Though I had big plans since age 4 to be a doctor, I never quite made it to medical school. Therefore, I cannot empathize with the plight of the general practitioner faced with countless minor ailments on a daily basis, of which they need to know not only how to recognize, but how to treat. That said, here's a story...
About year ago, I returned from Fiji with an odd rash on my upper arms. I figured I must have picked up something while traveling and went to see my doctor. She took one look and said, "Oh, it's just a dermatitis," and prescribed me some steroid laden ointment to rub on it a couple times a day. Her rather flippant response was frustrating at best, but I figured she knew what she was talking about.
One year later, despite religious use of said ointment, the rashy mess still dominates my upper arms and shoulders. It fades at times, but returns almost the instant I stop using the ointment. Why stop using it? Well, adding insult to chronic injury, continual use of steroid ointments thins the user's skin. This leaves me with two options: 1-keep using it to keep the rash under control but eventually wear the skin down to see-through quality, or 2-stop using it and allow the rash to take over. Neither option is terribly enticing.
Long story longer, an allergist I visited last week, despite admitting to not knowing much about skin conditions, advised me to stop using the steroid ointment and use only moisturizer. I listened and even bought the suggested moisturizer in the hospital's pharmacy. Not surprisingly the rash is back -- worse than ever.
Ever more frustrated, I decided to do some google searching for upper arm rashes. After a lot of clicking through articles about and awful pictures of psoriasis and excema, I stumbled upon the description for a rather common condition called Keratosis Pilaris, or KP. KP is a genetic skin condition that affects 40%(!!) of adults worldwide. It's typically found on the upper arms (ding!) among other body parts and returns when not continually treated (ding!). It's a genetic condition that stems from a buildup of cells that get trapped around hair follicles and, of course, there is no cure... story of my life.
The info on the web about KP was actually rather helpful. It does seem as though some continual treatment with a moderately expensive moisturizer (not the one the doc recommended), followed up with gentle sugar scrubs a couple of times a week, might keep the ugly red bumps at bay. It might not though. Who knows.
The point of the story is this: I don't expect my doctor(s) to know every ailment I might show up in the office sporting, but to not recognize a skin condition that 40% of all adults have is simply unacceptable. Likewise, to repeatedly deny me access to a dermatologist is even worse (and yes, I asked on multiple occasions). If they knew what I had, they should have never prescribed the steroid ointment for more than a very short duration to get the main outbreak under control, then given me information on how to maintain healthy skin with other non-steroid products. It would have also been nice to know the name of the condition. The fact is, they didn't tell me because they didn't know. Again, it's absolutely unacceptable. Kaiser sucks. HMO insurance sucks. I should have gone to med school.
photo: My right arm as of today (4/3/07). Not to be a drama queen, but it actually looks worse in person. The flash washed out some of the detail.
