Diversity, Equity, and Inclusion Initiatives in Dermatology Organizations

Over the past few years, there have been concerted efforts to increase diversity in the field of dermatology. This has been achieved through the creation of Diversity, Equity, and Inclusion (DEI) initiatives in dermatology organizations that strive to provide resources and opportunities for trainees who are underrepresented in medicine. This article compiles the ongoing DEI initiatives in the American Academy of Dermatology, Women's Dermatologic Society, Association of Professors of Dermatology Society, Society for Investigative Dermatology, Skin of Color Society, American Society for Dermatologic Surgery, The Dermatology Section of the National Medical Association, and Society for Pediatric Dermatology.

Factors associated with suspected nonmelanoma skin cancers, dysplastic nevus, and cutaneous melanoma among first-time SpotMe screening program participants during 2009-2010

BACKGROUND

There have been no studies of the American Academy of Dermatology's SpotMe skin cancer screening program to collectively analyze and determine the factors associated with suspected basal cell carcinoma (BCC), squamous cell carcinoma (SCC), dysplastic nevus (DN), and cutaneous melanoma (CM) diagnoses.

OBJECTIVE

Describe the demographics, risk factors, and access to care profiles associated with suspected diagnoses of BCC, SCC, DN, and CM among first-time SpotMe screenees during 2009-2010.

METHODS

We conducted a cross-sectional analysis of data from the SpotMe skin cancer screenings conducted in 2009 and 2010. We performed multivariable logistic regression analysis for each diagnosis, incorporating standard demographic, access to care, and risk factor variables in the models.

RESULTS

Men, those without a regular dermatologist, persons reporting recently changing moles, and those with a personal history of melanoma were at increased risk for each of the suspected diagnoses analyzed. Uninsured persons were at increased risk for suspected malignancies (BCC, SCC, and CM).

LIMITATIONS

Lack of histologic confirmation for diagnoses and cross-sectional design.

CONCLUSION

Among first-time SpotMe participants, suspected diagnoses of BCC, SCC, DN, and CM shared several associated factors, which may be considered when planning outreach and screening for populations at risk for skin cancer.

Publication Outcomes of Abstracts Presented at American Academy of Dermatology Annual Meeting

Objectives: As the most highly attended dermatology conference in the United States, the AAD Meeting plays an especially critical role in the dissemination of dermatologic research. We sought to address the paucity of data regarding the fate of abstracts presented at AAD meetings to better understand the likelihood of publication after presentation as well as what factors may influence publication outcomes.Materials and Methods: We conducted a literature search for each abstract presented in 2015 and 2016 to determine publication outcomes inclusive of latency to publication and journals represented.Results: We found that the majority of abstracts presented at AAD Meetings do not reach publication, with 44.7% and 43.5% reaching publication in 2015 and 2016, respectively. Abstracts are likely to be published within one year of presentation. Publication outcomes are stratified by abstract category and study design.Conclusion: There is considerable consistency in publication outcomes for abstracts presented at AAD Meetings for 2015 and 2016. Publication rates are comparable to other conferences in dermatology and other disciplines. These findings provide insight into the fate of the wealth of research presented at AAD meetings and what factors may influence an abstract being published.

The influence of social media on acne treatment: A cross-sectional survey

BACKGROUND/OBJECTIVES

Social media use has been suggested to worsen psychiatric health among adolescents, especially those with visible skin lesions including acne. However, little is known about social media's impact on acne treatment. The purpose of the study sought to characterize the influence of social media use on acne treatment.

METHODS

We conducted a cross-sectional survey of West Virginia University ambulatory patients whose chief complaint was acne was conducted. The survey collected sociodemographics and queried whether individuals accessed social media for acne treatment advice or not, whether changes to acne care were made based on social media, and whether these changes aligned with the American Academy of Dermatology (AAD) clinical guidelines for acne management.

RESULTS

Of 130 respondents, 45% consulted social media for acne treatment advice (54% of women vs 31% of men). 41% of adolescents and 51% of adults consulted social media. The most used platforms were YouTube and Instagram (58% each). Social media users often tried an OTC treatment (81%) or dietary modification (40%). However, only 31% of participants consulting social media made changes fully aligned with AAD clinical guidelines.

CONCLUSIONS

Social media-influenced acne treatment advice is prevalent, especially among women, adolescents, and young adults. This treatment advice frequently does not align with AAD guidelines, with notably 40% of respondents choosing dietary modification for acne management. These results suggest that dermatologists should inquire about social media acne treatment advice and directly address misinformation.

Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines

Atopic dermatitis (AD) is a chronic pruritic inflammatory disease that commonly presents in the pediatric population. Although definitions and diagnosis of AD have largely been agreed upon, allergists and dermatologists have similar and divergent approaches to the management of AD. This review facilitated integration of the American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma & Immunology Joint Task Force 2012 AD Practice Parameter and the 2014 American Academy of Dermatology guidelines to highlight the basic principles of AD management and discuss therapies and management of AD from the distinct perspectives of the allergist and dermatologist.

Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis

Atopic dermatitis (AD) is a chronic, pruritic, inflammatory dermatosis that affects up to 25% of children and 2% to 3% of adults. This guideline addresses important clinical questions that arise in the management and care of AD, providing updated and expanded recommendations based on the available evidence. In this first of 4 sections, methods for the diagnosis and monitoring of disease, outcomes measures for assessment, and common clinical associations that affect patients with AD are discussed. Known risk factors for the development of disease are also reviewed.

