They are the face and the cross of follicular lymphoma. Ana's big eyes express joy: “I am here thanks to research.”. I've had cancer in remission for two years.”. Perhaps, a contained happiness, because in front of her, in conversation, the two c

What happens when your skin rebels against you? The case of atopic dermatitis is much more than a skin rash. It's a daily fight against itch, pain and shame, and more common than you think. It is one of the most common inflammatory pathologies, affecting 20% of children and 10% of adults.. But, even so, there is great ignorance about the enormous impact that this disease has on the lives of patients.

“The skin is the way in which we relate to the environment and what happens with atopic dermatitis is that an immunological disorder occurs that causes this barrier to alter, react by thickening and fighting brutally,” explains Pablo Coto. , dermatologist at the Vital Álvarez Buylla Hospital in Mieres. Most of the diagnoses occur at an early age, between three and twelve months, while in adults it is more complex, because “sometimes it reappears after having disappeared as a child or because it is an adult when they have their first episode,” details.

The main symptom of this dysfunction is, without a doubt, itching, which causes the need to scratch the skin to try to relieve it, which triggers a continuous cycle of itching and scratching.. This is the trigger for a series of consequences that affect daily activities such as sleep, work and studies.. Not in vain, half of adults with this condition have sleep disturbances an average of 162 nights a year and, at least 87%, have problems falling asleep almost always.

The psychological toll that is paid carries a high price. “Anxiety, depression, isolation, frustration and even self-medication occur, with abuse of substances such as marijuana to make the itch go away,” says the expert.. According to the Spanish Society of Allergology and Clinical Immunology, these types of problems occur in up to 50% of patients.. And not only that. It must be taken into account that people with atopic dermatitis have a higher risk of developing other atopic disorders such as asthma, rhinitis or food allergies.

Beyond all of the above, Coto highlights the high degree of social trivialization that surrounds this disease, since many people consider it mild and that it only affects the skin.. He also believes that there is a “lack of education and re-education of primary care doctors when treating the patient” and that “sometimes it is diagnosed without having it, in addition to the fact that a soap and other products business has been set up. that trivialize it,” he asserts.

While this problem has persisted over time, Coto warns that the incidence of the disease has tripled in recent decades due to several factors.. Among them, urbanization and hygiene theory, which suggests that less exposure to allergens in childhood may increase predisposition to disease.. They have also had to do with it, he says, the alteration of the intestinal microbiota due to changes in diet and medications, and the fact that the availability of treatments has led to an increase in diagnoses.

NOTABLE PROGRESS

The encouraging aspect lies in the great advances recorded, thanks to better knowledge of the disease.. “Drugs have been developed that are monoclonal antibodies and small molecules that attack or inhibit proteins specifically inherited in patients with atopic dermatitis and that give a high hope of living without it,” explains Coto.

For this reason, he believes that it is very important that an adequate identification be made, to refer the patient early to the specialist and find the ideal treatment: “You have to be aware that you can be well, thanks to therapeutic alternatives with which to modify the course of the disease without having to resign.”

This ambition, he clarifies, must be shared by the dermatologist: “You cannot be satisfied with relieving the patient, but you must go further and address the remission of the disease and fight for therapeutic alternatives, because they are rare drugs that, unfortunately, They do not have the same accessibility in all Spanish communities for economic reasons.

The discrepancy between what the doctor and the patient see continues to be one of the challenges to be faced. “Perhaps the dermatologist perceives that the affected body surface has gone from 30% to 10%, but does not take into account that the person's priority is to alleviate the symptoms, because they are still not sleeping and scratching,” he warns.. This, he adds, is what highlights the need to incorporate common tools and records for evaluation and measurement of results and reported experiences.

He also perceives it as essential to improve psychosocial care for the sick, for which he sees virtual worlds and the metaverse as a solution for the future.. In fact, he has already led the first meeting with patients through a tool that, he hopes, will become the new ally in their fight against this disease.

