The P on my face was not P

[dijon78]

Hi everyone. The p on my face was not p, but instead, seborrheic dermatitis.

Below, I have written my story, simply to explain that not all doctors are created equal and that not all doctors know the tiny differences between all of the possible diseases. Never hesitate to get a second or third (in my case)opinion.

About a year ago, I found a red P-looking plaque on my face (cheek). I had had P on my elbows and eyebrow for a couple of years.

When the spot appeared, I don't know why, but I put this steriod-based cream on the spot - bad move. It made it go away for about a day or so, and then the spot came back with a super-amplified vengeance (like 3 times the original size).

Immediately, I went to a new derm. I mentioned that I had a history of P. I also mentioned (upon reading some posts here at the forum) that the red on my face might also be seborrheic dermatitis (which apparently can co-exist on the body). I had read that SD is a fungus (different that p) but appears on the eyebrows and near the nose and looks quite the same as p.

Anyway, my new derm vetoed my opinion, said that it was most likely P. She gave me something that would "clear whichever it was", called Silkis, which I believe is a Vitimin D derivative. That did not help and made it worse. After the spot had spread more, I stopped the treatment.

A little panic-y, I began to pursue the seborrheic dermatitis idea -- I had read that Neutrogena cream can be somewhat effective for that particular disease. I tried the cream and it seemed to clear some of the red, but nothing ever really cleared.

Then the summer came. Every thing went away when I tanned. Now, I thought that the spot must be P, because everyone says that P gets better with the sun. However, when the sun went away, the red spot came back.

About 7 months into this thing, I saw another derm (about something else) who immediately diagnosed the spot on my cheek and eyebrow as seborrheic dermatitis. He told me to take this anti-fungal cream called MyCoster 1% (it might just be sold in French markets?). Anyways, after about 3 weeks, I could see the spot on my face and eyebrow (which I had always thought was P) going away. They have since been gone for a while.

So, please make sure that the P on your face is really P. Not all doctors know the differences between diseases, apparently. If you research thoroughly, and all the clues lead in one direction, but your doctor leads you in another, don't waste time like I did, and get a second opinion. Best to all.

[sergecosta]

HI Dijon78

I'm curious - what was the texture of your spots? Can you describe its pattern or behavior?

I was diagonosed with an overlap of psoriasis and seb derm - but my dermatologist said that they wouldn't treat sebd derm any different. I just have an unusual reaction to dermatophytes and my skin reacts psoriasis-like to it - I can't eliminate the organisms forever, so my derm says.

[dijon78]

Okay, texture. It became a bit flakey when it got bad. It didn't ich at all, basically, although I remember a bit of iching on my eyebrow from time to time. Mostly flakey though, but not on my cheek.

I might be able to give more insight on the behavior though. For months, it would go from really flakey and red to not so flakey and red, but never quite go away. The spot on my cheek seemed to react well, at times, to the Neutragena. Then, always, the spots would come back, but it wouldn't relpace itself exactly. Sometimes it would veer in a slightly different direction - meaning it would start from the same base and effect new areas of skin, mabey even leaving a previously affected part of the spot as normal skin.

The biggest reaction, was to this vitamin D medicine. The medicine was the kind that stays on the skin for a long time, like a thin clear film. The plaques just fed off of it. They would exponentiate with just about every application. I tried the Silkis twice (many months apart, each time for about a week). Each time the spots got seriously big and red, and then contracted after a went off the medicine.

SD is a fungus. You treat a fungus with an anti-fungal cream. P seems to often be treated with medicines that slow the growth of new skin - this is how the Silkis (Vitamin D) was supposed to work.

One thing to note is that an anti-fungal cream will NOT treat P (this is what my doctor told me). Thus, you can detuct that the red is SD, if the anti-fungal creams work -- but you can not deduct which is which very easily testing things the other way around. Thus, you might want to try the anti-fungal option on a small area. This is what I did. I had the plaques on both eyebrows. I put the Silkis (Vit. D) on one and the Mycoster (anti-fungal) on the other. The Mycoster showed improvement within 2 weeks.

The 2nd, incorrect, doctor said the same thing - we treat both the same. Personally, I don't believe this. Do research on SD and treatment options. You won't see the Vitamin D that she prescribed me written there. Instead, you'll see anti-fungal treatments.

Best to All

[sergecosta]

Thanks dijon78

My doctor too says that it is both seb derm and psoriasis. I plan on doing UVB treatments, which my doctor suggested I do, real soon. I would prefer to find something that really works but not a topical steroid.

I agree with you with the Vitamin D observation. Dovonex, which is a Vitamin D derivative, never once worked for me. I absolutely am certain that it caused a major rash around my nose that lasted for 2 weeks. I did not use anything on there after that, not even hydrocortisone during that time and it went away mostly.

I will ask my doctor for a Ciclopirox gel (which is the active ingredient in your MyCoster). We'll see.

Anyhow, I thank you for bringing up the subject because I too have been very dissatisfied with my regimen. I would expect that in your case, the redness could come back and forth - as it will only hold off microorganisms for a short time. The fungus you are talking about is pityrosporum ovale or malassezia furfur which lives on everyone's face. Some people are overly sensitized to it and it appears that you, and perhaps me, are.

I'm looking forward to UVB as I can tell you unequivocally, and being a busy graduate student, I get no sun at all. I spend lots of time indoors with my face in books and work during the afternoon and evening.

The description that you offer is quite similiar to mine. My psoriasis is not elevated at all. It feels flakey, sometimes waxy, and after a shower dry. When it was bad, washing it used to make the serum of my skin come out and make it sticky. I handle my scalp a lot better than my delicate skin. My scalp is clear but flakey - it never gets red unless I scratch it to death.

Anyhow, on a different note, I have been using mineral oil on my skin - and this is really a fantastic item. Even something as pure petroleum jelly w/o AHA used to make me more red. My facial skin feels like a baby's. I swear by this product. Far better than P&S and any other cream you can put on your face!

Thanks for the input and will let you know how I make out
Sergio

[RichJ]

hi dijon78,
thank you for sharing that and welcome to the p family. you have met some of the wonderful people on here and will find alot of great info. welcome and nice to meet you.

have a good night all

richard

[scratchydee]

Thanks for sharing this info. I have red spots on my eyebrows and my hairline. I recently just got a tiny spot on my eyelid and my undereye area. I hope it is not spreading. It does seem different them my p I have on the rest of my body. Your info gives my something to think about- Thanks!!