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Background Nonenergy and injectable treatments are frequently used for facial rejuvenation. Many publications have addressed methods to reduce adverse events related to the procedure; however, no algorithm exists on temporol before, during, and after measures for nonenergy and injectable treatments. Methods A panel of dermatologists and plastic surgeons convened a virtual meeting to develop an algorithm for measures before, during, and after nonenergy and injectable treatments based on the best available evidence and the panelists' experience and opinion. For the project, a Delphi method was applied, which was adapted from face-to-face meetings to a virtual meeting to discuss the outcome of literature searches to reach a consensus on the algorithm. Results The four sections of the algorithm address measures for optimizing outcome before, during, and after the procedure. Prevention includes avoiding excessive sun exposure and the use of a broad-spectrum sunscreen with an SPF 30 or higher. Before nonenergy-based and injectable treatments, the avoidance of alcohol, retinol peels, and agents such as acetylsalicylic acid and non-steroidal anti-inflammatory drugs, amongst other agents, is advised. Isopropyl alcohol, chlorhexidine, or hypochlorous acid (HOCl) prepare the skin before nonenergy and injectable treatments. The advisors recognize HOCL as particularly useful as it is active against bacterial, viral, fungal microorganisms and biofilm. The literature is inconsistent about the use of topical agents and skincare before and after the procedure. Conclusions The algorithm aims to support an optimal treatment outcome for their patients, providing physicians with guidance on measures before, during, and after nonenergy and injectable treatments. J Drugs Dermatol. 2021;20:11(Suppl):s3-10.

Background Laser and energy-based devices may be used for many cutaneous indications, including facial resurfacing, improving skin conditions, and reducing signs of photoaging. Currently, no consensus papers or guidelines exist concerning peri-operative agents and specifically their use for laser skin resurfacing and their potential/possible role in prevention or treatment of side effects. Aim To explore current practice using laser and energy devices, a survey was developed to identify the trends in pre- and postprocedural treatment measures. Methods The survey was sent out digitally to 300 randomly selected US dermatologist and plastic surgeon physicians practicing medical esthetics using laser and other energy devices treatment for facial rejuvenation. The survey gathered information on demographics, types of devices used in the clinic and pre-/postprocedural measures for facial laser, and other energy-based devices treatment. Results The survey was active from June 15, to July 15, 2018, and fifty-eight dermatologists and plastic surgeons completed the survey (19.3% response rate, 58/300). The results showed inconsistency in skin preparation strategies and postprocedure wound care. The majority of survey participants (55/58 [96%]) reported prophylactic oral antiviral use pre- and post-treatment; however, there was inconsistency about when to start and when to stop the use. A similar inconsistency existed in the recommended period of post-treatment sun protection before and after treatment. Conclusion The results of the survey confirmed the lack of consistency in the types and duration of pre- and postprocedural measures-emphasizing the need for evidence-based recommendations to optimize outcomes, prevent infection, enhance comfort, and reduce downtime.

Introduction Every year in the United States, over 1 billion dollars are spent on aesthetic injectables, such as soft tissue fillers and neurotoxins. In 2018, the total amount of injectable treatments performed surpassed 2 671 130 procedures. While often mild and transient, adverse events (AEs) can occur following these procedures. AEs may include common side effects such as bruising, or rare, but serious AEs such as infections. While previous investigators have evaluated methods of reducing risks of AEs due to the treatment procedure itself, few investigations have evaluated measures employed before and/or after treatment (ie, peri-procedure). Methods An electronic survey was sent to aesthetic clinicians with experience performing injectable treatments. The survey collected information regarding general information (eg, demographics and specialty), type of injectable devices used, current peri-procedures, and an exploration of future options for peri-procedural measures. Results Most aesthetic clinicians did not use prophylactic topical or systemic antimicrobials, nor prophylactic topical antiviral therapy. However, approximately 65% of clinicians reported using prophylactic systemic antivirals for patients with a history of herpes simplex virus. A variety of products were used to prepare the skin prior to injectable procedures. Postprocedure, multiple over-the-counter wound repair products were recommended by >70% of injectors. However, there was a large variety of products recommended with no majority consensus. Conclusions Currently, there are no peri-procedural standards of practice when performing aesthetic injectable treatments. Efforts are underway for the development of best-practice algorithms.

