Contact Dr. Camisa

Naples Office
261 9th St. South
Naples, FL 34102
239-216-4337

 

Fort Myers Office
7331 Gladiolus Drive
Fort Myers, FL 33908
239-437-8810

 


 

All Natural Products
Dermexelle is a healing aid for superficial wounds, burns, fissures and ulcerations. Apply to wound 2-3 times daily.

 

 

 

 

SweetFeet cream is used for moisturization and healing of dry, sore, cracked skin of palms and soles, especially psoriasis and eczema. Massage into skin at bedtime. Cotton gloves or socks are optional
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81 Responses to Contact Dr. Camisa

  1. amy daltrui says:

    Hi Dr Camisa-
    I’m sure you don’t remember me… but you were my doctor about ten years ago at Cleveland Clinic in naples. I have had varying degrees of Alopecia Areata for the past twelve years. I am interested in new treatments including the Excimer Laser. Have you tried this treatment for AA?
    Amy

  2. Colby says:

    Dear Dr. Camisa,
    I have had a mysterious medical journey over the past 3-4 years, and after reading some of your website, I think perhaps you can help. I am a white, otherwise healthy young 40 year old.
    Three years ago I had a breakout of painful sores on several areas of my body that my dermatologist at the time biopsied and determined to be sweets syndrome. I have had two subsequent breakouts of same sores since then all successfully cleared up with with prednisone treatment. I often feel as if they are brewing just under the skin… (sounds strange..)
    Additionally, two and a half years ago I began have mouth pain and discomfort. This was ultimately found to be sjogrens syndrome via blood tests. I am currently under the care of a rheumatologist, but I still feel there is more going on and that all these odd issues are somehow related. I’m taking several medications and perhaps they help, but I’m still suffering- considerably.
    I have marked fatigue unlike anything I’ve ever experienced before and I am generally “achy” and uncomfortable.
    I look like a perfectly healthy woman which makes it difficult for others to understand how this has changed my quality of life.
    Please let me know if you think you may be able to help me get to the bottom of these strange diagnoses. I appreciate your input.

    • DrCamisa says:

      The cause of Sweet’s is unknown, and Sjogren’s is considered autoimmune in the same family as lupus, scleroderma, and rheumatoid arthritis. I am not certain if there is any connection. Sjogren’s is usually treated with a combination of prednisone, plaquenil, and saliva-producers such as Evoxac and Pilocarpine. Sjogren’s symptoms can overlap with the other diseases in the family, so I think it’s appropriate to stay with the rheumatologist or consult another one at a major center such as the Univ of Pittsburgh or the Mayo Clinic. If you get another breakout, it might be helpful to take additional skin biopsies with direct immunofluorescence testing to rule out other connective tissue diseases.

  3. Suhasini Ramalingam says:

    Dear Dr. Camisa,

    I am in market research and unable to get a good read on the prevalence and incidence of pustular psoriasis in the US. Your papers (extremely well written) on the same has the prevalence at 1.7%-2% of all psoriasis cases. Yet other articles and a French epi study puts incidence at 0.64 and prevalence at 1.76 per one million. I work for a biotech in CA and since the numbers are vastly different, any help to clarify would be very much appreciated.

    Thank you,
    Su

    • DrCamisa says:

      It is difficult to compare prevalence in an entire population and prevalence in the much smaller subset of psoriasis patients. If we use round numbers just for simplicity sake, if psoriasis affects 2% of the US population (let’s put it at 300,000,000 for the example), then there are 6,000,000 people living in the US with psoriasis. Now if 2% of these folks have pustular psoriasis, then there are 120,000 souls. If the estimate is closer to 1%, then there are only 60,000 people affected. I would combine the numbers of generalized, localized, and palm/sole pustular cases. Based on my experience in our Psoriasis Treatment Centers, I believe pustular psoriasis accounts for 1-2% of all our cases. The skew of referral may inflate the numbers a bit. I hope that helps.

  4. a davis says:

    Dear Dr Camisa,

    I am a PhD educated physical scientist who has recently become interested in the HPV virus due to a sudden widespread outbreak of “sebbhoreic keratoses” (SK) accompanied by a ‘premalignant lesion’ appearing on my neck. Within a few weeks, I now have gum problems and lichen planus in my mouth and also I can feel patches of my skin becoming more inflamed (no new soap used in these areas).

    I believe 100% that my ‘sebbhoreic keratoses’ are viral in origin (I won’t go into detail here) – and as well as the brown splotches I have teeny tiny bumps/warts visible on my skin that do not clear up except on application of garlic or clotrimazole cream or very, very slowly with use of sulphur soap (corrosive wart killers spread them as they are too small to hit cleanly). I also believe my mouth problems are viral (gums perfectly healthy one week, look odd and horrible a fortnight later).