Fernando Valladares (Mar de Plata, Argentina, 1965) is one of the great communicators of climate change. The biologist, ecologist and CSIC researcher, winner of the BBVA Foundation Prize for Biodiversity Conservation, has been lavish in recent years in the mainstream media and on social networks, but until now he had never faced the challenge of condensing his knowledge, intuitions and hopes in an informative book. Recivilization (Destino) gives the title to its firm commitment to a different future, with its feet firmly rooted in the present and reviewing “the challenges, setbacks and motivations” of this turbulent 21st century.

Will the extreme summer of 2023 be the new normal? The word normal does not fit anywhere. Everything is going to be very changeable and very variable, and we are going to continue breaking temperature records at a very high speed, to a certain extent unpredictable.. We have had a series of summers in a row that are not normal at all; They are rather extraordinary for what has happened in the last century and a half, since when we have records and instrumentation. We have been able to calculate what the temperatures have been in the last 100,000 years, and even on that scale it is not normal at all. We are in an exponential phase. Although one thing seems certain: with all the heat we have been through, we are going to remember these summers as the coolest of those yet to live. Do we have to be prepared for devastating storms like Daniel, after what we have seen in Libya? It has been a real catastrophe, not only in Libya, but also in Greece. Everything happened in a chain, from the cold drop and the DANA that we had in Spain. The intensity of rainfall can only be explained by an extraordinarily warm sea, and that is what is happening in the Mediterranean. We have now had record temperatures in the world's seas for three years. And the thermal anomaly cannot be explained by El Niño alone (the natural warming phenomenon of the Pacific). In temperate zones, tropical cyclones are being declared, and the term medicanes or Mediterranean hurricanes has already been coined.. It will happen more and more frequently. Stored heat makes precipitation more torrential and catastrophic. And this is an effect of climate change. Don't we run the risk of turning climate change into the scapegoat for all evils? Of course we run that risk, and of simplifying things so much that in the end everything is climate change, with which “nothing is climate change”, and in the end we feed denialism and hoaxes. But a society that does not assume the level of risk we are in will pay dearly for the consequences, we are already paying them.. We live in a conformist and self-soothing society, and this is where scientists come and worry people with news about climate change.. But we are going to need not only scientists, but also sociologists, psychologists or anthropologists to see how we manage this risk, and how we also deal with the uncertainties that await us along the way.. There are risks, but you have to assume them. And one of them is to trust scientists. There is also the risk of not trusting scientists when perhaps they are the only ones who can get us out of this mess.. Society has the last word. North American climatologist Patrick T. Brown recently sparked controversy by confessing that he cherry-picked the data to conclude that climate change had increased the risk of fires in California to “maximize” the chances of seeing his study published in Nature.. The question was asked by the Los Angeles Times: Can we trust scientists? I would respond with a counterquestion.. Who wants to question trust in scientists? Undoubtedly, there are scientists of all colors, just as there are people who are not willing to listen to the truth.. There are also people who believe that science is exact and unanimous.. It must be emphasized in passing that climate change is a very complex issue, and that in science there are many nuances. Who wants to trust the nuances? Or in the resounding statement of some scientist who claims to pronounce himself in a very striking way? I believe that society generally trusts scientists, and we see surveys in all countries in which they are among the most highly valued professionals.. In companies, there are those who trust scientists and those who are not interested. And the politicians? In the sector of those who make the big decisions, there are also skeptics of scientists. But of course we can trust the scientists. When faced with key problems, they are much better prepared to analyze, make assessments and foresee the consequences of something as complex as climate change.. Now, scientists are people, and we have biases, and limitations, errors and emotions, no matter how much we pretend to be objective and neutral. Can you be a scientist and an activist at the same time? It is evident that you can be things. It is not incompatible at all, rather they are two activities that complement each other.. I remember what Einstein said: “With the privilege of knowledge comes the responsibility of action.”