I have the offer of seeing a specialist privately...

[suzi2]

but I haven't a clue who to see!

I have discoid eczema and pompholyx since being pg with DD (who is 4 months). I'm bleeding, itchy, bandaged a lot. I've been seen by the dermatologist and get seen most weeks at the skin clinic there for dressings etc. But they can't offer any other options that sticking with the steroid creams and bandage stuff. They won't give oral steroids . Mind you, a few weeks of them for my asthma a few months ago didn't come close to clearing it.

I also took a couple of bizarre mouth symptom allergies a few weeks ago to something unknown (I'm highly allergic to nuts but it wasn't that). I've been referred for testing (to the dermatologist I see!) but it's being treated as a standard case and will likely take 6 months. My lips swelled badly last night after having a very good cry about how itchy and sore my skin was... so i suspect it's something systemic!

Anyway, I've been wondering about the possibility of seeing someone who can help more. I'm sure that all of this is hormonal or due to stress hormones or my liver not working right or food allergies or something. It has to be something surely? And surely there is someone out there who can find out what? Or offer better treatment?

Now a relative has offered to pay for me to be seen privately. i'm in Fife, Scotland and I haven't a clue who to see. My GP has said, in the past, that he would need a name...

any ideas?

I can ask my dh to find you a specialist
he is a medical lawyer and has access to this sort of info
he is away tonight but will ask him tomorrow

here is a list from Dr Foster in your area you could trawl through and see if any specialise in your area

Could I also suggest that you try chinese herbal medicine. I had terrible eczema for years and after 12 weeks of this i have had none for 15 years

if you want allergy testing have a look at this list of clinics www.bsaci.org/clinics/all_clinics

there are clinics at Glasgow and Aberdeen with consultant immunologists.

You could ask for a second opinion from another dermatologist - are you seeing one at Ninewells?

I assume you're keeping a food diary and you've already tried probiotics. Have you considered an exclusion diet to see if that helps? I'd be a bit concerned that you might pay out to see a specialist and not get any benefit back.

Thanks everyone. I'm being seen at Queen Margaret. I do take probiotics and do keep a food diary, and so far nothing is coming up.

Exclusion diets... my understanding was that you basically ate only basic, unlikely to be allergic foods and then reintroduce possible allergens? I don't feel I could do that as I'm breastfeeding at the moment and I worry that it'll affect DD. But going the other way (simply excluding possibilities) is tricky as I wouldn't have a clue where to start!

I might look into the allergy testing as a starting point. Can anyone tell me whether the generalised blood testing is accurate? I have heard stories of them getting things wrong. Mind you, it would give me a good starting point for an exclusion diet? Skin prick testing is trickier as I'm not entirely sure what the problem foods were!

Sorry, I'm rambling again. Thanks for the info. I think I'm maybe grasping at straws to find anything to improve it though aren't I?

NHS allergy consultants don't usually just test for everything, its expensive. They can use some mixtures to help narrow things down. No test is entirely reliable, the gold standard is whether your condition improves when you avoid what is identifed and get worse when it is reintroduced.

Common food allergens (not necessarily in this order) are cow's milk, soy, eggs, wheat, peanuts, nuts, fish and shellfish. Tomato and strawberry are also fairly common. A strict exclusion diet contains 8 foods - I forget exactly but I think lamb, rice, pear and aubergine are in it. Although you are breastfeeding two weeks on an exclusion diet is unlikly to harm your child as they take priority on getting the nutrients from your body. This book would help www.amazon.co.uk/Allergy-Bible-Understanding-Diagnosi ng-Intolerances/dp/1844001725

Have you considered allergies to common household chemicals? Dust mite allergy is common, although that would normally cause respiratory problems rather than skin problems. Have they mentioned patch tests to you? If it was me I'd probably want to see a NHS dermatologist at a teaching hospital for a second opinion before paying privately if they suggested a possible allergy. Would Edinburgh or Glasgow be more accessible than Dundee?

What were the mouth problems, if you don't mind saying? I'm just wondering if lichen planus is a possibility as that causes oral problems and can be brought on by pregnancy?

sorry - I was in a rush earlier and not sounding very sympathetic. An exclusion diet is hard work and with a young baby you probably have enough on your plate already. Unfortunately its the best, and quickest, way I know to find out if food allergy is part of your problem. If your skin improved then it would be worth paying to see an allergy specialist to help identify the food, if not you could save the money to see someone else.

Sodium Lauryl Sulphate could also be a possible cause of your problems - see
www.greenpeople.co.uk/info_features_sls.aspx Hard to avoid it, especially in toothpaste, but possible if you try hard and shop in health food stores.

I don't know an easy way to test for problems with SLS - possibly an immunologist would know. You shouldn't have to suffer like this but it can be quite difficult to track down a cause so the more you can do yourself to investigate possibilities the quicker you may find an answer. My (limited) experience of dermatologists is that if its not fatal they aren't that interested - but maybe I was unlucky.

Thanks tatt - I don't use things with SLS in them. Rubber gloves for all chemically things though I tend to clean with a steam cleaner and e-cloths as much as possible. I do have a dust mite allergy (according to testing done about 25 years ago!) and have asthma although my asthma is fantastic at the moment and oddly enough has been since I was pg with my DS 2.5 years ago. When I had testing all those years ago (skin prick ones) it came up with a mild allergy to egg, milk and 'cereal' whatever 'cereal' is! I don't really eat eggy things as I don't like the taste but don't worry too much if it's in something, same for milk. Perhaps I should

By mouth symptoms I mean lips swelling, tongue swelling a bit, mouth tingling. I'm allergic to nuts and it was like a mild nut reaction. I didn't have any breathing trouble or sickness.

I think that when I do see the dermatologist about the allergies (why I can't speak to them about that just now during my eczema appointments I do not know!) they will be offering skin prick testing if they feel that my reaction will be safe enough.

Edinburgh and Dundee are both very accessible for me. I think I might arrange to see my GP to discuss this all in the first instance a bit more.

I've just googled lichen planus.... I think that's what I have on my feet and not pompholyx! And that's definately what is on my forearms. I'm back to the dermatologist next week so will go armed with this info. From the pictures and description is is quite plain to me that it's lichen planus so I'm surprised that they haven't suggested it!

Suzi2 - a good way of finding a specialist is to ring the BUPA healthline and ask for approved consultants in your area (allergy). Consultants with a specific interst in allergies may cross several different disciplines. that's how I found my daughter's allergy specialist in Kent. You don't have to be a BUPA member to call the healthline.

well if you're allergic to nuts my first assumption for the mouth problems would be that there was some nut contamination of your food. But it is worth being allergy tested and especially getting tested for pine nuts (unless you eat them safely) and lupine. Might also be worth asking for a test for soy (because its the same family as peanut) and for wheat as you had a mild positive for cereal before.

Unfortunately lupine doesn't have to be declared on packaging yet, many nut allergic people test positive for it and the reaction could have been to that. Your gp can do a blood test and send it away for testing, you don't have to wait to see a consultant. The difficulty is persuading them to test as each allergen costs about £8.

Skin problems can be difficult to diagnose -has the dermatologist done a skin biopsy to confirm the diagnosis? I wouldn't assume he got it wrong and it may not make much difference to the treatemnt.

If you wanted a second opinion from a dermatologist at Dundee here are a couple www.fernbrae.co.uk/hospital/consultants.cfm You could google them to see if they look interesting.