Abraham Kazemi, MD, is the director of Cosmetic and Laser Dermatology for Virginia’s Pinnacle Dermatology sites.

Abrahem Kazemi, MD

Addressing Discoid Lupus in Skin of Color: Clinical and Social Challenges

, Abrahem Kazemi, MD, board-certified dermatologist and director of cosmetics and laser dermatology for Pinnacle Dermatology, reflects on a challenging yet ultimately rewarding case that underscores the intersection of dermatology, systemic disease, and social determinants of health. Through the lens of a young, underinsured African American man with early signs of discoid lupus erythematosus (DLE), Kazemi illustrates the complexities of delivering equitable dermatologic care in vulnerable populations.

Kazemi recounts that the patient initially presented with scalp sores, scarring, and hair loss—clinical features suggestive of early DLE, a subtype of chronic cutaneous lupus erythematosus. On closer examination, he identified atrophic, depigmented plaques within the conchal bowls of the ears, further supporting the diagnosis. Recognizing the potential for permanent scarring alopecia and disfiguring dyspigmentation—particularly devastating in skin of color—Kazemi acted swiftly. He performed multiple punch biopsies, ordered comprehensive laboratory testing including autoimmune panels and standard bloodwork, and initiated treatment with intralesional corticosteroids, oral doxycycline, and topical steroids tailored for facial and body involvement.

Despite early diagnostic confirmation of DLE on biopsy, the case quickly became more complicated. Kazemi emphasized DLE may precede or coexist with systemic lupus erythematosus (SLE), which occurs in a minority, but clinically significant, subset of individuals. He stressed the importance of ruling out systemic involvement, particularly given the increased risk of lupus nephritis and severe renal outcomes in African American populations. However, the patient did not initially complete recommended laboratory work and was inconsistent with follow-up visits and medication adherence.

When the patient’s disease worsened, Kazemi confronted what initially appeared to be noncompliance. Upon further discussion, the patient revealed unstable housing and frequent transitions between shelters, limiting his ability to maintain consistent treatment or appointments. Recognizing that the issue was not apathy but structural instability, Kazemi expanded the care team. He personally contacted the patient’s Medicaid provider to identify an in-network rheumatologist, coordinated care despite a six-month specialist wait time, initiated hydroxychloroquine therapy himself, and ultimately convened a multidisciplinary meeting with social work, rheumatology, and primary care.

Over time, with coordinated support and stabilization of the patient’s living conditions, adherence improved. Kazemi reports that the patient’s cutaneous disease is now well controlled and, importantly, that systemic lupus was ruled out.

The segment highlights a central message: dermatology is not “skin deep.” Kazemi’s account reinforces the need for clinicians to address both medical complexity and social barriers to achieve meaningful outcomes, particularly in patients with skin of color facing disproportionate health and socioeconomic challenges.

Editor’s note: This summary was produced with the help of AI tools.

Kazemi A. Skin of Color Savvy: Serving the Underserved in Dermatology, With Abrahem Kazemi, MD. HCPLive. February 16, 2026. Accessed February 18, 2026. 

https://www.hcplive.com/view/skin-of-color-savvy-serving-underserved-dermatology-abrahem-kazemi-md

Kazemi A. Daily Challenges as a Dermatologist Helping Underserved Patients. HCPLive. February 17, 2026. Accessed February 18, 2026. 

https://www.hcplive.com/view/daily-challenges-as-dermatologist-helping-underserved-patients

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This segment of the latest Skin of Color Savvy episode highlights discoid lupus in skin of color, housing barriers, and Medicaid navigation.

Daily Challenges as a Dermatologist Helping Underserved Patients, With Abrahem Kazemi, MD

Skin of Color Savvy: The Art and Science of Treating Patients of Color

, Abrahem Kazemi, MD, reflects on the evolving challenges and rewards of modern dermatologic practice, highlighting how resilience, clinical expertise, and a commitment to underserved populations intersect in his daily work.

He describes challenge as a constant in dermatology—one that has been shaped in part by his residency training in New York City during the height of the COVID-19 pandemic. Having trained at the New York Medical College Department of Dermatology in Manhattan, he experienced a dramatic shift from routine clinical education to frontline emergency response. Working in special pathogen units and witnessing severe, often fatal cases of respiratory failure, he notes that the experience demanded courage and adaptability. That period, he explains, instilled in him the “thick skin” and decisiveness that now inform his approach to complex dermatologic cases.