Background Non-energy based devices used in aesthetic medicine include treatments such as microdermabrasion, microneedling, threads, and chemical peels. Practitioners may use these devices to address signs of facial photo- and chronological aging (fine lines, wrinkles, pigmentary, and skin textural changes). Currently, consensus papers or guidelines are lacking in peri-procedural measures or their potential role in the prevention or treatment of adverse events in non-energy based aesthetic procedures. Aims To explore current practices using non-energy devices, a survey was developed to identify trends in peri-procedure treatment measures. Patients/methods The survey was sent electronically to 2000 dermatologists and 388 plastic surgeons. Randomly selected sites included those practicing medical aesthetics using non-energy devices for facial rejuvenation. The survey gathered information related to practitioner demographics, types of devices used, and peri-procedural measures for non-energy device-based treatments. Results The survey was active from February to May 2019. Nine hundred and twenty clinicians opened the survey, and 109 surveys were completed, providing a total response rate of 11.8%. The results revealed inconsistencies with regards to skin preparation strategies and post-procedure care. While the majority of clinicians indicated a need for topical treatments to reduce inflammation, prevent scarring, and shorten time to healing, a standard of care was not observed. Conclusions The results of this survey confirm a lack of standardized measures for peri-procedural care when using non-energy based devices for aesthetic medicine treatments. These findings emphasize the need for evidence-based recommendations for optimizing patient outcomes, reducing and managing adverse events, and shortening time to healing.

Hispanics are generally diagnosed at more advanced stages of melanoma than non-Hispanic Whites, leading to lower survival rates. As skin cancer incidence is attributable to lifetime exposure to ultraviolet light, encouraging the performance of sun safety behaviors in childhood is an important strategy to address this divide. Problematically, we know little about the barriers to sun safety among Hispanic youth, especially among the Hispanics living in South Florida. To address this gap, we conducted focus groups among parents of Hispanic children aged 4-10 to understand the unique barriers to sun protection among this audience. Results revealed four categories of barriers: child-based barriers, external barriers, parental enactment barriers, and parental proper adherence barriers. These results are discussed in terms of their implications for future intervention research among this audience.

Background Lichen planopilaris (LPP) is a rare inflammatory lymphocyte-mediated disease of the scalp considered to have an autoimmune pathogenesis. Objectives To identify the prevalence of medical comorbidities in patients with classic LPP (CLPP) and frontal fibrosing alopecia (FFA). Methods The medical records of 206 LPP patients and 323 control patients were retrospectively reviewed for existing comorbidities. The control group consisted of 257 patients with androgenetic alopecia (ICD 9 = 704.0 or ICD 10 = L64.9) and 66 patients with actinic keratosis (ICD 9 = 702.0 or ICD 10 = L57.0). Results Systemic lupus erythematosus (SLE) was found in 4.37% of all patients with LPP (including CLPP and the FFA subtype) and in 0.31% of controls. Female patients with the FFA subtype were more likely to have SLE than controls (OR 31.034, 95% CI 2.405-400.382, P = 0.0085). Limitations This study is limited in that it is a retrospective chart review. Conclusion Female patients with FFA are significantly more likely to have SLE. Patients with LPP (including CLPP and the FFA subtype) are less likely to have diabetes. Patients with CLPP excluding FFA are less likely to have hypertension, heart disease, and hypothyroidism.

