By 2005, she seemed to experience an attack nearly every Saturday, sometimes at home while getting ready to photograph a wedding, at other times in the middle of a shoot. Grigsby worried that her job was stressing her out, but wondered how: She enjoyed photographing weddings and didn’t feel anxious.
Several times, Grigsby said, the itching got so bad she jumped in her car and drove to a nearby emergency room, hoping the doctor on duty could figure out what was wrong. But while sitting in the waiting room the problem would go away; feeling foolish, Grigsby would leave before seeing a doctor, relieved that she didn’t have to describe symptoms that sounded psychosomatic.
Many months after her last trip to the ER, Grigsby learned the improbable reason for her intense bouts of prickly itching.
At first Grigsby, now 64, thought her problem might be an intense reaction to a soap or skin lotion. She switched brands many times, then made an appointment with her allergist; he performed skin tests intended to induce the episodes, but could not replicate the itching. He told her he suspected the problem was an exacerbation of her mold allergy.
The doctor prescribed various antihistamines and, to retard the growth of mold in her home, told her to use large fans and lights in areas prone to dampness.
None of the measures worked, and the episodes became more frequent.
Grigsby bought new towels. She tried to stay out of her bedroom closet, fearing it harbored mold spores. She even used a different bathroom in her house. When nothing helped, she began to think her problem was stress-related.
In 2006, Grigsby consulted her internist, who after three visits referred her to a dermatologist, Jay Viernes.
During their first appointment, on a Friday afternoon in October, Viernes peppered Grigsby with questions, most focused on the timing of her attacks and possible triggers.
He then advised her to take only cool showers and to call him Monday to report whether the water temperature had made a difference.
“When we train, we learn that itching is a big cause of complaint with patients,” Viernes said. Unexplained itching, he noted, has numerous causes. Most cases are harmless and clear up on their own with little or no treatment, but itching can also be a symptom of serious illness, including several cancers and a blood disorder.
Viernes said that his first thought was that Grigsby might have cholinergic uticaria, a form of itchy hives triggered by heat, although she did not have the classic red blotches characteristic of hives. A second, more exotic diagnosis occurred to him, one he spent part of that weekend researching, just in case.