On the dermatology beat

On various of my skin conditions, six of which have recently drawn attention (by my caregivers, my family doctor, or me) while all improving or entirely clearing up in the past week or so, quite mysteriously in several cases — all the more remarkably in that the conditions have a variety of different etiologies.

I’ll start with a small epiphany on 5/20, after a visit to my pedicurist, who remarked on a pustule of sorts on the sole of my right foot (she also remarked on the thinness and fragility of the skin on my legs and on the disappearance of the lymphatic-fluid scabs on those legs since my last visit to her; both of these will come up below).

So that’s #1 on my list: a large pimple resembling a mosquito bite, tender and itchy; I get a lot of them, and have for at least 10 years. The list continues …

#2: 2 dark crusty patches on my right hand (which first concerned my family doctor some months ago); they appeared several years ago, and sloughed off during the last few days.

#3: a callus-like patch, but pebbly in appearance and yellowish, on my right arm just above the elbow (in a place where no callus would have reason to develop; I have a real callus on the tip of my left elbow, which I rest on my worktable when I’m thinking, and #3 looks nothing like it.

(#2 and #3 together caused my family doctor, on my most recent visit (April 13th), to order up an appointment with a dermatologist. Medical care being what it is, the first available appointment wasn’t until nearly two months away — June 7th, so I’ll now go to a dermatologist to treat a series of conditions that have in fact disappeared, as #2 and #3 have. I guess we can talk about #1, one example of which has not yet disappeared.)

#4: whitehead pimples on my nose, never particularly obtrusive, but part of my life since adolescence (70 years ago), but which cleared up completely a week ago.

#5: lymphatic fluid scabs, whose causes I believe I understand; they’re the remnant of the weeping sores on my legs that I’ve posted about (side effects of the edema associated with my kidney disease, an edema now eliminated, primarily by the extreme course of diuretics I’m on). I treated the sores myself with a long course of surgical dressings, changed daily, and then softening with daily applications of coconut oil, which I continue now as a protective measure.

But the last scabs sloughed off several weeks ago.

#6: a flaking-off of the skin on my arms and legs, but especially notable on my legs, where large flakes of skin drop to the floor wherever I stand repeatedly, causing a figurative snowstorm on the rug below. My previous rheumatologist recommended the coconut oil as symptomatic treatment, and that was helpful, but not preventive.

This is presumably a form of psoriasis, so yet another one of my auto-immune conditions, but apparently benign. Just unsightly; I stand up in one spot alongside my bed to whizz every hour throughout the night, so in a single night quite a pile of skin flakes accumulated, requiring a daily clean-up. Then with the oil treatments, the flake-off abated considerably, until it was a weekly clean-up, then a clean-up every other week. Now the problem is scarcely noticeable.

#5 and #6 seem to have been alleviated by my treatments, over a fairly long period of time. The puzzle concerns #1-4, which showed no response to any treatment and then, pretty much all together, cleared up dramatically in only a few days.

It can’t be a coincidence that in those few days my appearance / demeanor has brightened up in a way that causes people — my caregivers, my doctors — to remark on how great I look.  Meanwhile, I’ve been tremendously energized — not an unmixed blessing, because it includes shorter sleep times, leading to my getting up at midnight roughly every other day, and working 17-hour days, until I collapse into bed at 5 or 6 pm.

I haven’t been posting about all of the things I’ve gotten done, because a single day’s list would look like shameless preening and boasting, but I’m proud of what I’m getting done, and happy to be doing it.

Yes, I know. This won’t last. Eventually I will have a heart attack or a stroke or contract some form of cancer, and then it will be a question of asking for hospice treatment, so that I can be allowed to die. I’m ready for that. Meanwhile, I’m making the best of each day as it comes.

But the skin stuff. Some comments on specific conditions.

#1: those pustules / pimples. Here I quote, edited and amended, e-mail from me to my Bayarea Geriatric caregivers on 5/20, commenting on the instance that the pedicurist had noted, which they were concerned might be an abscess, and Erick Barros had photographed:

A pimple with a dark head

But I am an idiot; I should have recognized — epiphanic moment — what it was. It’s a pimple / pustule from a persistent (that is, chronic) microbial infection that I suffer from. Some have darker heads, some yellow heads, some have no visible head; they are tender, and itchy.

My attempts to have them identified in the past — I’ve had the pustules checked at PAMF (because of my 2003 bout with MRSA, which terrifies me), and they’re not Staphlococcus aureus, but they’re something microbial, maybe viral rather than bacterial — just led to the doctors telling me, rather contemptuously, that they were mosquito bites. On very unlikely parts of my body (I have a persistent one on my right buttock), in the winter when there are no mosquitoes, and at times when I haven’t been out in my little garden. (Sometimes I wonder why I consult doctors.)

I had one (with no head) on the (lower surface of the) middle finger of my left hand that lasted for more than a year, always itchy and tender. A new little one (with a dark head) just appeared at the base of my right thumb, which is what made me realize why the spot on the sole of my foot looked so familiar.

So not to worry. It could probably be treated with some antibiotic, but I very much do not want to mess with antibiotics unless absolutely necessary.

The one on my buttock and that new little one at the base of the thumb both just vanished completely two days ago. The one on the sole of my foot is rapidly retreating; it’s no longer tender or itchy, and I had to feel the sole of my foot to see if it was still there at all. I expect it to be gone soon.

#2 and #3. Since I’ve been coconut-oiling my arms and legs (in treating #5 and #6), I thought to use some of the oil to soften #2 and #3, which didn’t itch or otherwise annoy me, but did look dry and ugly. To no effect until a few days ago, when one of the #2 crusts just came off in my hand, leaving nothing visible or palpable at the site, and then yesterday the other one came off in the same way.

They were there for several years, and then they were gone. It had never occurred to me to take pictures of them, so I no longer have any evidence that they ever existed.

Something similar happened to #3, except instead of sloughing off, it receded over a couple of days. You can’t see that there was ever anything there, but I can feel the slight rough raised patch that remains. Nothing to take a picture of, though.

#4: goodbye after 70 years. Well, the pimples could always come back, and the somewhat oily skin that goes along with them, but it’s definitely odd to have them just vanish. I keep checking in the bathroom mirror to see if it’s still so.

And that’s the dermatological news from my house. I haven’t changed my diet in any major way (I’ve lost my taste for sweet stuff, but my diet is scarcely sugar-free). I haven’t changed my medications in 6 weeks (surely some kind of record for me); I continue a very low “maintenance” (says my rheumatologist) level of prednisone, 5 mg. Yet my body has obviously changed, in startling ways. Meanwhile, I ride the wave.

And I have no idea what I will say to the dermatologist next week. Not what I’ve said to you (just over 1400 words, according to WordPress), because it has to fit into a 15-minute appointment.

One Response to “On the dermatology beat”

  1. Max Vasilatos Says:

    Interesting, and I note that my spouse Donnie has just gotten inexplicably much better in the last week or so also, to everyone’s great cheer. The only other oddity we/you/he share is some geography where the weather has been strikingly unusual lately, but I don’t see any rhyme or reason in there. So, eat drink and be merry, for tomorrow we die.

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