Hi, this is my first post in a medical community before and I hope that my life experience, struggles, and determination will help other sufferers of this disease in understanding and dealing with this painful condition.
Before I start I am not a medical professional, most of this information I will tell you has been gathered from reading medical/immunology books, medical articles, other chronic sufferers' articles, and my own personal experience.
Here's a little info about me:
My name is Alan and I am 25 yrs old... I have a chronic skin condition since birth which was originally diaganosed as eczema. Later around when I was 20 it was diagnose as Atopic dermatitis type A (I do not have Job Syndrome). This condition originally only affected my arms, chest, stomach, legs, neck and back. Now it affects my whole body from head to toe. Doctors have told me most people eventually grow out of this skin condition when they get older, I guess I was one of those unlucky few. This condition has prevented me from working long hours as I got older and I currently only can work 16 hours a week without being hugely effected. My food allergies include nuts, strawberries, pineapples, tomatoes, shellfish, and green beans (wheat also but its very mild). My environment alleriges are grassweeds and oak trees. From when I was 20-25 I had my IGE levels checked and were found to go from 8,000 to 17,000 (the levels probably reach higher when I was a child during my extreme flares. I've visited countless clinics throughout Massachusetts (including Brigham in Boston) meeting with dermatologists, allergists, and immunologist specialists. I have tried steroids creams, allergy shots (took them for 2 years), UV treatment, and immune suppressents.
Here's a little information of my atopic dermatitis type A condition:
This condition effects my body from head to toe and people who happen to meet/know people with this condition please realize it can be a very painful experience. I am in a constant state of itching at all times every single day of my life. Flare ups tend to leave my skin red and very elevated (this is caused by the mast cells becoming overly sensitive and releasing massive amounts of histamine). In flared regions I tend to have a clear liquid oozing out of the region with a very distinctive smell (doctors have told me this is the byproduct of the mast cells aka histamine). Everytime I flare up it usually takes 3-5 days for my flared sections to dry, then crack open and scab on me (this is with using steroid creams). Without medical treatment I have gone with my skin in a flare state almost up to a month before it healed on me. During this flared state the skin becomes very sensitive to touch and can be very uncomfortable with clothing on top (Most of my if not all of my sheets and clothing are very soft, smooth and breatheable). On top of all this I also have had to deal with constant infections due to the skin opening or because of the histamine build up in the skin.
Here is some information of treatments I have researched and tried (I will talk of advantages and disadvantages):
Steroid Creams- I have been using this my whole life even though I don't like it (from west court, to hydrocortisone, to triamnicolone.. and who knows how many other creams). When I was younger the doctors would just constantly fill out prescriptions of steroid creams all the time without a care in the world. As a result the skin behind my kneecaps, in front of my elbows, on my inner thighs, and on my neck have shown signs of thinning in my later years (this effect seems to be permanent since even til this day the skin is thinned). Steroid creams block the inhibitors of the histamine which helps reduce the amount release on to the skin. While this tends to be the most basic effective direction to recovering from a flare up it also has it's dangers. Please remember that whatever you put on your skin is eventually absorbed and can go into your blood effecting your organs (liver in particular). Today I use steroid creams as little as I can even if Im constantly flared for months on end. I try not to apply it to my skin everyday for if you do not only is it dangerous, but it eventually becomes ineffective. If you wait a day or two then try re-appyling the cream again it will have regain it's effectiveness in controlling the flare up.
Allergy Shots: The idea of this is to inject you with small proportions of the allergen to help your immune system build an immunity to the allergen. For two years I use to go to my allergist to receive these (at first it was weekly, then became monthly, then became every few months). I have had some minimal good results from this in reducing my response to certain environmental allergies (not food). While it does not completely stop your reaction to your allergen it does help and I recommend this for children when growing up. There isn't any serious disadvantages I've experienced with this except for having to go to the allergist all the time when I was younger.
UV Treatment: UV treatment uses ultra-violet rays to bombard your body to help dry out the histamine in your skin. I tried UV treatment for about a half a year at first going a couple times a week or once a week. While it was working at first and gave me a nice tan my treatments tended to leave my skin feeling very dry after I received it. Also, I find out that the treatments tend to only help your body dry out the histamine that's in your skin for that point in time. Histamine tended to buildup under my skin the next day after the treatment leaving me with itchy skin from the histamine and dry skin. In the end I gave up UV treatment after one bad experience. I came in one day with my skin extremely flared hoping the UV could help ease my pain. As a result the normal treatment time ended up affecting my body more then it should have and left me with 3rd degree burns on top of my flare from head to toe. I was hospitalize for a week in Boston recovering from that. Never again did I touch the UV. (Just for anyone else's curiousity I discovered that the flared regions of my body tended to appear a very dark purple under the UV light),
Immune Suppressent Drugs: I've had experience with prednisone and cyclosporin and read about Xolair. I will explain all of them in due time. During my hospitalization the doctors prescribed me with prednisone and it almost seem to work like magic relieving my skin. The skin began to dry out and the itching was completely gone! (I was amazed by this, first time in 20 years I did not feel itchy at all.. I actually almost cried because of it). Later I found out my dermatologist at Brigham wasn't very happy with this. He had told me he did not want me on the prednisone because users tend to get addicted to it because it actually completely stops the itching and also is very harmful to my health. So, after he suggested I try out this other drug called cyclosporin which is less dangerous to my health, but I would have deal with the itching once again. For your information these two drugs are both very harmful because they not only weaken your immune system, but they also can cause liver failure. Over the next few weeks he began to get off me off the prednisone drug and eventually onto the cyclosporin. Doctors have prescribed me prednisone in the past to me and it always worked very effectively in controlling extreme flare ups... the only problem is it is very dangeous long term. Now to explain my experience with cyclosporin. At first the low dosage helped me a little bit, but I found when I tried working long hours again my skin would once again flare. Eventually my dermatologist kept upping the dose until it was maxed out for my body weight. I found out because of this I could almost work near 40 hours having only mild flares. So, for 2 1/2 years this became my situation averaging around 300-400mg of cyclosporin a day (please wait for next post)