    • DrCamisa says:

      The azole anti-fungals have some mild anti-bacterial effect and possibly antiviral as well, as you suggested. I believe they also provide some anti-inflammatory effects because I have been able to help some folks with oral erosive lichen planus with a weekly oral dose of fluconazole.

  5. Nikki Trush says:

    Hi Dr Camisa,
    I have a question about the growth and metastasis of skin cancers, specifically basal cell carcinoma and squamous cell carcinoma. Can you break down the cell biology, explaining why a squamous cell carcinoma will metastisize and basal cell carcinoma will not (or rarely).

    Thank you for your time!

    • DrCamisa says:

      This is a really complicated issue. I will try to answer without oversimplifying, but I can assure you that there are many details I have left out, and even more yet to be discovered.
      Much is known about these two common “non-melanoma skin cancers,” but some of what follows is theoretical. First, both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are derived from skin epithelial cells that have been exposed to excessive sun exposure over many years. BCC tend to occur in skin where there are more sebaceous (oil) glands. It is believed that both types of cancer start with a mutation in a tumor suppressor gene in a single cell, and that cell replicates many times to form the tumor. More mutations occur in both types over time, but BCC tend to have the mutations on chromosome #9 and SCC have mutations on multiple chromosomes.
      As you said, BCC almost never metastasize to lymph nodes or other body organs, but they are locally invasive and destructive. SCC are biologically capable of metastasizing, however, you should understand that for chronically sun-damaged skin, the rate of metastasis is only about 5%. (It is much higher for SCC of mucous membranes, but there is no BCC counterpart to compare.)
      So far, the best theory as to why one metastasizes and the other does not, pertains to the stroma or dermal connective tissue surrounding the nests of BCC or SCC. The stroma is produced by fibroblasts in the dermis below the epithelium. The BCC are unconditionally dependent on this stroma for their growth and survival whereas the stroma of SCC are non-specific allowing these cells to grow at sites distant from the original tumor.

    • DrCamisa says:

      Try this: the malignant basal cells induce a stroma that envelops and nourishes them; they cannot live without this stroma and do not migrate (metastasize) away from it. The basal cells also secrete enzymes that digest protein that helps them destroy and invade adjacent healthy tissue. Does that help?

  6. Nikki Trush says:

    Thank you for taking the time to break that down. Though I had a read through it a couple times, I now have a greater understanding.

  7. JILL PAUL says:

    I live in California and have seen 2 Dermatologists + a Podiatrist for Psoriasis which was newly diagnosed 6 months ago. None of the Docs can give me any insight into my “NAIL” psoriasis and what to do for it. It is very embarrassing and rather painful. My Podiatrist today cut back my toe nails but wouldn’t address the finger nail problem. I think the Dermatologists just don’t know what to do. By the way, I am a seasoned RN with 42 years’ experience. I am sending a pic of one of my nails to Jackie who hopefully will show you on Friday and you can give an opinion. Short of cutting off my finger, I have no clue what to do. No one will advise – period. I would be happy to provide Medicare No. etc if that is what you require for a second opinion. I am running out of options here in California. Thank you so much.

    • DrCamisa says:

      Psoriasis of the nails is difficult but can be treated in many ways. Psoralen plus ultraviolet light (PUVA) helps. I used to give injections of diluted Kenalog, a steroid, and that worked great except it had to be repeated every month or two to maintain improvement. The injections are painful. Any internal drug that helps to clear the skin of psoriasis has the potential to also clear the nail disease. These treatments include methotrexate, cyclosporine, Enbrel, Humira, Remicade, and Stelara. More detailed info about nail psoriasis is available in my textbook Handbook of Psoriasis, ed.2, in the chapter on nails.

      • JILL PAUL says:

        Thank you Dr. Camisa. My twin who saw you yesterday in Naples advised me to buy your book which I have done. Unfortunately I did not give her a pic of one of my nails (most problematic) but will send it to her for her return visit to you. I would say that the other 9 finger nails are typical of Psoriasis – the one is not. Thank you.

        • DrCamisa says:

          It is certainly possible to have more than one nail problem at the same time, for example, psoriasis + fungal infection or psoriasis + effects of trauma to the nail. Let me know what you think of the book.

          • JILL PAUL says:

            Dr. Camisa: My twin who sees you tomorrow will not take a pic with her. If you could steer me in the right direction with someone at UCLA or S. Cal. who has a passion for Psoriasis like you seem to have, I would really appreciate knowing who to go to out here. I do believe that I have traumatized this one finger. I desperately need someone to advise me on how to remedy the situation. Just received your book yesterday and am looking forward to reading it. Since I am an RN, I’m glad to see that it will appeal to professionals as well as lay people. Thank you.

