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Dave On Diet Regimens and Reactions to Last Month’s Mail
from Dave W.

Backstory:  ="mso-bidi-font-weight:normal">Listen Up: Dave W. Comments Widely on ‘Anti-P Diets’
from Dave W.

Hiya, Ed!  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 daunting.

And my 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. 

Which actually 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!

The implied 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.

While I 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 story).

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 during treatment.

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 also:

And for Vix and Dovobet (Dovobet in England), 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:

Until next month (haha!) ... -Dave W. (


Ed’s Response:  Gracias!  -Ed

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