Crohn's Disease and My Annual Full-Body Skin Check
Last year, I wrote an article about finding a lump in my breast, and how much I wanted Crohn's and ulcerative colitis patients to know that the medications we take to manage our disease and preserve our quality of life can come with some pretty intense warnings – like increasing the possibility of developing certain types of cancer. At the end of the article, I included recommendations for monitoring your own risks, including being diligent with your annual skin checks.
A skin check as a part of my comprehensive care
I see my dermatologist once a year for a full-body skin check. I check in at the front desk, provide any updated insurance information available, and fill out a few pages of questionnaires. Once called back into an exam room, I peel my clothes off until I'm down to my underwear, don a thin paper gown, and wait, as the doctor scans my body in detail from head to toe, front and back, ensuring that there's nothing that looks new, different, or suspicious since the last time he saw me.
I have several raised freckles, and it's imperative that the doctor explore whether they've changed in size, shape, or color since my last visit. My dermatologist specifically takes photos of each and uploads them to my electronic chart in order to do a side-by-side as time goes on. Occasionally, like during my most recent visit, he'll ask to take a biopsy of something that looks potentially concerning to him, and he'll go ahead and do that during the same appointment time.
Potential side effects of Crohn's medications
As my body is being examined, my doctor asks a series of questions – about my exposure to things like the sun, alcohol, and nicotine, and then about my medications, specifically Remicade and azathioprine. He asks about changes, frequency, dose, side effects, and most importantly, if they're keeping my autoimmune diseases in remission. He reminds me that they can come with some potentially scary side effects, so doing my own full body skin checks at home are extremely important.
Asking about my skin rash
During this visit, I ask some general questions – one about the height of a freckle on my chest, another about a bump on my scalp, and then finally a few questions about a rash that comes and goes surrounding my joints (most commonly my knees and elbows). He verifies the freckle and the bump are likely nothing to worry about, and he explains the rash is more likely related to my rheumatoid arthritis rather than a side effect of the medications I take, and he asks me to snap some photos of it next time it arises.
Asking about long-term skin risks of my Crohn's medications
I also ask about time. I see him for a full body skin check each year, but the years are ticking by that I've been on these same medications that can cause increased risks of skin cancers and other problems. I ask him about the risks of continuing these treatment plans, and his response is the same as it has been in years prior – the benefits still outweigh the risks, but we keep a close out eye out incase anything changes so we can catch it as early as possible.
Is it time to see your dermatologist?
Here's my diligent patient reminder that if you haven't seen your dermatologist in a while, it's probably time to call and schedule an appointment. :)
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