but it was definitely causing my hair to get thin.  At the time I decided I'd rather have psoriasis than be bald.  Since then I’ve also tried 3 months of PUVA.  The PUVA actually made my skin worse!

During this time I saw a total of 4 different dermatologists.  Only my last derm  questioned whether my skin condition was really psoriasis, and then, only after both Soriatane and PUVA failed to give me any relief.  My derm suggested doing another biopsy.  We were both surprised when the diagnosis was not P! 

The report said that I have a peroketosis.  I do not know much about this yet or why I have it.  The research that I have done so far says that it is caused by excessive sun exposure.  Given that this is located on a part of my body that never sees the light of day this is definitely not  the case.  My derm told me that we may never know where it came from. 

I was prescribed a topical called Carac that has greatly improved my skin in only 2 weeks.  This is all starting to make sense.  The steroid creams helped to relieve the inflammation but the other topicals were of no real use. 

I never questioned the diagnosis myself.  Reading web sites like yours made me think that it is not unusual for psoriasis to not respond to treatments that are effective for others.  I was even considering trying MTX.  I guess the long and short of what I am saying is that if any of your readers have the smallest doubt that their skin condition may not be psoriasis seeing another derm or having another biopsy done is a good idea.

Thanks for the encouragement the past few years. –Dan A.


Ed’s Response:  Could I be saying “Goodbye” to someone who no longer needs FlakeHQ? 

Dan, I’m so glad you took the time to write and to let us know about your erroneous 6-year diagnosis of P.  That’s just awful.  And also awful, I can’t find a THING under “peroketosis.”  However, I did find a web page under “porokeratosis” — http://atlases.muni.cz/atl_en/sect_sect_24.html.  Reading it — what I could understand — sure sounded similar to equally technical expressions describing psoriasis.  But it didn’t tell me anything I could understand about the disease.

I searched WebMD for your drug, Carac (fluorouracil), which did yield a lot of information.  One comment:

Fluorouracil topical is used to treat scaly overgrowths of skin (actinic or solar keratoses). Fluorouracil topical may also be used in the treatment of superficial basal cell carcinoma. http://my.webmd.com/content/article/4046.1648

Carac, according to this article, works by killing the fastest-growing cells, such as abnormal skin cells.

The important thing is, now that you’ve apparently been correctly diagnosed, you’ve been prescribed the proper remedy and already it’s working.

After 10 years of symptoms and six years of barking up the wrong tree.

Can I be mad and happy at the same time?  I guess so.

Thanks for your warning to all of us, Dan.  I titled your correspondence the way I did so that, forevermore, it will stand out in the archives.

Best of luck to you.  And, in the future, if you feel like visiting us just for old time’s sake, please do.  Memberships at FlakeHQ can’t be issued in error and never lapse. -Ed

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