There is widespread medical misunderstanding of Red Skin Syndrome (RSS). When RSS is misdiagnosed the patient suffers through mistreatment as well. I have listed several of the “myths” that lead to misdiagnosis and mistreatment.
It is a magnificent feeling to recognize the unity of complex phenomena which appear to be things quite apart from the direct visible truth.
Albert Einstein1- Myth 1 –The bacteria “staph” (staphylococcus aureus and at times MRSA) – alights onto damaged skin and grows colonies.
REALIITY– Staph and MRSA also reside on normal skin. The colony sits there and does not cause any infection or disease. Too frequently doctors swab cultures of the RSS patient’s skin – growth of staph or MRSA occurs and the panicked doctors treat the patient with oral and IV antibiotics as an outpatient sometimes even admitting the patient into the hospital. The doctors are treating a lab test not the patient.
Wrong diagnosis. Wrong therapy.
2-Myth 2 – Every little water blister seen on the RSS skin is herpes simplex infection.
REALITY– Herpes is very rare. Without waiting for a culture that only takes 1-3 days, a rushed misdiagnosis leads to instant anti-herpes treatment. – Wrong diagnosis. Wrong therapy.
3-Myth 3 – Elidel and Protopic demonstrated superior results when initially tested on patients.
REALITY – A very forgiving “number system” of betterment was used in the studies and showed only minor statistically significant results. Despite this Elidel and Protopic were approved and after millions of dollars spent in hopes for skin improvement, the vast majority of patients saw little if any benefits. These medicines are a waste of time and money. Wrong diagnosis. Wrong therapy.
4- Myth 4 – Dr. Aron’s therapy eradicates “staph” as the culprit in RSS.
REALITY – Dr. Aron’s “success” is based on treating benign resident colonies of the bacteria. He then illogically takes the next step and treats “infection” with prolonged usage of antibiotics. He also uses a known spreader of infection on the total body – namely corticosteroids – and actually applies the steroids under wraps to get deeper into the skin! OUTRAGEOUS! Wrong diagnosis. Wrong therapy.
5- Myth 5 – Imuran, methotrexate, Cellcept, biologicals and monoclonal antibodies are successful treatments for RSS.
REALITY – There are no adequate studies and/or evaluations to prove their efficacy. They are almost always given while patients are still using steroids. Appropriate evaluations must be made before exposing more patients to untried and side effect prone methods. DANGEROUS!
My usage of cyclosporin has been scrutinized in over 400 patients who had ceased the use of steroids and were in the process of withdrawal. The results have shown relief while their skin problem ultimately resolved.
6- Myth 6 – Numerous creams ointments and additives to bath water offer RSS relief.
REALITY – Additives to bath water and numerous creams and ointments have created a cottage industry in talk and sales. There are no studies supporting their usage and patients typically quietly stop their usage when nothing of benefit happens. Waste of time. Waste of money.
7- Myth 7 – Eliminating particular foods or environmental materials will relieve RSS.
REALITY – Food and environmental testing is worthless. There is so much wasted time, money, inappropriate food avoidances from gluten free to important foodstuffs, inappropriate discarding of household furniture, pets, and other items that have no benefit whatsoever. This misguided trend has led to advocacy of the latest misguided fad of “auto-immune” disease. Eliminate topical steroids not dairy or Fido.
8- Myth 8 – Red Skin Syndrome is just “bad eczema.”
REALITY – The NEA is wrong. There is NO such entity as “bad eczema.” Red Skin Syndrome is a distinct identifiable condition caused by topical steroid addiction. All longer-term eczematous patients are steroid addicted.
9- Myth 9 – “There is no cure.”
WRONG. WRONG. WRONG. Red Skin Syndrome is caused by topical steroid use and the CURE is total and complete withdrawal from topical steroids.