          • DrCamisa says:

            I will look into a referral for you in your area. I actually wrote the Handbook of Psoriasis for Dermatologists, Dermatology Residents, medical students, and allied professionals. Patients just like to get it to learn about their condition in more detail. I tried to write it in a conversational style to make it easier to understand and enjoy. I’d be interested in your feedback. Best regards.

  8. aleisha says:

    Hi Dr. Camisa,

    I am from the Caribbean and I am currently seeking a top Dermatologist in the US. Do you also specialize in Discoid Lupus (DLE)?

  9. JILL PAUL says:

    I saw my Internist yesterday and he couldn’t believe the state of my one finger nail. Talked to my twin today and she said that possibly you had a name for me out here on the west coast. That would be wonderful since I doubt I’ll get to Fl in the near future. You have my email address so that would be best. Thank you so much Dr. Camisa. Still perusing your book and loving all the info. So much to digest. Thanks again.

    • DrCamisa says:

      I have names of some excellent dermatologists in your city as well as neighboring cities if you wish to travel: LA- A.Paul Kelly, Robt Modlin, Ron Reisner; Irvine-Charles Sexton, Gerald Weinstein; San Diego-Neal Bhatia, Philip Cohen, Richard Fitzpatrick; Sacramento-Peter Lynch.

  10. Allan says:

    Hi Dr Camisa,

    My son is being followed by a local dermatologist for Isoretinoin therapy. He is two months into his course, and so far it has been uneventful. His only significant co-morbidity is mild CAH for which he does take steroid replacements, but he has reached a full adult height of over 6 feet.

    My question is this…

    I’m being charged a E/M code of 99215 which I think is excessive for the history and physical performed. What would be your criteria for determining the appropriate level of care provided, and how would you code this type of office follow up? Could you justify a 99215 level visit?

    • DrCamisa says:

      The level of coding for billing is based on a certain number of points in the history, personal, family,social, review of systems, physical exam, and complexity of decision-making. A coder would have to audit every entry on the progress note to verify the level. I would start with asking the doctor’s billing agent about the appropriateness of the level charged. This is not my area of expertise.

  11. Jul says:

    I had a case of optic neuritis in July of 2012. I tested positive for the SSA antibody. All other tests came back negative. The first rheumatologist (the only one in our area) wrote me off because it wasn’t positive enough. Since then, the ssa level has elevated from 1.1 to 2.8. I have a butterfly rash that comes and goes. The second rheumatologist ordered a lip biopsy that came back negative. Could there be nothing wrong with me? I have had many other symptoms. I currently have issues with swelling in the center knuckle of my pointer and middle fingers. I need an opinion. I have stopped calling the doctors. Nobody knows anything! What’s your opinion?

    • DrCamisa says:

      Positive SSA antibodies are associated with Sjogren’s syndrome and subacute cultaneous lupus and sun sensitivity.Sometimes it’s not possible to make a definite diagnosis with only one positive antibody and a transient rash. It may be necessary to wait until more tests become positive or more symptoms develop. It might be helpful to have a dermatologist see the rash when it develops and perform a biopsy with direct immunofluorescence testing if it is indicated.

  12. Pat G says:

    I was recently diagnosed at your office with LichenPlanus/Frontal Fibrosing Alopecia. I was started on plaquenil a few weeks ago.
    Today I was reading your blog and noticed that 2 medications that can be responsible for this are HCTZ and Naprosen both of which I have been taking for some time. I wonder if i should be stopping those meds. Also I have in the past week developed some sore spots on the sides of my tongue and in the back area of the soft palate.

    • DrCamisa says:

      Although I think it unlikely that drugs cause the FFA-type of LP, I would certainly try stopping one of the drugs at a time. I recommend stopping naproxen first for at least a month before stopping the HCTZ. You should only do this with the consent of the doctor who prescribed these drugs in case you need to take a substitute in their place.

  13. donna says:

    my husband has a rash on thigh for 3 months ,saw dr had biopsy findings were not completely diagnostic says deep perivascular ,focally interstitial lymphocytic infiltrate which spares epidermis there is amphophilic granular amorphous material increased connective tissue mucin pas stain neg.for fungal hyphae ,now the rash is on hips lower belly has appt. with dermotologist in aug. can be seen before that what can we do for rash in meantime and can this be serious we r at wits end thank you

    • DrCamisa says:

      I’m sorry that I am unable to answer your questions. When a skin biopsy gives non-specific results, and the rash cannot be diagnosed from its visual appearance and pattern of distribution on the body, then it is usually necessary to perform additional biopsies from lesions in different stages of development. If an autoimmune problem is suspected, then it is helpful to take a skin biopsy for direct immunofluoresence testing as well.

