My Chinese medicine doc confirmed the dots were all scabs from scratching, probably at night. Luckily none of them are infected, just scabbed and painful when I move. The rest of the rash is getting lighter - now lavender/pink instead of purple/red. There is clearing in the center of my back and parts of my buttocks too. It's so weird not to obsess about my skin 24/7 now!!
I'll pick up the Plaquenil tomorrow and have been reading up on it. It seems I have been prescribed a high dose for my height and weight...which could ultimately lead to worse eye complications over time, so I need to figure it out for sure before I question my doctor. If I'm right, and he just gave me a "standard dose," he's fired. I'll ask the opthamologist about precise dosing. I think I've been prescribed 500 mg twice a day. The calculator I used suggested a max of 350 mg/day to preserve my eyes. Ugh. But the eye damage usually accrues over long-term use, years.
I also wanted to understand HOW Plaquenil works in autoimmune disease. I read a interview with a rheumatologist who said it raises HDL, lowers LDL and raises PH. So I thought...isn't the problem with our carb-loaded western diets that we end up too acid? We need to be more alkaline? I wondered whether Plaquenil is simply speeding up a pH conversion that could otherwise be accomplished through diet alone?
I've also been trying to understand what all the various anti-inflammatory diets have in common. I mean, how can people with the same disease be cured by different diets, one vegan, one paleo, one Dr. Fuhrman which allows legumes, etc. Why do all these various diets work for people, despite having radically different approaches to meat/legumes/nuts etc. Could curing our body acidity by alkalinizing the body be the simple common denominator??? (aside from eliminating gluten and dairy, of course)
So I looked further into Plaquenil and discovered (through Wikipedia of all places
), that someone has discovered how it works in autoimmune disease.
http://en.wikipedia.org/wiki/Plaquenil
Antimalarials are lipophilic weak bases and easily go through plasma membranes. The free base form accumulates in lysosomes (acidic cytoplasmic vesicles) and is then protonated,[8] resulting in concentrations within lysosomes up to 1000 times higher than in culture media. This increases the pH of the lysosome from 4 to 6.[9] Alteration in pH causes inhibition of lysosomal acidic proteases causing a diminished proteolysis effect.[10] Higher pH within lysosomes causes decreased intracellular processing, glycosylation, and secretion of proteins with many immunologic and nonimmunologic consequences.[11]These effects are believed to be the cause of a decreased immune cell functioning such as chemotaxis, phagocytosis and superoxide production by neutrophils.[12] Recently a novel mechanism has been described wherein hydroxychloroquine inhibits stimulation of the toll-like receptor (TLR) 9 family receptors. TLRs are cellular receptors for microbial products that induce inflammatory responses through activation of the innate immune system
Are toll-like receptor issues my smoking gun, perhaps?? They certainly play a role in skin AND gut mucosa. They seem to be reacting to microbes and antigens (not truly to self). And lo-and-behold, they are tied to nickel allergy!!!!!!!!!!! Coincidence?
Of course this article might as well be written in German for me. I'm lost on the biochemical descriptions. I need a translator. But from what I can piece together, I think I'm on to something, and I think it may have implications for everyone with MC too.
http://en.wikipedia.org/wiki/Toll-like_receptor
Schmidt et al. demonstrated that TLR4 is involved in the development of contact allergy to nickel in humans.[31] By binding to two non-conserved histidines, H456 and H458, Ni2+ cross-links the two receptor monomers, TLR4, and MD2, triggering formation of a dimer that structurally resembles the one induced by Lipopolysaccharide. That, in turn, activates the proinflammatory intracellular signal transduction cascades.