10564 Background: Cutaneous melanoma is a deadly form of skin cancer. Several studies have shown that early melanoma detection is associated with decreased mortality through self-examination and dermatology full-body skin exams. ABCD rule and the ugly duckling sign (UDS) are used to identify melanomas, but little research has explored the comparative efficacy of these approaches. This investigation compares the effectiveness of different mole identification training strategies and explores the effect of real-time feedback on decision-making. Methods: We developed an online melanoma identification game that tests differences between training types and expert feedback on mole identification. This online RCT tests a 4 (training: ABCD, UDS, both, control) X 3 (feedback: standard, motivational, control) factorial design on melanoma identification, skin cancer beliefs (perceived susceptibility and self-efficacy), and skin cancer prevention intentions. Standard feedback included expert evaluations of moles, whereas motivational feedback added statements grounded in fear appeals theory to encourage skin self-examination. An online research panel service was used to recruit 1025 US adults. Participants were randomly assigned to condition, completed a pretest, participated in the game intervention, and completed a posttest. Gameplay incorporates the same mechanics as Tinder (swipe left on benign moles and swipe right on malignant moles). Results: In total, participants reviewed 48 moles, 12 of which were melanomas. We used two-way ANCOVA for the analysis. ABCD training resulted in significantly higher melanoma identification than the control ( p =.011). Every training type resulted in significantly higher self-efficacy than the control ( p =.007). Additionally, there was a significant main effect of feedback on self-efficacy ( p =.001), where both standard and motivational feedback elicited significantly higher levels of self-efficacy than the control condition. Around 88% of participants intend to conduct skin self-exams and wear sunscreen. Conclusions: Our data suggests that “Whack a Mole” is an efficacious tool for melanoma training. ABCD and UDS training with interactive feedback are important to improve accuracy and ability for melanoma identification.

Chromoblastomycosis (CBM) is a slowly progressive cutaneous and subcutaneous mycosis mostly seen in tropical and subtropical areas and Fonsecaea pedrosoi is the most common cause. The authors describe the case of a diabetic Haitian woman, presenting with a chronic verrucous plaque without any history of trauma. Her histopathologic results showed epidermal hyperplasia and sclerotic bodies, which are diagnostic for CBM. Her therapy began with itraconazole 200 mg tablets twice a day. The unique feature of this patient is the coincidence of diabetes and CBM. However, to the best of our knowledge, this is the first documented case of human CBM in Miami, FL, which develops the awareness regarding this diagnosis among doctors in this area. There should be a close communication between dermatologists and pathologists to make an early diagnosis of CBM and also adequate therapy, which both are fundamental to improve patient's quality of life.

The American Academy of Dermatology has taken an active stance in addressing the lack of racial and ethnic diversity in the specialty. At the American Academy of Dermatology President's Conference on Diversity in Dermatology, which was held on August 5, 2017, key action items to increase the number of practicing board-certified dermatologists who are under-represented in medicine (UIM) were identified in 3 main areas. The action items include increasing the pipeline of UIM students applying to medical school, increasing UIM medical students' exposure to the field of dermatology and their level of interest in it, and increasing the number of UIM students recruited into dermatology residency programs.

This study determines the rates of dermoscopy in melanoma detection at the Miami Veterans Affairs Medical Center where dermatology residents are the frontline clinicians.

OBJECTIVES Research indicates that mood-based motivations may be an important predictor of indoor tanning bed use and may be related to indoor tanning dependence. Problematically, little research has been conducted to develop a psychometric measure of mood-based tanning motivations. The current study seeks to develop and validate the moodbased indoor tanning scale (MITS). METHODS Two studies were conducted to identify and verify the MITS factor structure as well as assess construct validity. Study 1 was conducted at 5 geographically diverse universities in the United States. Study 2 was conducted by using a national online sample in the United States. RESULTS Results from study 1 specified the factor structure of the MITS. Results from study 2 suggest that a one-point increase in the MITS measure corresponds with using indoor tanning beds 11 more times in the past year. CONCLUSIONS These findings demonstrate that moodbased tanning motivations are a strong predictor of indoor tanning intentions and behavior. Further, they suggest that health behavior researchers and healthcare practitioners can use the MITS to assess the extent to which mood-based motivations impact indoor tanning bed use.

Background: Even after the description of papuloerythroderma of Ofuji (PEO) in 1984, little is known about this clinical entity. Objective:To report on 2 new cases of PEO and review of the worldwide literature on this topic. Methods: Article citations were searched on several biomedical search engines (PubMed, EMBASE, SCOPUS, Google Scholar). Papers were retrieved either online or in print. Results: A grand total of 170 PEO cases were identified. Most patients were older than 55 years and of Asian or white descent, with an overall male/female ratio of 4.0. Itch and the deck-chair sign were observed in all patients. Peripheral eosinophilia, lymphocytopenia and increased serum IgE were common findings. Histopathology mostly showed aspecific inflammation, while 17 showed histological features of cutaneous T-cell lymphoma (CTCL). Atopy, malignancies, infections and drugs were rarely linked to PEO. Conclusion: PEO represents a rather monomorphous entity both clinically and, with the remarkable exception of CTCL, also histologically. Nonetheless, no causative factor could be identified in the vast majority of cases. An etiological classification and diagnostic criteria are proposed in the attempt to contribute framing this puzzling clinical entity.