  14. Shireen says:

    Good Day

    I have been conducting research of Lichen Planus on the skin and came across your website. I have been to a dermatologist and did the patch test to confirm I have Lichen Planus.

    I was given a course of prednisone, and the side effects really made me uncomfortable, especially weight gain. I have been using a steroid ointment which seems to help, but I think that too now could be having fading effects. After the meds there was a stop in the skin rashes, but has returned now and new spots are appearing. Can you please advise what other medication or ointments I could use to stop this completely?

    Shireen

    • DrCamisa says:

      Firstly, when you say “patch test,” I assume you meant “skin biopsy.” A skin biopsy can give a definite diagnosis of lichen planus (LP), but patch tests are used to detect skin allergies which are rarely the cause of LP. Generalized skin LP is often acute and eruptive and may resolve spontaneously within months, but sometimes it becomes a more chronic condition with flares and improvements over a period of years. Steroids, both internal and external are appropriate for the acute flares of LP. Increase in appetite with weight gain is a common side-effect of prednisone along with many others. It is also possible for the skin disease to become more resistant to the same topical steroid cream if used constantly for many months.
      For longer-lasting cases of LP, dermatologists have resorted to ultraviolet light therapy (either narrow-band UVB or PUVA) and the vitamin A-like drug called acitretin (not appropriate for women of child-bearing potential). For more severe cases, the immunosuppessive drug called mycophenolate mofetil has been used.

  15. Karen Sebo says:

    I have been dxd with discoid lupus mild case. I have been taking 400mg if plaquenil for 3 months seems a little better. Will the plaq prevent scarring and new lesions and when will the plaq clear up my the lesions have a few on each check and three on my scalpline on the forehead. I guess I am looking for a miracle. I am an outdoor person and am really scared of sun exposure now will I ever be able to be outside in the sun again without any protection. What treatment would u prescribe. Does lupus profundus accompany Dle, and am I able to go into subacute or systemic. I also have been itching constantly is their anything I can take. Dies plaq help with sun sensitivity or make u more sensitive to the sun I find differing opinions, is their any procedure that can take away the scarring. I hope one day their will be a cure because I do not like living my life inside.

    • DrCamisa says:

      Sun avoidance and sun protection are important components of cutaneous lupus treatment. One doesn’t have to stay indoors. Wearing a hat protects the scalp. Broad spectrum sunscreens (blocking UVA and UVB) protect exposed parts of the face as long as the SPF# is 30 or higher. It also must be reapplied after 2 hours.
      Plaquenil is an excellent drug for lupus and other sun-sensitive diseases. Cigarette-smoking interferes with the effectiveness of plaquenil, and therefore must be stopped. There is also a fern-extract pill called Heliocare which acts as an oral sunscreen pill which can add to the protection provided by topical sunscreens.
      Topical steroids are often prescribed along with plaquenil to help reduce the inflammation and scarring of lupus lesions. Some scarring caused by discoid lupus (DLE) may be permanent. Camouflage may be the best alternative because corrective surgical procedures may cause a flare of the lupus. Some cases of DLE go into complete remission.
      Lupus profundus is inflammation in the fatty tissues and is much less common than DLE. I have seen the two occur together in one patient, but I think that is rare. Patients with DLE have about a 10% chance of developing systemic lupus, but lupus profundus has a much higher risk, about 40-50%.

  16. Carol Mitasky says:

    Dear Dr. Camisa, Greetings…. I am a 54 year old woman with Cicatricial Pemphigoid. I currently live in the Boston area, and I have tried every treatment that my doctors know to try for my disease. I currently am undergoing a regimen of rituxan infusions ( 8 wk intervals ) and so far that is not deterring this disease from taking over my mouth (gums and throat), and now is spreading to some areas of my upper back. I have had many trips to the E.R. due to the lesions causing my airway to constrict. So far the disease is not in my eyes, and I am checked regularly for any signs of that. I document my illness very well with doctor visits and by taking pictures of CP’s progression. I guess I’m just wondering if you could offer me any hope of putting this disease into some kind of remission. I am open to suggestions, and even traveling to you ( I have health insurance )if you would consider helping me. Thank you for your time……Sincerely

    • DrCamisa says:

      Seeing that you live in Boston makes me believe that you are receiving state of the art care, especially with rituxan which is experimental for Cicatricial Pemphigoid (CP). Some experts, including Dr Ahmad in Boston, also advocate receiving monthly infusions of IVIG. Maybe you have already tried that. In any case, it is very difficult to get CP into remission.

