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 …

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 effective but performed much better when combined with a topical corticosteroid. …

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 …

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 …

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, …

My Dermatologist Says I Have Actinic Keratosis: What Is That?

Actinic keratosis (AK), also known as solar keratosis, are commonly referred to as pre-cancerous skin growths.  In fact, they are the most common pre-cancerous growth of humans.   Actinic keratoses (plural) are most commonly found on sun exposed areas, namely, the face, lips, bald scalp, and backs of hands and arms. …