Background Although age-adjusted incidence rates (per 100,000) for melanoma are lower among Hispanics and blacks (4.5 and 1.0, respectively) compared with white non-Hispanics (21.6), melanomas among minority populations in the United States are more likely to metastasize and have poorer outcomes. Methods A review of the literature was conducted on melanomas affecting Hispanic and black Americans. Results Because of the low index of suspicion in both the medical community and these ethnic populations, diagnosis is often delayed, resulting in advanced presentation and a poorer prognosis. Conclusions More comprehensive medical training, expanded public educational campaigns, and increased awareness among patients of all skin types to perform self skin checks are recommended. Further studies elucidating the etiology and risk factors for melanoma among minority populations are warranted.

Although age-adjusted incidence rates (per 100,000 population) for melanoma are lower among Hispanics (4.5) compared with non-Hispanic whites (21.6), melanoma in Hispanics is more likely to be diagnosed at more advanced stages, resulting in higher mortality than non-Hispanic whites in the USA. It is likely due to, in part, a lower index of suspicion in both the healthcare providers and the minority populations and, as such, diagnosis is often delayed, resulting in advanced presentation and a worse prognosis. More comprehensive medical training, expanded public education campaigns and increased awareness among patients of all skin types to perform self skin checks are highly recommended. Further studies elucidating the etiology and risk factors for melanoma among minority populations are needed.

Papillary eccrine adenoma (PEA) is an uncommon sweat gland neoplasm that occurs more frequently on the distal extremities of Black women. Clinically, it appears as a small, isolated, firm, dome-shaped cutaneous nodule. We report two unusual cases of PEA that presented clinically as cutaneous horn. Histologically, both cases showed the typical dermal morphology of PEA with overlying epidermal changes suggestive of human papillomavirus (HPV). However, HPV immunoperoxidase staining and polymerase chain reaction for HPV were negative in both cases. Concurrent occurrence of PEA and HPV-like epidermal changes may be coincidental; however, their co-occurrence may also be related to the environment induced by this adnexal tumor. Whether PEA with verrucous epidermal changes has a different clinical behavior or increased risk for a malignant transformation is unknown, as both patients were lost to follow-up.

Apligraf® is a bilayered tissue-engineered product consisting of a bovine collagen matrix with neonatal fibroblasts, overlaid by a stratified epithelium containing living keratinocytes. The United States Food and Drug Administration has approved its use for venous leg ulcers and neuropathic diabetic foot ulcers. Apligraf® provides a dermal matrix and produces cytokines similar to the human skin. However, its mechanism of action and ultimate fate in host wounds are unclear. The aim of this study was to evaluate the persistence of Apligraf® fibroblasts and keratinocytes in human acute partial-thickness wounds (split-thickness donor sites) treated with Apligraf®. In an open-label, within-patient, three-centered, controlled pilot study, 10 patients were treated with Apligraf®, Apligraf® dermis only (without epidermis), and a polyurethane film for donor site wounds of the same size, depth, and anatomical location. Apligraf® DNA persistence was the primary outcome measure. Basement membrane components, cosmetic outcome, time to wound healing, and safety parameters were secondary outcome measures. One week after the initial treatment, reverse transcription polymerase chain reaction analysis found that two Apligraf® and two Apligraf® dermis-only-treated sites had Apligraf® DNA present. Four weeks posttreatment, only one Apligraf® and one Apligraf® dermis-only sites showed the presence of Apligraf® DNA. There was no difference between the three treatment modalities in establishing basement membrane in donor site wounds. No differences in other secondary outcomes were found. Apligraf® DNA persisted in a minority of patients at 4 weeks in acute partial-thickness wounds. Apligraf®'s success in speeding healing of acute wounds appears to be related to factors other than the persistence of donor DNA or effect on basement membrane restoration.