  17. Carol Mitasky says:

    Thank you for your reply! Yes, you are right….nothing wants to even touch this disease…..and yes, I was seeing Dr. Ahmed in Boston for a few years. He is a very good doctor. Unfortunately though, my second treatment of the IVIG caused me to have aseptic meningitis; which subsequently ended his treatment plan for me. I had Rituxan infusions through Dr. Zachary Spiegelman (also a great doctor), but the treatment did not help at all. I am now doing Rituxan again at a different dosage. So far, no go…..but I am optimistic anyway, and feel like you have to ask around. Maybe there is some magic “pill” just on the horizon….lol! (gotta keep your sense of humor above all!) Thanks for your time. If you do hear of anything, I’ll be here! ; )

  18. Catherine Mires says:

    Dear Dr. Camisa, I am to begin phototherapy for the treatment of CTCL and was wondering if just sun bathing the affected area for a half hour three times a week would not have the same effect as the box?

    • DrCamisa says:

      Not likely. The lamps in the “light box” emit only narrow-band ultraviolet-B rays which are the ones that kill the cancer cells in the skin. Sunlight contains only a small amount of this ray along with plenty of short-wave UVB which causes sunburn and doesn’t help the disease. Sunlight also contains a lot of long-wave UVA which causes tanning and the most common types of skin cancer. Moreover, sunlight has never been tested in research studies like narrow-band UVB. The latter has a 70-80% chance of remission for early stages of CTCL.

  19. Lt says:

    Dear Dr Camisa,
    I am 55 years old and have been diagnosed with the generalizes form of Granuloma Annulare. Thank you for all your work to help improve the lives of people afflicted with these terrible skin diseases and also for your compassion and time you take in answering the many questions on this site.i am wondering if GA is an autoimmune disease? I also am worried that since I have spots on my arms, legs and face that I will get the horrible knuckle lesions as well. Does this happen in most cases? Finally, I am wondering if you know of two studies where patients were successfully treated with ROM therapy? Rifampin, oxyfloxacin , minocycline, once a month each for several months?
    Thank you and god bless you.

    • DrCamisa says:

      I now have 2 patients with generalized GA on ROM therapy. I will report here on their results in 2-3 months after re-evaluating.

  20. Lt says:

    Sorry, the drug is ofloxacin. One of the studies was published in JAMA Dermatology July 2009 vol. 145 #7.
    A doctor I Hamvazi also authored an article,but Iam unable to locate it. It was a follow up to a small study done in India that administered ROM once a month with all patients clearing after a few months. The discussion was that GA supposedly “resembles leprocy ” histalogically”, so the treatment for leprosy was studied on the GA patients. This study was published in the Indian Journal of Dermatology , May -June 2013,197-199. Shillpa Garg and Sukrit Beveja.
    My dermatologist would not even look at this article.
    I have read thousands of threads of GA patients and have come across two patients whom are going to begin this treatment as the word may be getting around that there has been success in small studies of pts with Generalized GA
    You seem like a wonderful, concerned and compassionate physician. I am wondering if you would tell me if you have also come across these studies and what you think about it.
    Any help and insightj would be so very much appreciated.
    Thank you.

    • DrCamisa says:

      Thank you for the info. I found the abstracts for the 2 articles you mentioned. I would just not be comfortable exposing my patients to three different antibiotics because of all of the potential side effects and drug interactions. The authors have a good hypothesis as you clearly outlined, but I think they need to perform a small study that randomizes patients to either placebo or the drug combo and follow them. It’s best if both the investigators and the patients don’t know which they’re getting. Only the pharmacist should know, and he is not involved with the study until it’s over. This is important because granuloma annulare can wax and wane on its own, and it’s possible that such heavy treatment would have a strong placebo-effect.

  21. Judith Jensen says:

    I took dose #4 this AM. Feeling pretty good compared to yesterday. Fingers crossed!

  22. Melody Galka says:

    Dr. Camisa,

    How are you? My husband and I are patients of yours. I have a friend who has Dystrophic Epidermolysis Bulosa. He is 17 years old. It is the Dominant version. I was wondering if you have any research or information on this topic and if you would accept him as a patient. The family has looked into current research but found that the recessive version is given priority and they haven’t found anything worthwhile for the dominant version. He has what looks like Plantars warts on the bottom of both feet and the doctors are afraid to treat them by freezing or by laser due to blistering. He also has restricted movement at the ankle.
    Any help you can provide would be greatly appreciated!

