DALLAS ‚?? Dr. Alan Menter has found his passion in a disease that is red and itchy, a disease that gets sufferers kicked out of public swimming pools, a disease that controls wardrobe and intimacy and can lead to a host of other health problems.
Psoriasis affects what may sound like a small segment of the population ‚?? 2 percent. That‚??s close to 6.5 million people in the United States alone. Talk to Menter, and you get the feeling that even if the number were a fraction of that, he‚??d still be traveling around the globe to help make the lives of sufferers easier.
‚??I could spend 20 or 30 minutes talking to a psoriasis patient,‚?Ě Menter says between seeing patients on an early November morning.
Days earlier, he had returned home from conferences in San Francisco and South Africa; in a few hours, he‚??ll leave for another in San Antonio, Texas.
‚??Then I could go into another room, remove a skin cancer from a patient, and double my income,‚?Ě says Menter, chief of the dermatology division at Baylor University Medical Center at Dallas. ‚??From a personal standpoint, this is more satisfying than anything else. I love what I do. I adore what I do.‚?Ě
Dr. Mike Ramsay, president of the Baylor Research Institute, through which Menter‚??s research is conducted, calls Menter a luminary.
‚??In ‚??94, he was the first person to identify the gene associated with psoriasis,‚?Ě Ramsay says. The men have known each other since Menter came to Baylor in 1975.
‚??Alan‚??s had a passion for it since he got into dermatology,‚?Ě Ramsay says. ‚??You come to Alan, you get all the latest therapies because all the companies come to him to do Phase One trials. He knows the disease backwards. He knows what is likely to work, what won‚??t, the side effects.‚?Ě
It‚??s a passion, Ramsay says, that Menter, 71, has transferred from the rugby playing fields of South Africa to the lab in Dallas. ‚??He was an internationally known sports figure. It shows he has passion, passion for what he does. In sports, he was a leader. Now he turns his passion to psoriasis.‚?Ě
Psoriasis is a disease that presents in patches on the skin, but its ramifications run much deeper. People with psoriasis have a stronger incidence than the general population of high cholesterol, obesity, diabetes and heart disease. They‚??re likely to develop arthritis and joint problems, and to be depressed. The disease can be treated, but not cured.
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Tammy Farrington, 54, remembers all too well its effects, which first struck her at age 5. She‚??s suffered from pain in her joints and hands; when she was a fashion model, its fiery presence on arms and legs dictated what she could and couldn‚??t wear, or whether she would work at all.
‚??I tried to hide it,‚?Ě says Farrington, one of Menter‚??s patients on this November morning. ‚??People would ask, ‚??What happened to you?‚?? or ‚??Oooh, does that hurt?‚??‚?Ě
Within six months of her first appointment with Menter, her skin and symptoms had cleared. She keeps her disease at bay through shots he prescribes, which she gives herself in the leg twice a month.
‚??This is the mildest I‚??ve seen it in years,‚?Ě he tells her, checking out her elbows and knees, where she‚??s tended to have flare-ups. Before leaving her examining room, he asks, ‚??When are you going to finish your studies?‚?Ě
‚??December,‚?Ě says Farrington, who is earning a degree from the Art Institute of Pittsburgh.
‚??I‚??m very proud of you,‚?Ě says Menter, who is chief of the division of dermatology at Baylor.
In the hallway, he marvels at how Farrington has changed since the first time he saw her. ‚??Tammy is bubbly and outgoing now. When she first came, she was totally introspective.‚?Ě
That‚??s hardly unusual.
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Menter remembers, years ago, getting a phone call from a psychiatrist, asking whether he could do anything for a 13-year-old who had dropped out of school after being continually teased by classmates.