. In his case, he referred to the implications of nuclear energy. With the impact of climate change, I would say that scientists have a responsibility to be activists. I greatly respect scientists who are not scientists and who remain focused on the pure task of research.. But there has to be diversity, as in all changes. I also greatly respect, for example, the IPCC scientists who have turned to activism, and have spent days in jail. I have not reached that extreme, but what is happening disconcerts me, distracts me, and worries me.. I believe that scientists can go beyond mere communication and help break down inertia in society.. Our studies are often the basis of the activism of groups such as Extinction Rebellion or Fridays by Future. I would even say that we are “blackleg” activists, because we understand the implications of what is happening. How many times have you been called an alarmist or fatalist? More alarmist than fatalist…. But when I sound the alarm, I always put the counterpoint and warn that the window is closing, as if implying that we still have room for action.. Although it is more of a metaphorical idea, since we are looking at an old window that does not close properly, and there will always be gaps left.. What does close is the window open to great opportunities to keep the climate within the security zone. And how much time do we have? There are many studies trying to establish a date of no return. I would say we have a decade left to take climate change very seriously. Every time we have to do more things in less time. Although I am not in favor of setting our objectives in stone either.. Sustainability is a process, not a goal that we have to impose ourselves with a business perspective. It's not bad to have a goal, but we're not going to put it around our neck like a noose.. Recivilizing is also putting the focus on the process, truly living in the present, which is the only thing we have. In your book you talk about three possible scenarios: extinction/collapse, authoritarianism and transformation. Which do you think is the most likely? Personally, what do you think? What excites me the most and makes me get out of bed every day is the idea that the transformation we need is still possible. But that depends on the level of euphoria or optimism you have that day.. I still see strands of common sense in society that point towards that path, although I don't always see it clearly.. I hope that this dynamic and transformative horizon ends up emerging, that is why I have written this book. Recivilization begins, however, by confirming this declaration of “war against us and against nature” in which we are. It is a call to take advantage of this historical situation in the that we live in, in which many things are happening and will happen, pleasant and unpleasant, terrible and peaceful, and in which more and more changes are going to occur. My intention has been to raise questions that affect the essence of civilization. We know that we are in a critical moment, and in the face of this we can remain impassive and cling to the status quo or, as I propose in the book, take advantage of the opportunity to become “civilized” again.. Civilization is ultimately a will, a human objective, and we have done it wrong. We have set ourselves a course of conflict and collapse, we have adopted a belligerent, aggressive and violent attitude that is turning against us. The time has come to call a truce and turn the way we do things upside down. Among other “basic decisions” that the book raises is that of degrowth, a word that scares many people. It is normal for people to twist the gesture when you hear decrease, I would be surprised if they didn't do it. From the moment we are born, we grow, and we are weighed and measured to verify it.. Growing has always meant earning more, the formula for individual success. How are you going to convince people that decreasing collectively can be the new measure of success? I try in the book with several narratives, I try to be kind, present arguments that encourage complicity and empathy, and make people see everything that there is to gain from degrowth.. But of course it is a topic that raises blisters, and there are those who prefer to call it post-growth. I prefer to talk about degrowth because it is a term that does not raise doubts.. As a scientist, I am in favor of saying things clearly: we are talking about cooling GDP, reducing production and reducing consumption. What can I do to change the world? The long road from personal changes to collective action. We have made the road longer in recent decades because we have stopped living in society.. We are a collection of individuals, where the individual is rewarded and where it is difficult for us to put ourselves in the context of society.. To change this civilization, we have to agree on some essential things. We have gone too far by valuing individuality, which has to be communal for society to prosper.. We must find a balance. When one launches into environmental activism, one must be well armed psychologically. We must not forget about personal care, because the path begins precisely with ourselves.. What we also cannot do is fall into eco-anxiety or depression, and remain blocked precisely because of the knowledge we have.. We need everyone to push to change the world. Are climate summits useful for anything? What can we expect from COP28 in Dubai, taking into account that oil is playing at home? It is not lost on anyone that COP28 is going to be a gigantic exercise in hypocrisy. A lot of money is going to be spent to make people believe that we are better than we are, and to ensure that fossil fuel companies do not fail, because we continue to think that they are essential and that we have to continue burning until there is not a drop left. more oil. Now, hypocrisy sometimes has good things, because it allows us to reconcile contradictory bets, such as those of environmentalists and oil companies.. A little hypocrisy can grease diplomacy. But I also fear that COP28 could polarize positions, in this context of geopolitical tension and distrust in institutions.. At least I hope that a way is found to finance the global south, to be able to deal with disasters like the one we have seen in Libya.

La Recivilización, by Fernando Valladares, is now on sale (Editorial Destino). You can buy it here.