    Thank you! Melody Galka

    • DrCamisa says:

      Hello. This is such a rare disease. I have only seen one case in the last decade! So I am no expert. I’m not even sure if there is any treatment other than preventing trauma that leads to blisters, and preventing or treating infections in open blisters or wounds. I would recommend that patient like this get a consultation from someone who specializes in EB. You can find names and places from the patient advocate group for these diseases called DEBRA.

  23. Yvonne Giroux says:

    I was your patient when living in Naples. I had to move to Michigan, got lichen planus saw 7 derms. Gave me cream steroids,had all fillings removed, have had to have teeth
    pulled now have it in vulva, hair is falling out, nails a mess,toenails have fungus. Worked at desk at clev clinic
    Valet area for 10 years. Can u recommend anyone outside Detroit area . Wish I lived back there. Thank you

    • DrCamisa says:

      This is a very bad case of LP. I think you would have to consult the Dermatology Dept at Ann Arbor or Henry Ford. Good luck.

  24. Yvonne Giroux says:

    Need to add I take hydrachlorathiazide ,Levothyroxine,
    Omeprazole .

    • DrCamisa says:

      Hydrochlorthiazide has been implicated as a possible cause of LP. This might be relevant if the rash started after the drug was taken.

  25. Judith Jensen says:

    I cry “uncle”! I am having the worst breakout of BP on my ankle. Many blisters, swollen, red, hot foot. I am taking the minocycline 2x daily and I called my pharmacist for methotrexate. (05/02). I will cope with the acne, if I break out again. Question is: may I still enjoy my evening cocktail?

    • DrCamisa says:

      Yes, as long as your liver tests stay normal.

      • Judith Jensen says:

        Hello, my friend, here I am again! Perhaps I have been poking around on the Internet too much, but I still have not received any relief from my acne/folliculitis or whatever it is. Since I do have CLL, is it possible that these hard bumps on the nape of my neck are T-cell lymphoma? Is there some test I can do? Can these miserable lesions be biopsied? I make up stories to my hairdresser and massage therapist, so they are not repulsed. Thankfully, the BP is in remission, but this condition is much worse to live with. I am not giving up on this. There has to be a solution or answer. Thank you.

  26. Jeanette Patton says:

    i would be grateful if you could forward me an email address for a consultation with Dr Camisa. It’s for my Son, we live in Scotland and he has severe oral Lichen Planus added to this he has type 1 diabetes and we would be grateful for the doctors advice. Kindest regards. Jeanette Patton.

    • DrCamisa says:

      We are currently not doing personal email consultations due to issues of patient confidentiality and ability to collect payment. We are in the process of developing these capabilities and may be able to do it later this summer. Thank you for your inquiry.

  27. rajdeep das says:

    i have a big odd looking flat dysplastic nuvus mole on right hand. it is hairy, pitch black, 1inch radius circular mole. i am from india. should i send u pictures. kindly reply.

    • DrCamisa says:

      No,I cannot diagnose a lesion this way. You should be examined by your own physician or dermatologist.

  28. siddharth jain says:

    Name : Sanskriti Jain
    Date of Birth : 06th January 2010
    Gender : Girl
    Place of Birth : Ahmedabad, Gujarat, India
    Religion : Jain, Hindu
    Problem : Lichen Planus of Skin and Mouth
    Brief :

    Sanskriti Jain was born healthy on above-mentioned date. She took all vaccinations on time. When she was about 3 years approximately October 2012 Dermatologists diagnosed her as having Lichen Planus. This was required because she has some scarring on her left leg which was diagnosed as Lichen Planus. After some medication of Allopathic Medications there was not a satisfactory result. She was in February 2013 given tablet dapsone, betnesol (two times a week), some tacrilimos cream and mms cream for application. Due to not getting desired results and being scared of side effects of steroids we did the following.

    In May 2013 we shifted to Siddha Medication, which is, an alternative ayurvedic medication practiced treated by Dr. J R Krishnamurthy of Chennai, Tamilnadu. The results were remarkable and recovery started, we could see changes almost in 2 weeks time. New lesions stopped appearing and old ones started going in remission. Almost 90 percent cured for 2 years we could see the recovery and only the scars remained. She was on normal diet with some restriction on Tomatoes and Milk for sometime. Which was removed after some time and she started consuming normal diet. Her scars had faded and hardly any active lesion was seen.

    In the year 2015 in month of March or April we saw some changes in the scars, which again started getting active. We had gone to Europe for a vacation in April 2015 where temperature’s were 6 degree’s to 20 degrees also there was considerable walking leading to her getting tired sometimes. No other substantial change was there in routine life. We being vegetarians had to eat pasta and pizza on routine basis with tomato and cheese. Also she had chocolates and hazelnuts. But nothing out of ordinary.

