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No Help from a Caribbean Climate
from Michael M.

I've mailed before about a couple of things, but I'll give you another rundown on my psoriasis experience.

Until around 3 years ago my P was pretty insignificant — scalp P which was easily managed and some minor spots on elbows and armpits. Anyway I was always fearful of the psoriasis spreading to more of my body and developing PA. Living in Ireland until that point I always tried to take advantage of any sunny weather we get thinking that by getting as much sun as possible would help my P from getting worse. Anyway around 3 years ago, I was lucky enough to secure a job in the Cayman Islands (Caribbean) which was a dream come true in term of living in a sunny climate. After 3 years here and a lot of sun exposure my P is, unfortunately, worse than ever.

During my time in the sun the following has happened:

  • Small spots on my body have not cleared and have spread slightly on my elbows.

  • Have developed palm psoriasis which went into remission for a year but is now creeping back.

  • Have developed nail psoriasis in hands mainly which effects maybe 4 fingers out of ten.

  • Have developed joint swelling (probably PA) in one big toe and one little finger.

  • Scalp psoriasis is now worse than ever.

As thing were getting worse I've been to the derm who has tried me on the following: Dovobet, Dovonex, Dermavate, Olux foam, steroid shampoos.... In the past my topicals worked quite well back home but I think out here the general high temperatures renders them inactive, especially any liquid scalp applications. One thing I did notice when my palm psoriasis was at it's worst:  It virtually cleared itself over a 2 week break back home to Ireland for Christmas. Could this be linked to the desalinated water used in Cayman for everyday cleaning use as opposed to the 'natural' water used in Ireland? My derm is currently suggesting Enbrel which looks like an increasingly likely option at this stage.

Anyway thanks for listening, I just thought it might be interesting to hear from someone who is lucky enough to live in year ‘round sunshine and how it affects their psoriasis. Thanks, -Michael M.

*****

Ed’s Response:  Hi, Michael.  I’m assuming you are the Michael M. who posted in the October ’02 update an inquiry about Bioskin products?  No matter ... just curious.

Thanks for the report on being a flaking Erinder in the Caribbean.  Though I’m sorry your emersion in “sun and surf” hasn’t proven to be your answer to flaking, your report reinforces what we’ve always suspected — that reactions to anything are individualized and what works for one might not for another.

With regard to the sudden improvement of your palm P upon vacationing back home in Ireland, and the possibility that it had to do with tap water, there ARE strong proponents of water chemistry as a culprit and a treatment for P.  In your case it’s difficult to test, since your two sources of water are an ocean apart.  And you can’t carry “conditioned” water around with you to wash your hands!  I’m sure you’ll be vacationing back home again sometime.  If Enbrel hasn’t cleared you up when that happens, it will be interesting to see if the water works its magic again.  -Ed

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