Background The incidence rates of melanoma and non-Hodgkin's lymphoma (NHL) have increased substantially worldwide over the past several decades. It has been hypothesized that ultraviolet light exposure through sunlight may be a common environmental risk factor shared by both skin cancer and NHL. Objective The purpose of this study was to better understand the association between skin cancer and NHL and to evaluate its implication in clinical practice. Methods We reviewed the current literature on the link between the two malignancies and on the role of ultraviolet light in the development of NHL. Publications were selected using a PUBMED search with the terms “non-Hodgkin's lymphoma” and “skin cancer.” Epidemiologic studies in English and published after 1995 were the focus. Conclusions Large population-based studies support an increased risk of subsequent NHL among patients with skin cancers (both melanoma and nonmelanoma skin cancers) and a risk of skin cancer development in patients with NHL, although support for a direct relationship between ultraviolet light and the incidence of NHL is weak and inconsistent. Given their increased risk of developing skin cancers, patients with a history of NHL may benefit from a full-body examination during their visits. SHASA HU, MD, DANIEL G. FEDERMAN, MD, FANGCHAO MA, MD, PHD, AND ROBERT S. KIRSNER, MD, PHD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.

Manicures can result in nail damage via instrumentation, nail polish, nail polish removers, and artificial nails. We report nail weakness, brittleness, and thinning in five subjects after the application of a new manicure system called gel polish and removal with acetone and manual peeling. All subjects complained that the polish was very difficult to remove and that their nails became much thinner after the procedure. Pseudoleukonychia and onychoschizia lamellina were noted on examination. One subject underwent ultrasound and reflectance confocal microscopy (RCM) measurements of nail plate before and after the gel polish application, which showed thinned nail plate (0.063 vs. 0.050 cm and 0.059 vs. 0.030 cm, respectively). Overall, we call attention to the adverse effects of gel polish manicures in five subjects. In addition, our case illustrates potential utility of ultrasound and RCM in measuring nail plate thickness.

The increasing incidence of allogeneic transplants in Coccidioides-endemic areas such as the southwestern United States and Latin America highlights the importance of considering reactivation of donor coccidioidomycosis in transplant recipients. We report the case of a 42-year-old Nicaraguan woman who had multiple firm, violaceous subcutaneous nodules 1 month after her orthotopic liver transplant. Histopathology of a biopsy specimen, immunodiffusion assay, and donor serologic testing results were consistent with disseminated cutaneous coccidioidomycosis secondary to donor reactivation. Screening of donors in Coccidioides-endemic areas with serology, organ culture, and chest radiography should be considered before transplantation. Recipients in endemic areas may benefit from prophylactic antifungal therapy.

Minority populations have disproportionately more advanced stage melanoma and worse survival. To clarify the impact of race and ethnicity on late-stage melanoma diagnosis, we performed spatial analysis of geocoded melanoma cases diagnosed in Florida, 1999–2008, to identify geographic clusters of higher-than-expected incidence of late-stage melanoma and developed predictive models for melanoma cases in high-risk neighborhoods accounting for area-based poverty, race/ethnicity, patient insurance status, age, and gender. In the adjusted model, Hispanic ethnicity and census tract-level poverty are the strongest predictors for clustering of late-stage melanoma. Hispanic whites were 43% more likely to live in neighborhoods with excessive late-stage melanoma (P

Background Onychomatricoma is a benign fibroepithelial nail matrix tumor that infiltrates the nail plate leading to multiple tunneled cavities lined with matrix epithelium and filled with serum. Diagnostic features of onychomatricoma on reflectance confocal microscopy (RCM) have not been previously described. Objective We sought to demonstrate the feasibility of using RCM to diagnose onychomatricoma. Methods Reflectance confocal microscopy was used to evaluate four patients with onychomatricoma before tumor excision. We evaluated the affected nail and one unaffected nail of each patient with VivaScope 1500 (Lucid Inc., Rochester, NY, USA). Results Reflectance confocal microscopy evaluation of onychomatricomas revealed longitudinal dark areas and bright/grey lines, forming channel like structures. The channels were outlined by bright circular lines with grey dot centers. These RCM features correlated with the pathology of the onychomatricomas within the nail plate. Limitations Proximal portion of onychomatricoma was not reach by RCM. Conclusions Reflectance confocal microscopy can assist in rapid and noninvasive diagnosis of onychomatricoma showing characteristic channel like structures within nail plates.

