Chapter 1
The Beginning

I served four years on active duty in the U.S. Coast Guard (largely without distinction) during the waning years of the Viet Nam war (1969‑1973). I was seventeen when I enlisted. It was, in retrospect, a marvelous four years. I lost my virginity, lost my stammer, discovered I had skin problems, got married, and participated — albeit from a safe distance — in our nation's quest for peace with honor.

A young MD in the Public Health Service diagnosed strange white patches on my chest as "vitiligo." This is a "condition" in which the body is unable to turn vitamin D into melanin, the pigment that gives us Caucasians the ability to tan. I treated the diagnosis with indifference. What the hell? I was married, quite invested in the new-found raptures of conjugality, feeling in all ways quite vigorous. So I can't tan? So what? Who needs it?

The vitiligo that had been concentrated on my chest in 1970 had, by 1975, spread to my limbs. Now I was in college on the GI Bill, still married, still enjoying the raptures of youth and manhood. But now I was also "an older man on campus" and a veteran, to boot. The vitiligo became something of an embarrassment in summer school, to and from which I rode sleeveless on a motorcycle, hence getting lots of sun exposure. Blotches on my arms tanned quite nicely, other blotches became pink, then peeled and returned to stark whiteness. It so happened the blotches of melanin-deficient skin tended to focus on the inside of my forearms. They became quite distinctive.

I told young coeds the white blotches on my forearms were burn scars caused when a canister of napalm I was carrying got hit by a sniper bullet and blew up in my arms. This lie generated interesting manifestations of sympathy until one day I shared it with a young woman who also had vitiligo. She concluded, correctly, that I was full of ... well, you know.

Twenty years later the vitiligo still exists but I don't mind it much. The only parts of my body that get sun exposure are my hands. Blotches on the backs of my hands will tan, the majority of skin just burns. The tan blotches look like liver spots in contrast to their pink or white surroundings.

I look at my blotched hands now for signs of erupting psoriasis lesions. The vitiligo is no more than an old familiarity — compared to the psoriasis.

Nothing in the literature I've surveyed suggests a connection between vitiligo and psoriasis. My dermatologists shrug off my inquiries about the possible connection.  

I was diagnosed a psoriatic at the age of thirty-nine. By then, lies about tragic accidents in Viet Nam were out of the question. Besides, psoriasis, unlike vitiligo, is not so discussable because it's much more disgusting. The red, flaking lesions that constitute "plaque psoriasis" aren't nearly as tolerable as vitiligo's scar-like white splotches of skin.

By the time I was initially diagnosed a psoriatic, I'd been out of college for thirteen years, out of my first marriage and into my second, and into the waning years of what had been a meteoric career in a high-tech telecommunications industry. In other words, I'd already "been around the block" a few times and the worst physical abnormality I'd had to contend with was the vitiligo. In retrospect, I can see this rather late-in-life manifestation of my psoriasis was both bad and good.

It was bad because I considered what I was losing; i.e., skin I wouldn't hesitate to "reveal." With psoriasis, for me there would be no more short-sleeve shirts and Bermuda shorts; no more bathing suits on the beach; no more convivial visits in the spa or gym locker room. All those realizations were very depressing.

But the good side was that, for awhile, I had a life full of all those things — memories to lean on — and could be thankful for thirty-nine years of psoriasis-free living.

 

Many psoriatics “manifest” their disease at much earlier ages than me. There are some who have never known life without psoriasis. What do they lean on? I hope it's a sense of self-worth that resides tenaciously beneath the skin.