December, '99 | Briefing | Mail | Don't Say This | Articles | Other Places | Archives | Send Mail | Ed Dewke | Legal Stuff

Reverse Koebner? and "Zone" Diet
from Flaking in Alabama

Dear Ed: This is my second time visiting and just wanted to say—love, love, love the website! I don't have much time to spend on the computer as I have two little monkeys, a 1 and 4 year-old. My own psoriasis story started at age 14, on the scalp. I'm 32 now and still have it on the scalp, along with a couple of nails, anal area (very sexy), and just a couple of spots here and there. I've used all the shampoos (prescribed and over-the-counter) without much success. The only one that seems to offer some relief is Extra Strength Denorex and I think its just from the menthol in it. For my other areas, I've only ever been prescribed Lidex and Temovate, which just keep my lesions from getting worse. My dad was in the military and so is my husband, so I've moved around a lot and been seen by probably 10-12 derms (military and civilian). None has ever given me any other options. All these other medicines that you all are writing about are news to me.

I read in your archives about someone who used trauma as treatment. Well, I've got a little story about accidental trauma. My nail psoriasis showed up during my first pregnancy and although mild, its been pretty constant ever since. Last year I slammed my thumb in my car door (actually had to unlock it with the other hand to extract myself—it was smashed!!) and it of course turned purple and black. I didn't lose the nail, probably because the nail was semi-detached from the psoriasis and so I didn't build up pressure underneath. Anyway, it took 4 months for my wavy, black nail to grow out but then my nail was clear for almost an entire year. Interesting, eh?

The other thing that I wanted to chat about was that I went with a group of girls for a day of beauty treatments at a local chi-chi spa. While I was getting my facial, the lady asked me if I had any skin problems and I told her psoriasis. She went on to tell me that her son (who owns the spa) is also afflicted. She called it his "skin challenge." (As we say in the South, "Isn't that precious?"). Then she told me that he has all but cleared up by being on that "In the Zone" diet for the last year. Has anyone else heard of this? I'm somewhat familiar with the diet (my father-in-law did it) but wondering if its just a fluke. She said that her son has had a traumatic year with personal problems and remarkably has not flared up.

Gotta go change a dirty diaper. Toodles -Flaky in Alabama


Ed's Response: Thanks for coming back, Flaky! Your trauma story is interesting. It almost sounds like "reverse Koebner," which I just made up. The Koebner Phenomenon predicts lesions will appear at sites where skin has been traumatized. Example: I sported lesions that looked like my gut surgery scars for six years! Smashing your thumb certainly qualifies as "trauma," so your nail P going away on that thumb is surprising. Though for you this was good news, this constitutes one of those "Don't Try This At Home..." warnings to other flakers. Tired of your awful looking fingernails? Well, slamming them in a car door might help, but ... we don't recommend it.

I'm surprised that amongst all those derms (10-12) you've seen through the years, your prescrips haven't varied more. You might want to think about emailing NPF for a referral in your area. Though I've been to a variety of derms with contrasting impressions, I've never run into one reluctant to vary my prescrips for topicals.

Check out the Zone Diet at Ironically, the diet is based on tight control of one's insulin production, hence maintaining a "zone" of blood sugar levels that optimizes metabolism. Maintaining one's insulin level, hence one's blood sugar level, is accomplished by following the prescribed diet. (I say "ironically" for personal reasons, as I am a Type 1—insulin dependent—diabetic. My pancreas doesn't manufacture any insulin so in a very real sense I'm "zoneless." Actually, though, through managing the combination of diet and insulin injections we Type 1 diabetics are supposed to achieve a near-normal ability to control our blood sugar levels. Based on my personal experience, in reality I am still far out of the "zone.")

Would the Zone Diet help flaking? Could be. Diet is so fundamental to our biological functions that virtually everything about our health is related in some fashion to what (and how) we eat. (See, Are We What We Eat? in the archives for more.) There is enough anecdotal evidence to suggest P does respond to dietary therapies for some people, at least some of the time. This includes eating management regimens—the Zone Diet is one of these—as well as nutrition supplement regimens of various kinds (e.g., zinc). But very little empirical evidence supports the anecdotal claims. For one thing, short of Nazi tactics, difficult diets are hard to impose, maintain and police. They may also take very long periods of time to be effective, or before all the effects are noticed. What severe flaker would want to stop all current regimens for months or years—meanwhile letting his/her P run amok—while seeing if a diet might make a difference?

I don't try to dissuade anyone from trying diets or so-called "natural" or homeopathic therapies for their P. I do encourage folks to thoroughly understand and consider the risks, both physical and financial before making a decision. I am especially concerned about alternative approaches posed by people who sell something essential to the alternative.

Whatever you try, Flaky, good luck and keep us informed! -Ed

This Month's Mail | Archives