You were diagnosed with eczema by skin doctors for a long time and with multiple consultations. You were given the “gold standard” of eczema treatment – topical steroids to treat your symptoms. You were told by doctors that your condition cannot be “cured”. You were told to rely on topical and perhaps, systemic oral steroids for the rest of your life.

What if they were wrong?

What if your condition was misdiagnosed?

What if topical steroids is not the RIGHT treatment for your condition?

What if you were NOT suffering from eczema, but some other diseases or conditions that require some other specific treatment?

A woman was incorrectly diagnosed with epilepsy, irritable bowel syndrome, asthma, insomnia, eczema, cirrhosis and allergy to cats. It was many years before she was correctly diagnosed with variegate porphyria. It is considered rare but this is probably more due to the fact that it is often overlooked and misdiagnosed. There is no cure but symptoms can be alleviated by avoiding sunlight, a strict diet and avoiding physical contact with a range of chemicals such as newspaper ink.

What if cases like these are not unique, one-off situations, but commonly occurring and recurring?

What if your skin doctors are just too inexperienced and incompetent to make the right call, right diagnosis and right treatment?

These, my fellow skin friends, are just some of the reasons why we ended up in our situation.

Medicine is far from a hard science, even more so for Dermatology. Diagnosis in Dermatology rely on 3 areas: 1) Pattern recognition of skin lesions, 2) Clinical history of Patients and 3) Skin examinations. Each of these 3 areas have their limitations and much needed areas of improvement especially in terms of chronic inflammatory skin diseases like Eczema. Everything starts with the correct and accurate diagnosis. If doctors get it wrong from the start, everything else following that is then wrong.

1) Limitations of Pattern Recognition of Skin Lesions

There are just too many overlapping of similar symptoms across many skin diseases. The diagnosis of atopic eczema depends on the meeting of several criteria, non of which are highly specific to atopic eczema itself, as many other types of eczema could have those similar conditions and fulfill the same similar criteria.

2) Clinical History of Patients

How often does your skin doctor take your full history and try to understand them in detail, looking for the root allergenic cause of your skin conditions? Did they discuss your ethnicity, your race, your cultural practices, your job, your work environment, your pets, your diet, your medical history, your medical treatment history, your pets, your kids, your parents, your genetic history and profile, the people you come into contact with, the potential contact allergens that you come across on a daily basis, the route or environment you expose yourself most commonly, seasonal allergies, location of your house and other related questions?

Looking at all these in great detail may be too troublesome and difficult for your skin doctors. But more often than not, critically assessing these queries could provide greater insight and possibly identify the root causes of your skin symptoms.

3) Skin/tissue examination

For a typical “eczema” consultation, how often does your skin doctor request for a tissue graft / biopsy? Almost none.

Tissue examination is almost a non-factor in the diagnosis process, until something seriously bad happens (which by then is too late) or when the patient specifically requests for one.

Point is – for cases like eczema, the foundations of the diagnosis process are fundamentally weak. Until improvement in these areas occur, the quality of our healthcare remains questionable.

And this is the very reason why there are cases like you and me, cases of steroid-induced conditions, cases of topical steroid addiction, cases of misdiagnosis that have very severe implications on patients.

And what is worse? Doctors get away scot-free when they make such mistakes.

These are just reasons arising from the medical community. To be fair, patients themselves form part of this problem and are also part of the reasons for their own predicament. Many of this ideas are further expanded in my upcoming book project. Stay tuned for the book release for more information.

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