My Blog

Posts for tag: skincare

By Dr. David Fivenson, Sultan Qiblawi
April 06, 2020
Category: Uncategorized
Tags: dermatology   skincare   telemedicine  

Telemedicine is more important than ever. With the uncertainty the COVID-19 has bestowed on the world. We are being forced to rethink how we interact with each other, and conduct business on a daily basis. This extends to how we interact with our healthcare providers. With telemedicine in healthcare, there are ways that you can interact with your doctor and still receive the care and advice that you need without leaving your home. Dermatology is a visual field that is well suited to take advantage of the convenience and efficiency of telemedicine tools. With telemedicine, you are able to set up an appointment and use your internet enabled device to have a face-to-face appointment with you doctor. Your dermatologist will be able to see your skin, answer your questions, and give advice about what to do next in your treatment plan, without being in the same room as them. Since this technology is relatively new, people may not know much about how it works.  Here are a few important concepts to know about telemedicine and how it is done:

  1. Synchronous versus asynchronous appointments:

There are two main types of telemedicine appointments that you can schedule with you doctor, synchronous and asynchronous. Synchronous telemedicine appointments involve both parties to be online at the same time having a live session that includes both audio and video components. Essentially, this means that you are able to video chat with your doctor in real time and discuss your concerns with them, just like you would in a face-to-face appointment.

Asynchronous telemedicine is a term used to describe store-and-forward transmission of medical images and/or data that is recorded by the patient and then sent to the physician over a secure web server, encrypted email, specially designed store and forward software or electronic health record. Once the physician receives the information, they can assess the patient’s concern and send back their diagnosis, treatment, and recommendations back electronically or fax their recommendations. This means that a patient is able to record themselves with their questions and concerns and send this to their physician and wait for their recommendations. The difference between this and synchronous telemedicine, is that asynchronous encounters do not occur in real time, as where synchronous encounters happen in real time.

  1. Digital platforms:

Telemedicine software is a sector of health IT that focuses on delivering clinical healthcare via secure audio and video connection. These platforms are the means in which you can interact with your doctor and discuss your concerns with them. There are numerous platforms in which you can interact with your physician via telemedicine. Mobile applications (we use Chiron and Hale at Fivenson Dermatology currently) can be downloaded onto your computer or mobile device and securely run your virtual appointment with your physician.  This is similar to popular apps like Facetime, What’s App, Skype but with all the necessary security to protect our personal health information

If you are interested in doing setting up a telemedicine appointment at Fivenson Dermatology, you can request a virtual appointment here.The rise of these applications makes telemedicine easier than ever and it offers great convenience for patients. This encounter is ideal for patients who are not able to make to the office. This includes people who cannot leave their place of work, taking care of their children, or not able to leave their homes. It also allows people to get the advice of physicians that they trust while they are out of town, and still need advice about their skin.  Insurance coverage is still variable but growing (temporarily it is much more widespread due to the government’s response to the COVID-19 pandemic with relaxation of the HIPAA privacy rules)


By Sultan Qiblawi
June 16, 2019
Category: Uncategorized
Tags: Skin   dermatology   pemphigus   autoimmune   medicine   skincare  


There are a subset of dermatological diseases that are not very well known to the general public that can be painful, and potentially life threatening. In today’s post, I want to shed some light on one of these diseases: pemphigus vulgaris.

First off, I would like to give you some stats about how frequently this disease occurs in the general population. Pemphigus vulgaris affects about 0.7-5 people per 1,000,000 per year in the general population. This is not a very common disease, but its affects can be debilitating and missing this diagnosis can pose serious problem for the person who actually has it.

Dr. Fivenson is a nationally recognized leader in bullous diseases, like pemphigus, and he sees hundreds of these patients. He, and his team, are here to make sure you get the most accurate distilled information about rare dermatological disorders, and what you should look out for.

So what is pemphigus?

Pemphigus is a rare chronic blistering skin condition that is caused by the immune system attacking the body. These types of diseases are called autoimmune diseases, and in this case, your immune cells are making antibodies against your skin, specifically the epidermis. This means that the disease is not contagious, and cannot be transferred to people by any mode of transmission (i.e. blood, fluids).  It can happen to people at any age, but it tends to happen to middle aged adults or older adults.

Pemphigus vulgaris: this subtype of pemphigus creates blisters that generally start in the mouth and then appear on the skin or the genital mucous membranes (i.e. vagina, urethra, and underside of the foreskin). There can also be nail loss, alteration of the skin pigment, and severe disability if it is not taken care of quickly. Pemphigus vulgaris is not a disease that will go away by itself. It needs active treatment to control the flares and reduce downstream complications.

What should you look out for?

Pemphigus causes severe blistering in the mouth and other parts of the skin. Sometimes your skin can readily peel off and this can lead to increased infection, dehydration, and disfigurement. The blistering can be very painful, can have severe itching, and can even burn. 

The type of blister you get is also characteristic of the disease: big, flaccid bullae that burst easily. This means that the blisters will rarely form because they rupture almost immediately after they form. The rupturing blisters lead to multiple, superficial, ulcerated sores throughout the mouth. These painful sores are the more common sign that people initially see. 

What should you do if you suspect you have this?

If you suspect that you have this type of dermatological disease or any other concerns with your skin, contact your dermatologist. They will be able to guide you and work with you to see exactly what you have. There are also fantastic resources on our website about pemphigus and other blistering skin diseases that you can read about on Patient Resources page.

Dr. Fivenson is a nationally recognized specialist in autoimmune skin disorders, like pemphigus. He is board certified in dermatology and immunodermatology, and has published over 125 peer reviewed articles in dermatology. 




Contact Us

Office Hours
Monday:8:00 AM - 5:00 PM
Tuesday:8:00 AM - 5:00 PM
Wednesday:8:00 AM - 5:00 PM
Thursday:8:00 AM - 5:00 PM

After Hours

For Non-Emergency questions, use the patient portal or use the Contact Us form

In case of Emergency, call St Joseph Mercy Hospital Operators at
( 734) 712-3456 and have Dr. Fivenson paged