Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
"I have had outbreaks of erythema nodosum since 1993. My dermatologist told me it was an allergic reaction to something in my blood stream. She suggested I pay attention to what I have been eating when I start to break out in these painful bumps. So I did. It was soy...anything with soy in it is a big "no" for me! That was what triggered it. To this day, if I slip up and eat something with soy in it, I will break out on my legs. So I suggest to everybody out there who is stumped and cannot figure out why you're breaking out with these painful bumps, pay attention to what you're eating! It may be something as simple as what you're putting in your mouth! I hope this helps, because I know how painful this can be!"
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What is erythema nodosum?
Erythema nodosum is a
type of skin inflammation that is located in a certain portion of the fatty layer of skin. Erythema nodosum (also called EN) results
in reddish, painful, tender lumps most commonly located in the front of the
legs below the knees. The tender lumps, or nodules, of erythema
nodosum range in size from 1 to 5 centimeters. The nodular swelling is caused
by a special pattern of inflammation in the fatty layer of skin.
Erythema nodosum can be self-limited and resolve on its own in three
to six
weeks. Upon resolution, it may leave only a temporary bruised appearance or leave a chronic indentation in the skin where the fatty layer has been injured.
There are several scenarios for the outcome of erythema nodosum. Typically, these areas of nodular tenderness range in size from about a dime to a quarter and they may be tender and inflamed off and on for a period of weeks. They usually then resolve spontaneously, each one of the little areas of inflammation shrinking down and then becoming flat rather than raised and inflamed. They leave a bruised appearance. Then, they resolve spontaneously completely. Other lesions can sometimes pop up elsewhere. This may occur for periods of weeks to months and then eventually goes away. However, chronic erythema nodosum that may last for years is another pattern. Chronic erythema nodosum, with intermittent recurrences, can occur with or without an underlying disease present.
Strep throat is a sore throat caused by a bacterium called streptococcus (strep) that can be treated through antibiotics. Common symptoms of strep throat include pinkeye, runny nose, skin rash, cough, hoarseness, diarrhea and more. Complications of untreated strep throat include middle ear infections, meningitis, pneumonia, rheumatic fever, and more.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Herpes simplex infections are common and when they appear around the mouth and lips, people often refer to them as "cold sores" and "fever blisters." Canker sores are different than cold sores. Air droplets can spread the virus, as can direct contact with the fluid from the blisters. Cold sore treatment include over-the-counter medication as well as prescription medications.
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis bacteria. Symptoms include weakness, fever, weight loss, night sweats and in worse cases, chest pain, shortness of breath, and coughing up blood. A person with an active infection (a positive TB skin test, abnormal chest x-ray and TB bacteria in their sputum) requires treatment with izoniazid, rifampin, ethambutol and pyrazinaide.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Sarcoidosis, a disease resulting from chronic inflammation, causes small lumps (granulomas) to develop in a great range of body tissues and can appear in almost any body organ. However, sarcoidosis most often starts in the lungs or lymph nodes.
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
Behcet's syndrome is a disease characterized by three symptoms: genital ulcers, recurring mouth ulcers, and inflammation around the pupil of the eye. Symptoms of Behcet's syndrome may also include inflammation of other areas of the body, such as the brain, joints, skin, retina, and bowels. Oral steroids, antiinflammatory drugs, and steroid gels, pastes, and creams may be used to treat Behcet's syndrome.
Valley fever (coccidioidomycosis) is a disease caused by the inhalation of the Coccidioides immitis or C. posadasii fungus. Symptoms are flu-like and resolve over two to six weeks. Infection typically requires no treatment, though there are many antifungal drugs to treat valley fever.
Sarcoidosis is a disease that results from a specific type of inflammation of
tissues of the body. It can appear in almost any body organ, but it starts most
often in
the lungs or lymph nodes.
The cause of sarcoidosis is unknown. The disease can
appear suddenly and disappear. Or it can develop gradually and go on
to produce symptoms that come and go, sometimes for a lifetime.
As sarcoidosis progresses, microscopic lumps of a specific form of inflammation, called granulomas, appear in the affected tissues. In the majority of cases, these granulomas
clear up, either with or without treatment. In the few cases where the
granulomas do not heal and disappear, the tissues tend to remain inflamed and
become scarred (fibrotic).
Sarcoidosis was first identified over 100 years ago by
two dermatologists working independently, Dr. Jonathan Hutchinson in England and
Dr. Caesar Boeck in Norway. Sarcoidosis was o...
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