To examine and compare the temporal trends in melanoma incidence and stage at diagnosis among whites, Hispanics, and blacks in Florida from 1990 to 2004.Cross-sectional and retrospective analysis.Florida Cancer Data System.Melanoma cases with known stage and race/ethnicity reported from 1990 to 2004.Age-adjusted melanoma incidence and stage at diagnosis.Of 41 072 cases of melanoma, 39 670 cases were reported for white non-Hispanics (WNHs), 1148 for white Hispanics (WHs), and 254 for blacks. Melanoma incidence rates increased by 3.0% per year among WNH men (P.001), 3.6% among WNH women (P.001), 3.4% among WH women (P = .01), and 0.9% among WH men (P = .52), while remaining relatively stable among black men and women. Both WHs and blacks had significantly more advanced melanoma at presentation: 18% of WH and 26% of black patients had either regional or distant-stage melanoma at diagnosis compared with 12% of WNH patients. The proportion of distant-stage melanoma diagnosed among WHs and blacks changed little from 1990 to 2004, compared with a steady decrease in the percentage of melanoma cases diagnosed at distant stage among WNHs (P.001). Such differences in the time trends of the proportion of distant-stage melanoma remained after excluding in situ cases.The rising melanoma incidence among WNHs and WHs emphasizes the need for primary prevention. The persistence of disparity in melanoma stage at diagnosis among WHs, blacks, and WNHs warrants closer examination of secondary prevention efforts in minority groups.

Transplant immunosuppressants have been implicated in the increased incidence of non-melanoma skin cancer in transplant recipients, most of whom harbor considerable UVB-induced DNA damage in their skin prior to transplantation. This study was designed to evaluate the effects of two commonly used immunosuppressive drugs, cyclosporine A (CsA) and sirolimus (SRL), on the development and progression of UVB-induced non-melanoma skin cancer. SKH-1 hairless mice were exposed to UVB alone for 15 weeks, and then were treated with CsA, SRL, or CsA+SRL for 9 weeks following cessation of UVB treatment. Compared with vehicle, CsA treatment resulted in enhanced tumor size and progression. In contrast, mice treated with SRL or CsA+SRL had decreased tumor multiplicity, size, and progression compared with vehicle-treated mice. CsA, but not SRL or combined treatment, increased dermal mast cell numbers and TGF-β1 levels in the skin. These findings demonstrate that specific immunosuppressive agents differentially alter the cutaneous tumor microenvironment, which in turn may contribute to enhanced development of UVB-induced skin cancer in transplant recipients. Furthermore, these results suggest that CsA alone causes enhanced growth and progression of skin cancer, whereas co-administration of SRL with CsA causes the opposite effect.

The genetic basis of psoriasis has long been recognized, including the knowledge that family members of patients with psoriasis are at greater risk of developing the disease (Henselers and Christophers, 1995). Several lines of evidence suggest that genes regulating IL-12 and IL-23 may be important in its pathogenesis. Part of the rationale stems from observations indicating that patients with psoriasis and those with Crohn's disease share common features: patients with Crohn's disease are five times more likely than the general population to have psoriasis, and both diseases respond to anti-tumor necrosis factor-α therapy (Lee et al., 1990). A recent genome-wide association scan identified a highly significant association between Crohn's disease and a single-nucleotide polymorphism (SNP) in the coding region of the IL23R gene (Duerr et al., 2006), suggesting that this polymorphism might be present in patients with psoriasis. Additional studies from several diverse ethnic populations throughout the world have determined that psoriasis is associated with SNPs in IL-12 and IL-23 or their receptors (Capon et al., 2007; Cargill et al., 2007; Chang et al., 2007; Tsunemi et al., 2002).

Despite improvements in prevention and screening, mortality from advanced melanoma has not improved (Geller et al., 2007) and ultraviolet radiation (UV) is a major risk factor for melanoma development (Fears et al., 2002). Greater understanding of the mechanisms of melanoma development may lead to novel treatment options. As opposed to keratinocytes, which routinely undergo apoptosis after UVB irradiation, melanocytes resist apoptosis. In previous work, melanocytes and melanoma cells responded to UVB by activating an original pathway involving Gadd45a, one of the several growth-arrest and DNA damage–inducible genes (Lefort et al., 2001).

