Plaquenil Use in Autoimmune Diseases by Dermatologists and Rheumatologists

It may surprise you to learn that anti-malarial drugs are used by dermatologists and rheumatologists. But not to treat malaria! Chloroquine and hydroxychloroquine

plaqueniltabs(commonly known by its old brand-name Plaquenil) were first used … Continue reading

Granuloma Annulare and Necrobiosis Lipoidica

Granuloma annulare (GA) is a skin disease commonly encountered in our clinic, either as an initial self-motivated visit or on consultation from another physician. The rash consists of small smooth bumps that may be skin-colored, pink, reddish-purple, brownish-orange. … Continue reading

Skin Diseases and Granulocyte White Blood Cells: Hidradenitis Suppurativa, Sweet’s Syndrome, and Pyoderma Gangrenosum

Granulocytes are the predominant white blood cells released from the bone marrow.  They are responsible for ingesting and killing or inactivating most infectious organisms, a process called phagocytosis.  The granules referred to in the name are actually the lysosomes in the cell that contain caustic and digestive enzymes. These same … Continue reading

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

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

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

Scabies and Poison Ivy Confusion

You might reasonably ask, how could one confuse these two distinct entities?  Scabies is an infestation of the skin caused by the sarcoptes mite and poison ivy is an allergic contact dermatitis caused by a resin in the plant.  Confusion does indeed exist with the layperson and the inexperienced health … Continue reading