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Dermatitis - Extreme Skin Condition

Extreme Skin Issues: Dermatitis, Prurigo nodularis, Nodular prurigo

I've had skin issues for more than 15 years. I have tried many doctors and dermatologists but no one could cure. Following are the details hopefully someone can help. Thank you in advance!

Duration: I'm a 40 years old male. The issue started more than 15 years ago in front of the lower legs. In the last 3-4 years it started spreading to my shoulders, arms and back.
How it starts: I start feeling a little irritation on the skin, it starts itching, gets very uncomfortable and I start scratching.
How it feels: Extremely itchy and dry
What I have used: Moisturizing lotions, Oils and Steroid: Clobetasol Propionate - Topical Cream.
What helps: Clobetasol Propionate steroid cream helped the most.
Doctor's analysis: Dermatitis, Prurigo nodularis or Nodular prurigo

Doctors and Dermatologists: They say that some of the foods I consume might make it worse but don't know what exactly is the problem and how to fix it.

Lab Tests: Doctors have done allergy tests and biopsy, came back negative.

What makes itching worse: Most meats especially beef. Spicy food. Green peppers I think. Fast food. Most restaurants food. Sweets/Desserts.
Also, especially at night, when sleeping, if I have to go to the bathroom, the irritation in my body is a lot more. Once I use the bathroom, it calms down a bit.
If I'm tense at work or worried in general, skin starts itching more.
The parts of the body area where I have these rashes/hives, feel a bit warmer than the rest of the body when it's itching.

What makes itching feel better: Shower/Bath, Allergy pill: Benadryl, Homeopathic: Nux Vomica

Other health issues: Rheumatoid Arthritis and Inflammation

Recently, for a few weeks I stopped eating all kinds of meats, sugar, non-home foods and spices. For the most part, I only ate fruits, vegetables, fruit and vegetable smoothies.  My body was a lot less itchy. The issue is that this diet is not very practical for a long term, so I need to find out what's going on with my body and fix it. As soon as I switched to regular food, itching started again.

Note: Also, most itching starts after half an hour to an hour of eating food.

Family History: This issue is not in my family medical history, to my knowledge.

I'm willing to try any medical methodology, medicine, lab tests, food habits etc. that can help. I'm open to allopathic, homeopathic, herbal or anything else.

Hopefully all these details will help but if you need to know anything more, please let me know.