In current practice in Northern Virginia, Kazemi sees between 60 and 80 patients per day and is among a limited number of board-certified dermatologists in the state who accept Medicaid. As a result, he frequently manages patients who present with advanced disease due to delayed access to care. He notes that these cases often include advanced skin cancers in rural populations, severe hidradenitis suppurativa, and scarring alopecias in patients of color. Beyond diagnostic and procedural complexity, he identifies treatment adherence and follow-up as ongoing challenges, particularly among patients navigating socioeconomic instability. Education, clear communication, and reinforcement of compliance, he emphasizes, are essential components of care. Despite the obstacles, he frames this work as both a responsibility and a source of professional pride.

The segment also highlights his focused clinical interests in skin of color, alopecias, hidradenitis suppurativa, and complex psoriasis. He discusses the psychosocial burden of hair loss disorders, particularly in women and men of color, and points to expanding therapeutic options as a promising development. Oral minoxidil and dutasteride, among other systemic therapies, are becoming more mainstream, while procedural interventions such as low-level laser therapy, platelet-rich plasma, platelet-rich fibrin, and microneedling are gaining traction within evidence-based frameworks.

He expresses particular interest in central centrifugal cicatricial alopecia (CCCA), noting prior dermatopathologic research correlating fibrosis with disease severity. The condition, he explains, remains underrecognized and often mischaracterized, underscoring the need for specialized expertise in melanin-rich skin. In hidradenitis suppurativa, he highlights the addition of newer biologics to the treatment armamentarium and anticipates the potential impact of emerging oral JAK inhibitors.

Throughout the segment, Kazemi underscores a broader theme: dermatology is rarely “just skin deep.” Clinical acumen must be paired with perseverance, advocacy, and a willingness to care for populations that others may overlook—an ethos that continues to shape his evolving practice.

Editor’s note: This summary was edited with the help of AI tools.

Kazemi A. Skin of Color Savvy: Serving the Underserved in Dermatology, With Abrahem Kazemi, MD. HCPLive. February 16, 2026. Accessed February 17, 2026. 

This clip from the latest episode of the Skin of Color Savvy podcast highlights Kazemi's experiences as a dermatologist working to help underserved communities.

Daily Challenges as a Dermatologist Helping Underserved Patients

Skin of Color Savvy: Serving the Underserved in Dermatology, With Abrahem Kazemi, MD

, board-certified dermatologist and director of cosmetics and laser dermatology for Pinnacle Dermatology, Abrahem Kazemi, MD, reflects on the personal and professional experiences that have shaped his approach to dermatologic care, particularly for underserved patient populations.

Practicing in northern Virginia, Kazemi describes building his clinic from the ground up and caring for a high-volume patient population that includes a significant number of Medicaid and underinsured individuals. He was asked about his journey into dermatology and shared that his interest was deeply personal. As a college student, he experienced severe nodulocystic acne and faced substantial barriers to accessing specialty care, resulting in delayed isotretinoin therapy and permanent scarring. That experience, he explained, instilled in him a commitment to closing gaps in dermatologic access and to practicing with empathy and humanism—values reinforced during his medical training at Howard University College of Medicine.

Kazemi also discussed the challenges of practicing dermatology in the wake of the COVID-19 pandemic, having completed residency training in New York City during the height of the crisis. He emphasized how that experience strengthened his resilience and prepared him to navigate complex clinical scenarios. Today, he frequently manages advanced presentations of disease among patients who face systemic barriers to care, including severe hidradenitis suppurativa, scarring alopecias such as central centrifugal cicatricial alopecia (CCCA), and advanced skin cancers.

His clinical interests center on skin of color, inflammatory dermatoses, and hair disorders. He highlighted advances in systemic and procedural therapies for alopecia and hidradenitis suppurativa, including newer biologics and emerging oral agents. In cosmetic dermatology, Kazemi underscored the importance of appropriate laser selection and parameter adjustment in melanin-rich skin, cautioning against procedures performed by inadequately trained providers due to the risk of dyspigmentation and scarring.

A particularly impactful case involved a young man with discoid lupus erythematosus complicated by social instability and limited resources. He described coordinating care across rheumatology, primary care, psychiatry, and social services to ensure appropriate evaluation and treatment, ultimately achieving disease control. The case, he noted, reinforced that dermatology is rarely “skin deep” and often intersects with broader systemic and social determinants of health.

Kazemi also spoke about his involvement with the Skin of Color Society, particularly on its Media and Communications Subcommittee, emphasizing the importance of elevating evidence-based messaging as demographic shifts increase the relevance of skin of color expertise nationwide. He concluded with a message to colleagues and trainees: resilience, self-belief, and perseverance are essential, as the impact of dermatologic care—especially for underserved communities—extends far beyond the clinic.

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Editor’s note: This interview summary was edited with the help of AI tools.

This Skin of Color Savvy episode featured Abrahem Kazemi, MD, who speaks on several notable experiences he had as a dermatologist.

Abrahem Kazemi, MD

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