Bullous Pemphigoid: Please Don’t Confuse It With Pemphigus Vulgaris

Bullous Pemphigoid (BP) is an uncommon autoimmune skin disease which leads to a very

itchy hive-like rash and blisters.  The blisters can occur anywhere on the body, but the underarms, arms, groins, and lower legs seem more commonly affected in my experience, sometimes limited to these areas alone.  The mucous … Continue reading

Psoriasis Treatments

Psoriasis is a heavy burden for both the physical and economic health of the nation, affecting about 7.5 million Americans.  The annual cost for treating psoriasis in the U.S. in 2008 was $11.25 billion.  The average cost per patient, estimated at $5500 per year, is much higher for more severe … Continue reading

When Should a Primary Care Doc Refer to a Dermatologist?

The answer to the question depends on the extent of training in dermatology and the individual physician’s comfort level in dealing with skin diseases.  Currently, the definition of “primary care providers” includes family practitioners, internists, pediatricians, and gynecologists, but may be expanded to include nurse practitioners.  The education of U.S. medical … Continue reading

Cyclosporine, Psoriasis, and Grapefruit Juice

Cyclosporine (CS), a potent immunosuppressive peptide, was discovered by Sandoz in 1975.  Clinical testing showed that it was very effective for preventing rejection of life-saving organ transplants such as kidney, heart, liver, and bone marrow.  Investigators also noted the impressive ability of CS to clear up any psoriasis on the … Continue reading

Rosai-Dorfman Disease

Rosai-Dorfman disease (RDD) is a rare disease characterized by proliferation of histiocytes in lymph nodes and other organs.  Skin involvement occurs in about 10% of systemic cases, but more cases of skin-limited RDD are being recognized, especially in women, based on recent case reports and personal experience.

The other name … Continue reading

REM Syndrome

What is REM syndrome?  It sounds like it could be a rock band, a sleep disorder, or science fiction, but it’s actually a rare skin disease.  I will present a brief case history.

A middle-aged women was referred by her Dermatologist for a rash of 3 years’ duration.  A skin … Continue reading

Importance of the Second Opinion: Editorial with Illustrative Cases

When I worked as a Dermatologist at the Cleveland Clinic, we encountered many patients    who were either referred by an outside Dermatologist, or self-referred, for a second opinion on their diagnosis or treatment or both.  Most patients would bring copies of their records for us to review, and invariably, … Continue reading

Painful Oral Erosions and White Patches

Case Report

A 55-year-old man presented with painful, burning sores in his mouth for several weeks,

aggravated by eating spicy foods and caffeine-containing drinks.  Examination showed multiple irregularly shaped erosions with yellow bases and a few white circular areas on the inside of both cheeks (the buccal mucosae).  An oral … Continue reading

Two Novel Treatments for Oral Lichen Planus Hold Promise

In the May 2012 issue of the Journal of the American Academy of Dermatology, there were two separate articles introducing new treatments for moderate to severe oral erosive lichen planus, the most difficult form of the disease to treat.

Curcumin Curcumin is the health-promoting compound derived from the Indian spice … Continue reading