From the Medical Board of the National Psoriasis Foundation: Recommendations for screening for hepatitis B infection prior to initiating anti-tumor necrosis factor-alfa inhibitors or other immunosuppressive agents in patients with psoriasis

BACKGROUND

No consensus exists regarding the optimal laboratory screening for hepatitis B infection that should be performed before initiating therapy with tumor necrosis factor-alfa inhibitors or other immunosuppressive agents.

OBJECTIVE

We sought to give guidelines on which tests to order for hepatitis B screening.

METHODS

We review the pathophysiology and serology of hepatitis B infection and provide recommendations for screening for hepatitis B infection in patients with psoriasis before beginning anti-tumor necrosis factor-alfa therapy or other immunosuppressive agents.

RESULTS

We propose the standardized use of triple serology testing: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody in combination with liver function tests as screening.

LIMITATIONS

Conclusions based on review of available literature is a limitation.

CONCLUSIONS

All patients with psoriasis who are candidates for tumor necrosis factor-alfa inhibitor should undergo screening for hepatitis B virus infection using the triple serology: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody. It is advisable that patients, who are candidates for ustekinumab, cyclosporine, or methotrexate undergo the same screening.

Current status of surgery in dermatology

An article titled "Current issues in dermatologic office-based surgery" was published in the JAAD in October 1999 (volume 41, issue 4, pp. 624-634). The article was developed by the Joint American Academy of Dermatology/American Society for Dermatologic Surgery Liaison Committee. A number of subjects were addressed in the article including surgical training program requirements for dermatology residents and selected advances in dermatologic surgery that had been pioneered by dermatologists. The article concluded with sections on credentialing, privileging, and accreditation of office-based surgical facilities. Much has changed since 1999, including more stringent requirements for surgical training during dermatology residency, and the establishment of 57 accredited Procedural Dermatology Fellowship Training Programs. All of these changes have been overseen and approved by the Residency Review Committee for Dermatology and the Accreditation Committee for Graduate Medical Education. The fertile academic environment of academic training programs with interaction between established dermatologic surgeons and fellows, as well as the inquisitive nature of many of our colleagues, has led to the numerous major advances in dermatologic surgery, which are described herein.

Online learning in a dermatology clerkship: piloting the new American Academy of Dermatology Medical Student Core Curriculum

BACKGROUND

Multiple studies have shown that both current and future primary care providers have insufficient education and training in dermatology. To address the limitations and wide variability in medical student dermatology instruction, the American Academy of Dermatology (AAD) created a standardized, online curriculum for both dermatology learners and educators.

OBJECTIVE

We sought to determine the impact of the integration of the AAD online curriculum into a 2-week introductory dermatology clerkship for fourth-year medical students.

METHODS

In addition to their clinical duties, we assigned 18 online modules at a rate of 1 to 3 per day. We evaluated knowledge acquisition using a 50-item, multiple-choice pretest and posttest. Postmodule and end-of-course questionnaires contained both closed and open-ended items soliciting students' perceptions about usability and satisfaction.

RESULTS

All 51 participants significantly improved in their dermatology knowledge (P < .001). The majority of students found the modules easy to navigate (95%) and worth their time (93%). All respondents supported the continuation of the modules as part of the dermatology clerkship.

LIMITATIONS

Without a control group who did not experience the online curriculum, we are unable to isolate the specific impact of the online modules on students' learning.

CONCLUSION

This study demonstrates the successful integration of this educational resource into a 2-week, university-based dermatology clerkship. Students' perceptions regarding usability and satisfaction were overwhelmingly positive, suggesting that the online curriculum is highly acceptable to learners. Widespread use of this curriculum may be a significant advancement in standardized dermatology learning for medical students.

Clinic teaching made easy: a prospective study of the American Academy of Dermatology core curriculum in primary care learners

BACKGROUND

Dermatology instruction for primary care learners is limited, and the American Academy of Dermatology (AAD) has developed a new core curriculum for dermatology.

OBJECTIVE

This study sought to prospectively evaluate short-term knowledge acquisition and long-term knowledge retention after using the AAD core curriculum during a clinical dermatology clerkship.

METHODS

Resident physicians and physician assistant students performing clerkships at military dermatology clinics were given access to the AAD core curriculum teaching modules before their public availability. Knowledge acquisition was measured with pretests and posttests, and a follow-up quiz was given up to a year after the dermatology rotation to assess knowledge retention.

RESULTS

In all, 82 primary care learners met inclusion criteria. Knowledge improved significantly from pretest to posttest (60.1 vs 77.4, P < .01). Of the 10 factors evaluated, only high use of the World Wide Web site was significantly associated with improved posttest scores (70.8 vs 82.2, P = .003). Long-term follow-up scores available from 38 participants were only slightly lower than their posttest scores (70.5 vs 78.9, P < .01) at a median time of 6.8 months after the clerkship. Students found the online modules clear, engaging, and worth their time and preferred them to other teaching methods such as textbook reading and lectures.

LIMITATIONS

The nonrandomized study was voluntary, so individual performance may be influenced by selection bias.

CONCLUSION

The more learners used the online curriculum, the better they scored on the posttest. This demonstrates the efficacy of the AAD core curriculum in teaching its goals and objectives for primary care learners performing a dermatology clerkship.