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Chapter 1
The Beginning

I served four years on active duty in the U.S. Coast Guard (largely without distinction) during the waning years of the Viet Nam war (1969‑1973). I was seventeen when I enlisted. It was, in retrospect, a marvelous four years. I lost my virginity, lost my stammer, discovered I had skin problems, got married, and participated — albeit from a safe distance — in our nation's quest for peace with honor.

A young MD in the Public Health Service diagnosed strange white patches on my chest as "vitiligo." This is a "condition" in which the body is unable to turn vitamin D into melanin, the pigment that gives us Caucasians the ability to tan. I treated the diagnosis with indifference. What the hell? I was married, quite invested in the new-found raptures of conjugality, feeling in all ways quite vigorous. So I can't tan? So what? Who needs it?

The vitiligo that had been concentrated on my chest in 1970 had, by 1975, spread to my limbs. Now I was in college on the GI Bill, still married, still enjoying the raptures of youth and manhood. But now I was also "an older man on campus" and a veteran, to boot. The vitiligo became something of an embarrassment in summer school, to and from which I rode sleeveless on a motorcycle, hence getting lots of sun exposure. Blotches on my arms tanned quite nicely, other blotches became pink, then peeled and returned to stark whiteness. It so happened the blotches of melanin-deficient skin tended to focus on the inside of my forearms. They became quite distinctive.

I told young coeds the white blotches on my forearms were burn scars caused when a canister of napalm I was carrying got hit by a sniper bullet and blew up in my arms. This lie generated interesting manifestations of sympathy until one day I shared it with a young woman who also had vitiligo. She concluded, correctly, that I was full of ... well, you know.

Twenty years later the vitiligo still exists but I don't mind it much. The only parts of my body that get sun exposure are my hands. Blotches on the backs of my hands will tan, the majority of skin just burns. The tan blotches look like liver spots in contrast to their pink or white surroundings.

I look at my blotched hands now for signs of erupting psoriasis lesions. The vitiligo is no more than an old familiarity — compared to the psoriasis.

Nothing in the literature I've surveyed suggests a connection between vitiligo and psoriasis. My dermatologists shrug off my inquiries about the possible connection.  


 

I was diagnosed a psoriatic at the age of thirty-nine. By then, lies about tragic accidents in Viet Nam were out of the question. Besides, psoriasis, unlike vitiligo, is not so discussable because it's much more disgusting. The red, flaking lesions that constitute "plaque psoriasis" aren't nearly as tolerable as vitiligo's scar-like white splotches of skin.

By the time I was initially diagnosed a psoriatic, I'd been out of college for thirteen years, out of my first marriage and into my second, and into the waning years of what had been a meteoric career in a high-tech telecommunications industry. In other words, I'd already "been around the block" a few times and the worst physical abnormality I'd had to contend with was the vitiligo. In retrospect, I can see this rather late-in-life manifestation of my psoriasis was both bad and good.

It was bad because I considered what I was losing; i.e., skin I wouldn't hesitate to "reveal." With psoriasis, for me there would be no more short-sleeve shirts and Bermuda shorts; no more bathing suits on the beach; no more convivial visits in the spa or gym locker room. All those realizations were very depressing.

But the good side was that, for awhile, I had a life full of all those things — memories to lean on — and could be thankful for thirty-nine years of psoriasis-free living.

 

Many psoriatics “manifest” their disease at much earlier ages than me. There are some who have never known life without psoriasis. What do they lean on? I hope it's a sense of self-worth that resides tenaciously beneath the skin.


●●●●●                                 

It was a crisp January night in Alexandria, Virginia. The woman beside me was nearly a stranger. We paused on the short walk back to her townhouse to listen to a man play steel drums on the sidewalk. He mistook us for lovers — perhaps a married couple — and played and sang a song just for us (which caused me to give him five dollars). It was during that song, played at about midnight, that she took my arm and huddled close to me. And I leaned into her, too. I hadn't been with a woman in several months. It felt good.

I returned with her to her townhouse ostensibly to fetch a book then take my leave, but once there things got started and she asked me not to leave. I didn't want to leave, but I didn't want to take off my clothes, either. I swallowed and said, "There's something you need to know about me. I'm a psoriatic."

Five hours later, as I was leaving, she smiled and called me her "spotted lover." It was the kindest gift anyone had given me in years.

●●●●●

Ed’s Postscript (11/27/2007): Though I developed psoriasis comparatively late in life, my vitiligo came before I was 30, which is typical. Not so typically, as I aged the vitiligo diminished. The last significant evidence of it was prematurely white hair showing up in my beard. According to WebMD, autoimmune disease is a risk factor for vitiligo — meaning having autoimmune disease makes it more likely that a person may develop vitiligo.  I developed vitiligo nearly two decades before my first diagnosed indication of an autoimmune disease —  psoriasis —  but since then have added type 1 diabetes to the list of my autoimmune demons.

The fact that I have less visible vitiligo today than I did thirty years ago might stem from any or several of these possibilities:

  • my melanin deficiency has mysteriously reversed

  • my "typical" skin pallor has lightened because of less sun exposure, hence vitiligo is less obvious

  • the onset of psoriasis “superseded” vitiligo

  • other lifestyle changes have mitigated the vitiligo

On the matter of intimacy, an additional thought: In 1995, at age 44, I was "single" once again. That's when the interlude described at the end of this chapter occurred. There were other interludes that year and, in retrospect, I refer to 1995 as my "year of living dangerously," which is true for a number of reasons, but none relating to my psoriasis. I, like many flakers, was terribly apprehensive of intimacy and most pleasantly relieved when my condition proved not to be the end of the world. Of course, I may have been lucky.

Contents of Flake: Confessions...

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2008 Ed Dewke