Friday, November 12, 2010

Teenage years are hard

Not the happiest news today, I'm afraid: some poor kid in Manchester, England apparently committed suicide after being taunted at school about his eczema.

It's hard to be a teenager. Many kids are insecure--they think that others think they're not tough enough, or not cool enough, or whatever-- so they bully and torment kids who don't fit in. And it's easy to single out the boy with the funny rash.

Of course there could be more to this story. The boy may have been suffering from clinical depression, which is distinct from general teenage angst. But who among us adults doesn't still keenly recall every casual remark that wounded us during those years?

I'm lucky. Although I definitely had eczema all the way through high school, nobody made a habit of jeering at me for it. (Instead, they jeered at my accent, haircut, trouser cuffs, and Bryan Adams cassettes, among other things.)

We should tell kids with eczema that life does get better. Your eczema may not improve, if you're one of the unlucky 2% or so. But past high school, you're not trapped in the zoo any more; the cliques aren't as intense, because people have little to gain by making you feel bad. The more life experience people have, the less they care about how your skin looks. And if you can feel confident in yourself, it shows on the outside.
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An important conference opened yesterday in Phoenix: the annual meeting of the American College of Allergy, Asthma, and Immunology. There's a particularly interesting session on Saturday from 1:30 to 3:00 pm. It's titled "The Great Atopic Dermatitis Raft Debate: The Greatest Role in the Pathophysiology of AD." (I don't know what "raft" means here.) It's basically a four-way mano-a-mano between presenting scientists, each of whom is claiming that the cells THEY study play the most important role in eczema. Our good friend Donald Leung (head of the Atopic Dermatitis Research Network) is in the T cell corner. He evidently wrote the abstract, because it says "Upon completion of this session, participants should be able to... describe the scientific evidence that supports T cells as playing the key role in causing AD."

Which is amusing, because the more I read about eczema, even in articles written by Leung, the more it emerges that eczema arises from a barrier defect in the outermost layer of the skin-- a defect in keratinocytes. (He does nod in their direction, saying keratinocytes have a "critical" role, but not the KEY role.

I've snoozed through many an academic conference presentation, but I'd sure like to be at that session! It'd be like Iron Chef, only immunology.

3 comments:

  1. Our Ped also puts emphasis on the T-cells, as he believes that so many of these allergic and autistic kids are skewed towards T2 rather than T1, making their immune systems hyperactive. My son is on a medication called low-dose naltrexone (LDN for short) for his allergies/eczema. It's been found to correct the T-cell imbalance, basically having a homeopathic effect on the body to correct many autoimmune issues. Many MS patients were experiencing great success with it and the autistic kid's blood panels were coming back identical to MS, so LDN was then tried on autistics with positive outcomes. It's now showing good results with allergies, cancers, corhns, and an AIDS study is soon to be released. Pretty fascinating stuff, check out: http://www.lowdosenaltrexone.org/#How_does_LDN_work

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  2. Thanks for the tip, EM. Yes, it's widely known that T cell populations in patients with AD are skewed toward type 2 helper T cells. These are the ones that stimulate the excessive IgE antibody response. I have read papers by eminent scientists suggesting that in the future doctors may try to alter the Th1/Th2 balance as part of AD treatment. I'm skeptical of naltrexone at this point because there haven't (to my knowledge) been any large studies showing effectiveness for conditions other than addiction. At low doses I'm guessing it isn't harmful though. I hope it works out well for your son.

    In MS there was one trial that seemed to show it improved the mental attitude of patients, but it was a small trial and the authors don't make any further conclusions. http://www.ncbi.nlm.nih.gov/pubmed/20695007

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  3. How long at 1mg /day,hs, before improvement begins.

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