Thanks for your feedback. I've read that these rams need very pristine water. The tank is about 3 months old. This fish is an original tank mate. He is in with two other german balloon rams, a rad tailed shark, 4 red eyed tetras, 4 headlight/tailight tetras, and 2 platies.
I need more testing strips, so I haven't checked water parameters, but I noticed this happened just shortly after I did a water change which stirred up a lot of waste. I usually keep up with weekly water changes, about 30% each time, but I skipped a week because of demands and OT at work. Hence, the added waste which was stirred up.
The tank is 29 gallons with a penguin 200.