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On Diet Regimens and Reactions to Last Month’s Mail
Up: Dave W. Comments Widely on ‘Anti-P Diets’
And just when I thought I'd written enough, you point out how I
didn't. You're absolutely
correct that even elimination-type dietary approaches to psoriasis are
going to be difficult, in general. There's
quite a bit of willpower involved when you've suddenly sworn off you
favorite food (for example). And
the TIME it'll take to go through even a short list of foods is fairly
agreement also extends to your comment on medications.
If you're trying to drop foods (either one at a time or by
category), and you start, stop, or switch drugs, all bets are off.
You won't know what's doing what.
underscores the problem behind a fairly-common style of
"testimonial" I see (it's not pervasive, by any means, but it's
not unheard of, either). The
claims go something like this:
Well, for the last six months I've been on Pagano's diet, and I've been swimming twice a week in my friend's backyard pool. Three months ago, I started using this 'Exorex' stuff which has bananas in it, and now I'm almost clear! Thank the powers that be for Dr. Pagano!
belief — that the diet is the sole working thing in this
"regimen" — is left, of course, unsupported.
And the fact that UV light (from the sun) and coal tar (the active
ingredient in Exorex) are both scientifically-supported psoriasis
treatments, which may both have contributed to the person's success, is
completely ignored. Pagano's
diet may have done nothing at all.
I kid you not,
Ed: I have seen a person list a dozen things he was using, at the same
time, for months, and he decided to pick the strangest, LEAST probable (in
my mind) one of them as what he felt was "most likely" to be
responsible for the "miracles" he saw in his skin.
understand the desire to use what I call "shotgun therapies"
(throwing a lot of different treatments at the disease at one time), I
really don't understand where the ability to state that any one of them
works "best" or "worst" comes from (unless, of course,
a person has used all of them separately, too, but that's a different
It is POSSIBLE
(though I won't say likely) that by slathering on six different kinds of
ointments, taking four vitamins and minerals, and by changing one's
general dietary habits, a person might, indeed, stumble across the One
True Cure for psoriasis. But
pointing to a particular mineral, say, and suggesting all of the benefit
came from it alone is to ignore the fact that you've treated yourself with
at least 11 different therapies, and they may not work as well — or at
all — when used separately!
Well, enough of
my ramblings on that particular puzzle of human behavior.
It certainly isn't confined to just us psoriatics, and I don't
think I'll ever find an answer.
For Fred in
Santa Monica (Wanted:
Santa Monica-based Flakers to Befriend),
your suggestion to check with the NPF should (in my opinion) also have
included asking the NPF if they know about any Santa Monica (or reasonably
nearby) psoriasis support groups. Fred's
request for info about psoriatics in his own city suggests he'd like some
face-to-face meetings. And if
there are no support groups nearby, Fred might enjoy the challenge of
starting one (and the NPF can help with that, too).
For Dian (Her
30-something Spirit in her 50-something Body),
there's also a Yahoo! Psoriasis Singles' Club, and a Psoriasis Personal
Ads site out there. Both can
be found listed on one of my Web pages:
With regard to
the Dovonex questions from Rachel (Needs
Improvement: Wedding Day Imminent),
Dovonex is specified for mild-to-moderate psoriasis because using too much
of it can lead to a condition called hypercalcemia, which is having too
much calcium in the blood. This
condition can lead to other, nastier conditions.
Those people with severe psoriasis may need to use more than the
maximum recommendation of 100 grams of Dovonex per week.
Doctors may allow this, but good doctors will also regularly
monitor calcium levels (with blood tests) to make sure they don't creep up
Also, for a
topical drug, Dovonex has one of the highest risks of side-effects.
Somewhere between 15 and 20% of psoriatics using Dovonex experience
increased itching, redness, or other types of irritations at the site of
drug application. The chance
that these kinds of things will happen increases if the drug is used under
occlusion, which typically means covering it with plastic wrap or a
bandage — or even a bra or other tight-fitting clothing.
Even areas of "natural" occlusion, where skin folds on
skin (armpits, groin, under the breasts, for example), tend to be bad
places to put Dovonex. See
And for Vix and
Dovobet (Dovobet in
I've read a press release from LEO Pharma, the maker of Dovobet, which
claims that Dovonex and betamethasone don't usually "get along"
when mixed. Differences in pH,
it seems, breaks both of them down. LEO
claims to have modified one or both drugs to make them pH
"friendly," and thus able to be mixed together in a tube with a
decent shelf life.
Most of the
Dovonex/Steroid regimens I'd heard of before were the "Dovonex in the
morning, steroid at night" type (as described by Rachel).
That'd keep the drugs from having these sorts of
effectiveness-reducing reactions with each other.
But I have no idea whether or not the same problem exists with a
Dovonex/Ultravate (halobetasol propionate, not betamethasone) combination.
For more on Dovonex and related drugs, see:
month (haha!) ... -Dave W.