    May 2015 We observed that she had started getting new lesions. This time she also has lesions on her lips and inside her mouth apart from here legs, stomach and hand. She is 5 and ½ years old now as of May 2015. Some injury on her knees also got converted to Lichen planus on her Right Knee.

    Kindly share email details so that i can send you pictures.

    1. Early Pictures of 2012 October – December
    2. Pictures after Remission
    3. Latest Pictures
    4. Prescriptions of doctors Datewise
    5. Current Medication Regime

    While we are confused on what went wrong we are getting back to Dr. Krishnamurthy for his advise. Also the leisons in mouth is a new matter. We have read on the internet that Trumeric when applied in the mouth can lead to a good success rate for reduction in leisons.

    Our questions are following:

    Why did she get lichen planus at age 3?

    What is the latest in treating Lichen Planus? Oral and on other body parts

    Is there a test to show why she got Lichen planus so that we can eradicate the root cause?

    Is there any recommendation on Food which is not to be taken or which should be eaten.

    If we don’t treat lichen planus with Steroids (which would have a very lasting side effect on her body) is there a chance that the problem might go out of hand.

    My daughter is only 5 years old and it is not bearable to see that she might not be able to do many things due to her skin condition. Pls advise us to fight this and get her out of this problem.

    Regards
    Siddharth Jain
    Father
    sjain@munoth.com
    0091 9974017401

    • DrCamisa says:

      It is heartbreaking to have a sick child. While LP in early childhood is very uncommon, it does occur. There is no test to tell you the root cause, although childhood LP might have a genetic tendency (positive family history). All foods that can be tolerated may be taken, that is, as long as they do not burn or cause pain to the mucous membranes. Treatment of LP is complicated in anyone, but especially so in children because the drugs may be more toxic. Your dermatologists have access to all the latest treatments and can advise. Most cases of childhood LP eventually go away spontaneously without treatment, but there is a chance of recurrence later in life.
      I would prefer that you not send photos to protect your child’s privacy on the internet. Thank you.

  29. Siddharth Jain says:

    Thankyou doctor for your prompt reply. I would like to know from you that in case we decide to use turmeric which has been in some experiments proven to be useful in lichen planus – is there a possibility that the problem becomes very big in the mean time and is then difficult for doctors to handle?

    Should i use steroids in her case?

    • DrCamisa says:

      I don’t think it’s essential to use steroids at all. In fact, I use curcumin supplements in my patients in 400 mg capsules once or twice per day. Curcumin is one of the active anti-inflammatory and anti-oxidant compounds found in the turmeric root.

  30. Hi Dr. Camisa,

    I work with Direct Capital, an online lending agency providing small and mid-size businesses with fast, easy access to the capital they need to grow and prosper. I wanted to reach out and let you know that we’ve just released our list of “Top Dermatology Blogs: The 50 Best Blogs to Learn About Cutting-Edge Dermatology Treatments and Techniques,” and you’ve made the list.

    Congratulations! You can see the full list here: http://blog.directcapital.com/business-insights/top-dermatology-blogs/

    It would be great if you’d share this news internally and/or with your audience on social media. You can find us on Twitter @DirectCapital

    Thanks so much for your time, and congratulations again!

    Angela Stringfellow

    • DrCamisa says:

      A big thank you to Direct Capital for including my blog on their Top 50 Dermatology Blog List. I am honored to be there.
      Dr. Camisa

  31. Miria says:

    I have been positively diagnosed with DM in September 2015 via skin biopsy. I was initially on Tacrolimus ointment for the Helitrope rash on my eyes and taking Pkaquenil daily dose of 400 mg. It is now February 2016 -and my rash and edema around my eyes came back in December. Though I’ve tried the Tacrolimus ointment for three weeks there was no improvement. I then tried cortisone ointment .5 on my eyes as well…still no improvement… Thank G-D I am not feeling any muscle problems at this time. The rashes are also under control, it really seems to be my eyes that are causing such problems. Is there anything I can take or do without it being too drastic as this is such a minor issue in the big picture of things…

    • DrCamisa says:

      I haven’t had much luck with tacrolimus either. You could try the 1% hydrocortisone cream once daily for the eyelid skin as long as you don’t get it in your eye.

  32. Denise says:

    Hi Dr.
    I have been diagnosed with discoid lupus about a year ago. I am concerned about scarring and hair loss. I have lost a significant amount of hair and have a few a few patchy hair loss areas. I was wondering if taking a turmeric supplement would help in scalp in reducing the inflammation in my scalp and stop the hair loss? I do not have many lesions just one of my scalp and one on my back. I’ll try to avoid all sun exposure but it’s very hard because I’m an outdoorsy person. any helpful information on how to treat inflammation naturally would be great and to reduce the hair loss. will hair ever grow back again? I do not have any scabs on my scalp but do see some color changes on my scalp where the lesion was. thanks for your time and hope to see your reply!

