Vitamin D Analogues for Psoriasis

Vitamin D analogues are popular for the local treatment of psoriasis.  The first compound approved in the U.S. was calcipotriene (brand name Dovonex) available as cream, ointment, and lotion (for the scalp) for twice daily application.  It was modestly … 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

What Are Dysplastic Moles? Opinion and Advice

To better understand the concept of “dysplastic moles,” we must agree on definitions of terms.  Dysplastic from dysplasia  means abnormal development of  tissue.  A mole in this context usually refers to a growth in skin that may be pigmented, flesh-colored, flat or raised, hairy or non-hairy.

A mole, also called a nevus, usually consists of … 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