I need help desperately, any input will be greatly appreciated!!!
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First of all, if you have RA, you have an autoimmune disease.  The steroids can help temporarily but make it more likely to come back worse and worse, as it further weakens your immune system by killing off some of the organisms that help you not get such things.  As for how you're eating, it is very practical, actually, though you might not like it as much as you like other foods.  Basically that diet was an anti-inflammatory diet, so it probably not only helped with the itching, which anti-histamines are helping meaning it's not only an allergy problem but also most likely an inflammation problem, but also with your RA.  Nightshades are particularly problematic for RA sufferers, which would include those green peppers, tomatoes, potatoes, eggplant, and other foods you can look up.  Try staying off those.  Dairy and wheat are the two most problematic foods for the most people, followed by corn and soy.  Lots of people have nut allergies, and some have peanut allergies (that's a legume like soy, not a nut, so different problems), but you don't seem to be manifesting the kind of reaction people get to nuts and peanuts.  So what I'd try for a while is keeping to the vegetable diet but add in whole grains that aren't wheat (you can also avoid other gluten containing grains, which would include rye, kamut, spelt, barley, wheat and triticale).  But most people don't have celiac disease and the gluten thing is a fad more than reality for most people, who really just have a problem with wheat.  So you can experiment, but you should get tested for celiac.  You don't have the whole host of symptoms, though, if the itching is the big problem.  For your protein, fish should be fine.  Meat is a big category -- beef is the biggest problem because, like wheat, it was invented by humans, not nature.  So folks who have a problem with beef might have no problem with venison or buffalo or fowl.  It could also be additives in food, so you might want to confine yourself to organically grown foods and avoid foods with a lot of additives in them or fed to them in how they're raised, but you can try going vegetarian with the one animal you eat being wild harvested fish harvested in clean waters relatively free of contaminants -- these also you find in health food stores, not so much in the supermarket.  And if you're juicing, only juice organically grown food, because when you juice you use a lot more of a veggie or fruit than you would eat and that's a lot of pesticides and artificial fertilizers etc. going down the gullet.  Basically, this would be eating an anti-inflammatory diet.  For more help, though, you're going to have to do some homework and see a professional, such as a holistic nutritionist (regular nutritionists are not going to do the trick most likely, just consider, they are the ones who devise hospital and school menus and we know those will kill anyone) or a naturopath or practitioner of integrated medicine, which would be a physician who has also studied natural medicine, giving you the best of both worlds.  And if you're going to use topicals for temporary relief, look at the ingredients.  If there's a lot of dye added or artificial chemicals avoid those.  Oils should be pure and known for their anti-inflammatory properties, such as aloe vera or jojoba.  The hot showers are temporary, they numb the area.  Cayenne creams might do the same thing, but temporarily.  Whatever bothers you, avoid, even if it makes no Earthly sense.  We are what we are.  Peace.
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Sorry, forgot to mention, your diet is practical only if you add protein to it in the form of legumes you're not allergic to, nuts and seeds you have no problem with, and combine them with some kind of whole grain which gives you almost a complete protein.  Safe grains and grain-like seeds are oats,brown rice, buckwheat, quinoa, amaranth, teff, sorghum, and others.  If there's no gluten problem, spelt tastes just like wheat but without the problems.  Adding fish will give you a complete protein source and a good source of B12, which you can't find really in plant food and avoiding dairy is a good idea.  Also try adding fermented foods, they are good for your intestinal flora.  Try taking probiotics.  You can't live without protein.  Something that's natural that might help as an antihistamine are freeze dried nettles, quercitin/vitamin C/bromelain combinations, Chinese skullcap, and some other things you can learn about.  Good luck.  And remember, this is just some ideas, not the expertise you can get from a professional.
Thank you so much for taking the time and responding in such great detail, I really appreciate it!!!

I'll make a list of what you recommended and learn more along the same lines.

Seems like primary doctor and dermatologist's knowledge is very limited in these areas. I'll definitely take your advice and find a holistic nutritionist or practitioner of integrated medicine in my area.

Lately, I feel like I have to self-study and teach myself a lot more about food intakes. I would like to learn a lot more about what foods and other healthy habits can help with RA and autoimmune disease. I would love to learn a lot more about the anti-inflammatory diet.

My skin dries up very badly, no matter what kind of lotion or oil I put on. I would love to know what kind of foods might help my body produce more skin oil. I have a cholesterol issue and taking medication for that, don't want to eat too many oily foods though.

This skin issue has started affecting my personal life, I just turned forty, so I'm desperate and willing to try anything!

If you can recommend a few books or some topics that I should study to get well educated in this area to develop food sense for my health conditions, that will be very helpful and I'll greatly appreciate it!

I can recommend a great general book called Prescription for Nutritional Healing.  But it's very general.  Should get you started.  And oily foods are not all equal.  Fish oil, flax seed oil, hemp seed oil, extra virgin olive oil are examples of fats that are good for you and might help with skin problems and dryness.  Since most of our problems are internal, not external, lotions will only feel good for most of us while they are freshly on us, which is why we get so addicted to constantly applying them.  Medical docs don't study much in the way of nutrition or natural forms of medicine, mostly they learn to ask about a symptom and then match a pharmaceutical product that tamps down the symptom.  This is very often the solution, but when something is wrong internally it won't help.  The worst foods for inflammation are sugar, but others exist that might affect some people adversely and not others, so it's more complicated.  Nightshades probably affect about 10-15% of RA sufferers, but it is interesting to note that a lot of the nightshades we eat now weren't eaten by humans who ate more by instinct.  A lot of them are native to the Western Hemisphere, but it wasn't until the Europeans colonized the place that these foods were eaten.  The natives avoided them.  So yeah, there's a lot to learn, but a ton more information out there than proven facts.  Learn, try, and if something works, good for you.  Peace.
Thank you for all the great info! I'll look into the book.
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