He certainly could, and he did. The teenager is now a young adult who went on to play soccer in college and is working on a doctorate in psychology. Menter calls the transformation ‚??a personal satisfaction.‚?Ě
‚??There‚??s a massive quality-of-life issue,‚?Ě he says. ‚??Young people with psoriasis have the highest incidence of depression of any other disease. Imagine a young female, 22, 23, trying to start dating and she has large patches over her arms and legs. It doesn‚??t make you feel attractive.‚?Ě
People hide their disease. ‚??I have patients where one spouse had it and the other didn‚??t know,‚?Ě Menter says. ‚??They‚??d never bathe in front of the other, never jump into bed before the lights were out.‚?Ě
Psoriasis has been known about since biblical times, he says. Until the 1800s, it was thought to be leprosy.
‚??We‚??ve always known psoriasis patients had more risks for cardiac disease, especially those with severe psoriasis,‚?Ě Menter says. ‚??It‚??s not just driven by obesity. It‚??s driven by inflammation. It gets into skin and joints.‚?Ě
Creams and lotions can help outbreaks only to a point, he says. Instead, injectable and systemic drugs work better, and work on a variety of health issues. When he tells patients of the ‚??good statistical evidence‚?Ě that the drugs ‚??won‚??t just improve skin and joints but their cardiovascular system as well,‚?Ě he says, ‚??their eyes are wide open.‚?Ě
Many drugs under development work on the inflammatory side, he says. By reducing inflammatory markers, ‚??they‚??re also playing an integral role in heart disease. That‚??s very, very significant. Five years ago, we had no knowledge about that.‚?Ě
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Menter became interested in psoriasis during medical school in England, when he discovered a few patches on himself.
‚??There are 23 genes for psoriasis,‚?Ě he says. ‚??I have every one known to mankind. I have nieces and nephews with it. One of my brothers has Crohn‚??s and psoriasis. I‚??ve seldom had one little patch on my scalp or my body.
‚??That‚??s the unknown. Why did one of my brothers get Crohn‚??s? What are the trigger factors? Is it dietary? Environmental? Stress?‚?Ě
The more he has learned, the more psoriasis fascinates him. His accomplishments are world-renowned and include founding the International Psoriasis Council in 2004. In June, he served as president of its World Psoriasis and Psoriatic Arthritis Conference, which attracted 300 rheumatologists from 67 countries.
‚??There was a lot of shared knowledge with rheumatology colleagues, debates about genetics, a lot of basic science,‚?Ě says Menter, whose annual air miles total close to 170,000. ‚??We came away with more understanding of the intricacies of psoriasis.‚?Ě
He speaks with ease and passion about studies, about research, about grants, about treatments. In October 2013, the Menter Psoriasis Gala will be held to honor him and raise money for his research. There‚??s no cure for psoriasis, but he can provide treatments and, above all, hope.
‚??I tell every one of my patients, ‚??You don‚??t have to live with your disease,‚??‚?Ě says Menter, who praises his staff members for their empathy helping patients through crises. ‚??With the depression rate and suicide rate being so high in young people because of their quality of life, treating them in a way that makes them more comfortable with themselves is very heartwarming, it really is.
‚??I do get quite a few hugs every day because it‚??s finally cleared.‚?Ě
What Dr. Alan Menter wants you to know about psoriasis:
_It‚??s not contagious.
_It‚??s associated with other internal conditions.
_It has three parameters: redness, thickness, scaling. But the way it presents itself, and which parts of the body it affects, vary from person to person.
_The wide variety of medications on the market can clear the majority of patients. ‚??If you stop treatment, in the vast majority, it comes back,‚?Ě he says. ‚??It‚??s like diabetes, like arthritis. You have to maintain treatment.‚?Ě
_Leann Rimes has it, as does Kim Kardashian and Stacy London, star of ‚??What Not to Wear.‚?Ě The late John Updike wrote about his psoriasis in his autobiography, ‚??The Diary of a Leper,‚?Ě which Menter says, ‚??was pretty traumatic. It describes what he went through, how he was ridiculed. It‚??s the best-ever personal story written by a well-known writer.‚?Ě
Psoriasis research, treatment is doctor‚??s life‚??s work