Frankie meets The Doctors on Skype asking about her four-year struggle with dry lips. She says that in addition to becoming very dry, they become inflamed, swell, and she has lost much of the pigment on them.
Dermatologist Dr. Sonia Batra asks if this has affected anywhere else on her body and Frankie says it has. She says her arms, her chest, the back of her neck… anywhere that is exposed to the sun. Frankie says she doesn’t have pain but it is uncomfortable and very itchy.
Dr. Batra thinks the primary issue is her body being triggered by the sun and the pigmentation change is a result of prior inflammation. Dr. Batra looked at the pathology reports of biopsies of various body parts and she believes when putting it all together, Frankie’s diagnosis is lichenoid photodermatitis. This is a contact allergy triggered by certain chemicals in makeup or products in combination with light. It causes very particular patterns of inflammation that disrupts the pigmentary layer in Frankie’s skin.
Frankie has done some basic allergy testing which shows a nickel allergy, which can be in certain cosmetics, but Dr. Batra thinks she needs more comprehensive allergy testing to determine what in conjunction with the light is triggering this reoccurring inflammation. In the meantime, before the actual cause is determined, Dr. Batra suggests some preventative measures. She says Frankie should wear sun protective clothing and use a good quality mineral-based broad-spectrum sunscreen. She thinks this will serve Frankie better than using antihistamines and cortisone to put on after the inflammation has already occurred.
To send Frankie on her way The Doctors have found dermatologist Dr. Joel Spiro who has offered to do a consultation and put Frankie on a treatment plan. Dr. Chris Smith will do another round of allergy testing and Kathleen Cronin of Colour Cosmetics (provided she is a candidate) will gift her a paramedical micropigmentation tattoo to help restore her lip color.