My Experience with Eczema, Asthma, and PLEVA

As a person with asthma, most of my symptoms are invisible. I can feel them, but people can’t see my shortness of breath or my wheeze.  Although, asthma has caused visible symptoms as well, skin symptoms. This is an article about my experiences with the atopic march, my own atopic dermatitis, and what I did to manage my skin conditions.

The atopic march

The skin condition most commonly linked to asthma is eczema. Over half of patients with moderate to severe eczema also have or will develop asthma.¹ The development of asthma from eczema, or vice versa, is known as the ‘atopic march.’ A link that is well known and commonly experienced, but yet-to-be fully understood.

In my experience, it is unclear which condition developed first. I was diagnosed with both conditions during infancy and have had both as long as I can remember. However, over the years it was asthma that stuck around as my eczema got better. My eczema is not gone, I still have flare-ups occasionally, depending on my environment and the activities I’m doing. Now that I have better tools for managing my atopic dermatitis I can keep it at bay for most of the year. Here are some things that helped me.

Caring for eczema

Eczema causes dryness of the skin, which prevents the skin from protecting against environmental irritants and allergens.² The Mayo Clinic has suggestions for how to prevent and treat eczema.

Prevention²:

• Keeping skin moisturized
• Identify and avoid triggers
• Take shorter showers and baths
• Use gentle soaps
• Dry your skin carefully and gently
• Take a bleach bath (1/2 cup of bleach: 40 gallons of water)

Treatments²:

• Medicated creams
• Oral medications
• Injectable medication
• Wet dressings
• Light therapy
• Behavior modification or biofeedback treatments (to stop scratching)

I don’t practice all of these management techniques, however it’s good to know them because atopic dermatitis is known to throw curve balls at us from time to time. Speaking of a curve ball, here’s a fun one that I got thrown at me.

My experience with other skin conditions

I was thrilled to finally get my eczema under control. Unfortunately, when I was in my early teens, I developed another, much more rare skin condition: Pityriasis lichenoides et varioliformis acuta or ‘PLEVA’. As it would turn out, it's so rare that I was sent to half a dozen dermatologists (doctors that specialize in the skin), and most of them had never heard of it or had only seen it in a textbook. So, I became a test subject for them as they passed me around to colleagues trying for a solution.

My PLEVA treatment

After a skin biopsy to confirm that I did have PLEVA, they began testing different treatments. I was given most of the treatments used to for eczema. Unfortunately, none of it worked at all and I was going on a year of having this skin condition. It wasn’t until I visited a dermatologist at the UCLA department of dermatology that I was given an unlikely treatment suggestion. The doctor noticed that the PLEVA was only under my clothing, and hypothesized that sunlight was a possible treatment. My mother let them know that we were planning a trip to the desert soon, a place where there would be plenty of sun.

The dermatologist was reluctant to recommend that I get a sunburn, on as much of my body as possible. So, that’s exactly what I did. After my painfully red skin peeled away, clear skin was the result and the condition never returned. Upon doing research for this article, I read that a recent treatment for PLEVA is phototherapy, under UV lamps or sunlight.³ I’d like to believe that I helped reach that conclusion.

Asthma and skin conditions

It’s not common that asthma is a visible disease, unless you witness a person using their medication. At certain times, there might be expressions of inflammation that show on the skin. These skin conditions aren’t necessarily symptoms of asthma, but they are often correlated or connected to asthma. In my experience, both my atopic dermatitis and my asthma have gone through numerous phases. If you are experiencing skin inflammation, the best doctor to see is a dermatologist. Depending on the condition, you might need to see more than one.