Puzzle solved: Derm featured on Discovery Health's 'Mystery Diagnosis'

National report - Little did dermatologist Luette Semmes, M.D., know that her successful treatment of a young patient with bullous pemphigoid would land her a spot on national television a few years later.

Dr. Semmes, who practices in the small town of Salisbury, Md., was featured as the doctor who helped Kati, whose gruesome blisters baffled non-dermatologists who misdiagnosed her time and time again. The episode, called “The Girl Whose Skin Came Off,” aired in late March 2010 on Discovery Health Channel’s “Mystery Diagnosis” program.

Dermatologist Luette Semmes, M.D., of Salisbury, Md., prepares for the taping of an episode of Discovery Health Channel’s “Mystery Diagnosis” series. (Photo: Discovery Health Channel)

“For me, it was exciting to be on national TV, but the patient was one that any dermatologist would have diagnosed,” Dr. Semmes says. “[I thought] it would be interesting to show people that dermatologists really can be useful for problem patients - we don’t just take care of warts and skin cancer and treat wrinkles.”

Mystery for some

About five years ago, Kati, then 18, arrived at a local college. Soon after, her roommates started questioning whether the blisters on her body were from some dreadful, contagious disease, according to Dr. Semmes.

Kati had been misdiagnosed by her pediatrician, who had treated her for a staph infection. When the problem didn’t resolve, the pediatrician then diagnosed her with eczema.

That didn’t surprise Dr. Semmes, because she says pediatricians often do not recognize bullous pemphigoid. What did baffle her, she says, was that doctors did not refer Kati to a dermatologist sooner.

In search of the correct diagnosis, Kati went to an emergency room a few times and eventually to the college clinic, where an astute physician saw her skin and contacted Dr. Semmes about the case.

“He called and said, ‘You have to see this girl right away,’” Dr. Semmes says.

The dermatologist was quick to recognize that Kati’s case fell into the category of autoimmune blistering disorders. She performed a biopsy, which revealed bullous pemphigoid.

Dr. Semmes treated Kati with prednisone, which cleared the blisters but caused a host of side effects, from weight gain (40 pounds) to acne and depression.

After Kati had been on prednisone for about four months, Dr. Semmes added mycophenolate mofetil (CellCept, Genentech), which allowed Kati to come off the prednisone after about one year, and come off the CellCept about six months later. The treatment worked to put the condition into remission.

Dr. Semmes had not seen Kati for years when the patient contacted the Discovery Health Channel, suggesting that “Mystery Diagnosis” cover the case.

“She called me and asked if (the show) could contact me,” Dr. Semmes says.

Lights, camera, action!

Dr. Semmes helped producers by providing accurate medical information. She appears on the episode to talk about Kati’s case and re-enact her treatment. The show, though, is more about the patient’s experience - the fear of not knowing, the frustration of misdiagnoses, and what it’s like to live with a disease or medical condition.

The dermatologist traveled to Baltimore for taping and had only positive things to say about the experience of being on national television.

“They filmed part of the show in a studio, with the mother talking, patient talking and the doctors talking. My part was about two hours of taping,” she says. “Another part of the show is the re-enactment … and that was at a rented clinic, made to look like my office.”

Even the dermatologist learned a few lessons from the show. She sees a case of bullous pemphigoid once every year or two, but always in older patients (usually older than age 65). Seeing it in a youngster was unusual, she says, and taking into consideration the social ramifications of the disease and treatment of a pediatric patient made Dr. Semmes think outside the box.

“(Kati) had just started school and really wanted to be independent. She wanted to live in the dorms … and almost was in denial about what she was going through,” Dr. Semmes says.

No Hollywood treatment

The dermatologist says she watched her television debut in late March, while eating popcorn with her children.

“My son, who is 16 years old, kind of summed it up: He said, ‘Wow, Mom. I’m looking at the TV, and you look so smart and professional and serious. Then, I turn around and you’re picking a popcorn kernel out of your teeth, in your pajamas on the couch.’”

Her patients were happy about her new-found stardom - one even thanked her for taking such good care of Kati. But, in a small town, Dr. Semmes explains, things don’t change much after being featured on national TV. No special treatment, she says.

To check for future air dates of “Mystery Diagnosis,” episode 810, “The Girl Whose Skin Came Off,” visit: http://health.discovery.com/tv-schedules/series.html?paid=62.15492.128501.29206.x&start=0