Making a difference in dermatology and beyond

by Lorien E. Menhennett

Dermatology: another unit in the medical school history books. During the course, more than one dermatologist-lecturer tried to convince us that derm is about more than eczema and acne. That it’s more than pimple-popping. That it’s … interesting. These lecturers tried to woo us with thrilling cases where the dermatologist saves the day. And yes, that must be exciting.

Personally though, what I found most moving about dermatology wasn’t the rare, life-threatening rashes. It was the “boring” bread-butter-cases.

Like psoriasis. Psoriasis never makes the headlines. It’s not at all exciting, from a medical perspective. But it affects people’s lives. According to some researchers, psoriasis can affect a person’s quality of life just as much as heart disease, cancer, diabetes, depression, or arthritis.*

That might be hard to picture. After all, what’s so bad about some scaly skin? But when you hear it from a patient who has lived with this, you understand. The psoriasis patient who talked to our class was a business executive. He talked about how embarrassing it was to see clients when the floor surrounding his desk chair was covered with flakes of dead skin, for example. Thankfully, this patient’s story had a happy ending — he got relief from one of the incredible new treatments now available.

UstekinumabThese treatments are amazing. They don’t work for everyone, but when they do they’re like magic. Here is a before-and-after image, from our psoriasis lecture, showing what one of these new therapies can accomplish in just a few months.

As far as diseases go, psoriasis may not be exciting or exotic. What’s exciting to me, though, is the incredible effect a dermatologist can have on a patient’s life by treating their severe psoriasis. That, to me, is a major appeal of dermatology. And at the heart of it, what I find appealing about medicine in general: making a positive impact on someone’s quality of life.

 

*Rapp SR, Feldman SR, Exum ML, Fleischer AB Jr, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol. 1999 Sep;41(3 Pt 1):401-7.

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