Getting under my skin.

In my first blogpost, I wrote a little about the health problems I've been having.  In today's post, I thought I'd write a little bit more about the most obvious one of them: my skin condition.

Gross anatomy

My mum tells me when I was an infant, I had a bad reaction to some formula and as a result, I developed sensitive skin.  I would put the intermittent appearance of rashes, spots and other blemishes as I was growing up down to this sensitivity, and for the most part, they would go away on their own.

About 18 months ago, new spots started appearing, but like always, I brushed it off as some sort of dermatitis.  They were extremely itchy, and I often found myself, unconsciously scratching at them, leaving deep craters in my skin (the medical term, I later found out, was my skin was excoriated because of the scratching).  They appeared across my chest, back, down my arms and some on my trunk, but the parts of my body that were most severely affected were my lower legs, around the shin.  They would appear as single lesions or as clusters, but always unbearably itchy.

They were quite obvious, and a constant source of embarrassment, and I often rehearsed explanations as to how I would explain my condition to people I met in case they'd ask.  "Oh, it's a skin allergy.  I get them really bad during summer/winter."  I would say it's dermatitis, psoriasis, or really bad acne, but really I didn't have a clue.  And for a long time, I ignored it.  I learned to hide it as much as I could, but it was difficult.  I'm usually very casual in my work attire: jeans and a Threadless tee is my basic template so the lesions on my arms were always visible to some degree.

What it isn't 

My biggest fear was that what I had was Kaposi's sarcoma (KS), a cancer commonly associated with HIV/AIDS.  I've always been circumspect about how I conduct myself sexually, but its never 100%. 

While my lesions looked for all the world like KS, I couldn't be sure until I sought help. So I did. My GP did a battery of tests which ruled out KS, but wasn't  able to definitively tell what it is. I was referred to a local dermatologist who  saw me and began treatment based on diagnosis of prurigo nodularis, basically "itchy spots" in Latin. Thanks for the obvious, medical science. 

When I first saw my dermatologist, he injected steroids all over my body to  provide immediate relief from the itching. While I felt like the human equivalent of a pincushion, I was grateful for the relief. I also took prednisolone, a glucocorticoid which acts as an anti-inflammatory. 

It helped a little bit, but wasn't able to resolve the worst of the lesions, and unfortunately, it also raised my blood sugar (which was bad news considering that I was already dealing with type-2 diabetes, but more on that another time).  When we didn't get much progress with prednisolone, my dermatologist eventually brought out the big guns and put me on cyclosporin, a drug commonly given to patients who have received organ transplants to prevent rejection, in addition to a preparation of 8% salicylic acid.

The good news is that I don't itch any more.  The scars are still very noticeable (you can see a bit of it on my shoulder in the photo), but fortunately, almost all of them have healed.  My shin area is still the most affected, but the skin is appears to be healing well there too.

Turn out the lights

Of course, there are implications to all this.  I'm all for full disclosure, especially when it comes to communicating to potential (sexual) partners.  And this is going to be those things that I'll have to explain if/when it comes to that.  I'm most concerned about them freaking out and rejecting me because of my skin condition.  There's no denying it's confronting, but will my explanation be enough?  Will they understand?  Are they going to be able to see past it?  I don't really know.  This is what I fear the most.

This is Day 6.