Can Simultaneous Psoriasis and Granuloma Annulare Annihilate Each Other?

In a previous post on this blog, I reported a patient who had psoriasis, granuloma annulare (GA), and alopecia areata. I recently saw two more cases where psoriasis was coincidentally associated with GA.

Case 1. A middle-aged lady was referred by her primary care doctor for a rash on the legs. Some of … Continue reading

Rash in a Patient with HIV Infection

A 50-year-old man presented  for the diagnosis and treatment of a rash on his legs and back for about 1 and 1/2 years. His past medical history was significant for HIV infection which had been treated with Highly Active Anti-Retroviral Therapy (HAART). He stated that his viral counts were undetectable and … Continue reading

Coexistence of 3 Autoimmune Diseases: Granuloma Annulare and Psoriasis and Alopecia Areata

A middle-aged woman consulted me for a rash on her palms and backs of hands for several years’ duration.  The rash consisted of smooth pinkish-red bumps on the knuckles and rings and arcs on the palms with central clearing. … Continue reading

Psoriasis Associated with Plaquenil (Hydroxychloroquine)

The following case studies illustrate examples where Plaquenil administration was associated with either new onset psoriasis or flaring of pre-existing psoriasis.

Case 1. A middle-aged woman sought another opinion for a puzzling rash which had been seen by two dermatologists. At first, skin biopsies showed features of eczema. Subsequent biopsies … Continue reading

Do I Have Lupus, Doctor?

Systemic Lupus Erythematosus (SLE) is a devastating autoimmune disease that can affect nearly every organ system in the body. The skin is no exception, and in fact, may be involved in 70-80% of cases. An equal number of patients may experience abnormal sun or ultraviolet light sensitivity, called photosensitivity. There are … Continue reading

How Efficient Is Your Dermatologist? Example from My Practice-Eczema or Ringworm

Dermatologists can be incredibly efficient and cost-effective in their practices because of their background and training in medicine and surgical procedures. We are not often acknowledged or appreciated for this by health insurance companies. The skin is the largest  organ in the body and plays an important role in immune … 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