It’s therefore natural to think of antibiotic therapy as the natural opposite of steroids, and this has some truth to it. In the case of infection — which, remember, is not the only cause of inflammation — steroids do inhibit the immune response. But bear in mind that antibiotics do not, as a general rule, actually support or promote the body’s inflammatory response; rather, they work independently by attacking the infection directly along their own pathways. The result is that some pathologies (such as the contentious cases of sepsis and epiglottitis) may respond both to steroids — to manage the excessive inflammatory response — and antibiotics — to help eliminate the source infection.
Treatment: If a pancreatic or liver tumor is identified and able to be surgically excised, the skin lesions may normalize for an extended period of time, but because these tumors metastasize (spread to other areas of the body) quickly, surgery is not curative. In cases of end stage liver disease, surgery is not possible, and the goal of therapy is to increase quality of life and decrease uncomfortable skin lesions with supportive care and addressing the nutritional abnormalities. Supportive care includes supplementing protein and necessary minerals and enzymes through the diet and oral supplements or by weekly intravenous amino acid infusions that are performed in the hospital on an outpatient basis until improvement in the skin is noted. Unfortunately, despite the supportive care, the disease will progress.
“I absolutely don’t think it’s in a better place. [With the introduction of the] biological passport combined with [Floyd] Landis testing positive, that was that moment when this s*** is getting real. The big shift did not happen in 2012. You guys can decide if he [Brian Cookson, the International Cycling Union president] has done a good job, if he’s been tough on Astana [the Kazakh team who had five riders from their senior and development teams test positive in 2014], whether he’s stuck with his mission statement. Plenty of people would argue he’s laid down on a lot of things, whether it’s expedited TUEs [Therapeutic Use Exemptions], Astana.”