    • DrCamisa says:

      Discoid lupus can definitely cause scarring, pigment changes,and hair loss (permanent) along with it. We use usually apply a potent topical steroid to prevent that. i have had some success in regrowing hair by injecting a steroid solution under the affected skin. Other natural supplements that have potent anti-inflammatory effects are green tea extract, resveratrol, and berry complete extract.

  33. Vicky Stevens says:

    I am seeking a dermatologist who has had experience in successfully treating oral lichen planus. I live in Illinois, but am willing to travel for help with this condition.

  34. Nancy Kura says:

    Dear Dr Camisa, My dear friend recently retired in Bonita Springs. She has been diagnosed with Pemphigus when in NY and was treated in NYC with Prednisone and Methotrexate. She has been in remission (although still on low does of Methotrexate) for about a year but is currently having a pretty bad flare up. I am in NY and trying to help her long distance as she is struggling to deal with the return of her disease. Her NYC Dr told her that she needs to see a Dr locally (as as he was flying back to NYC for follow up visits) at least once a week right now. Can you help or please refer someone in the area that specializes in this dreaded disease? Thank you so very much for any help you can provide.
    Nancy K.

    • Dr. Camisa says:

      I can certainly deal with problems like this locally. She needs to call the office for an appointment. I could see her either in South Ft Myers or Downtown Naples. Thank you for reaching out for her.

  35. Dr. Camisa says:

    I responded to you directly.

  36. Dan Thompson says:

    Dr Camisa,
    Hi, I was a patient of yours in 2013 at your Fort Myers office until I moved away. Have inverse psoriasis in gluteal cleft areas and secondary eczema issues . Currently in the Sarasota-Bradenton FL areas. I’m looking for a specialist locally or in Tampa to help me with a very stubborn disease. Dr Zamora or Dr Switlyk are not a option for me locally. Any recommendations?
    Regards,
    Dan Thompson

  37. Ann says:

    One of your articles you mention HCTZ and Naproxen to be linked to lichen planoplaris. Been fighting this on my scalp for 4 yrs could my Mobic be the contributing factor???

  38. Betty Clodfelter says:

    I live in Winston-Salem,NC and am a patient of Dr Joseph Jorizzo. I have burning mouth and have tried all types of solutions and nothing is working. Dr Jorizzo suggested I contact you to see if you have any suggestions. I am taking Neurontin 600mg 3 times a day. I tried Tacrolimus 1mg capsules in water swishing 2 times a day. Lidocaine 2% as need and clotrimazole 10mg touched 5 times a day. This problem is mainly in the roof of my mouth and can’t be seen by the eye but I feel it. I feel bad that no one can see what I feel. The burning is especially bad at night. Can you please let me know if you have any suggestions. Thank you

    • Dr. Camisa says:

      Those were all reasonable things to try for this atypical pain syndrome. My first line of therapy is clonazepam. I have also used Lyrica as third-line therapy.

  39. Shreyansh says:

    Dear Dr. Camisa,

    Greetings of the day!

    I got your information from web, for a disease called Lichen Planus.

    My sister-in-law, aged 24 years, got diagnosed with Lichen Planus a year back in India, trunk and neck being initially affected, and was on homeopathic treatment until now, when it started spreading to limbs. She has now switched to allopathic treatment under the supervision of a dermatologist back in India, who has diagnosed the disease to be Lichen Planus Pigmentosus. She is on the following prescribed medication right now:
    1) Vitamin ‘A,’ ‘C’ & ‘E’ Capsules
    2) Tacrolimus Ointment 0.1% w/w
    3) Skin Lightening Lotion (Kojic Acid Lotion)

    I would appreciate to know if you could help with this case. The patient can fly to the U.S. to see you, and also stay in the States for treatment if required.

    Note: The patient is married for 3 years now, and planning on pregnancy.

    Thanks.

    • Dr. Camisa says:

      All of these treatments sound appropriate to me for LP pigmentosus. I see no reason to travel. Also, she should check with her OB to see if the topical drugs are safe in pregnancy. (I’m not sure.)

  40. Katherine says:

    I have OLP with some involvement in other areas now. Do you know of any clinical dermatologists/immunologists that specialize in treatment of this disease in the Raleigh/Durham area? If so I would appreciate a response

    • Dr. Camisa says:

      I don’t know any individuals there treating OLP, but that is an area with major universities and medical schools. So I would call the Derm Depts and ask who specializes in your disease.

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