To examine skin cancer awareness and behavior in white Hispanic (WH) and white non-Hispanic (WNH) high school students because increasing incidence and delayed diagnosis of skin cancer in the growing Hispanic population in the United States represent an emerging health issue.Pilot survey study.A high school in Miami, Florida.A total of 369 high school students (221 WHs and 148 WNHs) were surveyed in the study.Survey data were collected regarding skin cancer knowledge, perceived risk, and sun protection behaviors. Differences between the 2 groups were compared with chi(2) tests.White Hispanic students were more likely to tan deeply (P = .04) but less likely to have heard of (P.01) or been told how to perform (P.01) skin self-examination. White Hispanics were less likely to wear sun-protective clothing or to use sunscreen with a sun protection factor of 15 or higher and reported a greater use of tanning beds. White Hispanic students also thought their chance of developing skin cancer was less than that of WNH students (P.01), which remained significant after adjustment for age, sex, family history, and skin sensitivity to sun. After adjustment, WHs were 2.5 times more likely than WNHs to have used a tanning bed in the past year. White Hispanics were also 60% less likely to have heard of skin self-examination (P.01) and 70% less likely than WNHs to have ever been told to perform the examination (P = .03). White Hispanics are about 1.8 and 2 times more likely to never or rarely wear protective clothing (P.01) and to use sunscreen (P = .01), respectively.There are disparities in knowledge, perceived risk of skin cancer, and sun-protective behaviors among WH and WNH high school students.

Objective To compare stage at diagnosis of melanoma between non-Hispanic white, non-Hispanic black, and Hispanic patients. Design Retrospective analysis. Setting Melanoma cases reported to the Florida Cancer Data System, with known stage and race/ethnicity information, for residents of Miami-Dade County, Florida, from 1997 to 2002. Patients Those diagnosed as having melanoma according to the Florida Cancer Data System. Main Outcome Measure Stage of melanoma at diagnosis. Results Of the 1690 melanoma cases reported with both stage and race/ethnicity information, 1176 (70%) were among non-Hispanic white patients, 485 (29%) were among Hispanic patients of any race, and 29 (2%) were among non-Hispanic black patients. Late-stage (regional and distant) diagnosis was more common among Hispanic (26%) and non-Hispanic black patients (52%) compared with non-Hispanic white patients (16%) ( P Conclusion Advanced stage of melanoma diagnosis among Hispanic and black patients suggests suboptimal secondary prevention efforts in minority populations.

Little information exists on the epidemiology of melanoma and the role of solar radiation in the development of melanoma in pigmented populations.To evaluate the relationship between exposure to solar radiation and the incidence of melanoma in US Hispanics and blacks.Population-based ecological study.State cancer registries of New York, New Jersey, Illinois, California, Texas, and Florida. Subjects Patients with invasive melanoma recorded by cancer registries.We obtained age-adjusted, race/ethnicity- and sex-specific incidence rates of melanoma from similar time periods from the 6 cancer registries. The incidence rates were correlated with the annual mean UV index and the latitude of residency.For both Hispanics and blacks, the incidence of melanoma was positively associated with the UV index and negatively associated with the latitude of residency. Statistically significant correlation between melanoma and the UV index (R = 0.93; P =.01) and latitude (R = -0.80; P =.05) was observed in black males. Hispanics and blacks have a significantly lower incidence of melanoma than whites, with blacks having the lowest rates of melanoma.Exposure to solar radiation appears to play a role in the development of melanoma in both Hispanics and blacks. Sun protection and melanoma risk education should be performed in these populations.

Non-Hodgkin’s lymphoma (NHL) is one of the most common cancers among American Hispanics. Several studies suggest that solar UV radiation (UVR) may be an environmental risk contributing to the rise of NHL over the past decades. These studies focused primarily on light-skinned Caucasian populations; it is unknown what role UVR plays in NHL for Hispanics. We described the incidence of NHL in Hispanics from selected states in the United States between 1989 and 2000. To evaluate the role of UVR, we correlated cancer rates with the UV index and latitude of residency. Variations in NHL incidence rates with estimated amount of UVR among whites and blacks from the selected states were also analyzed. We found that NHL occurred less frequently in Hispanics than in whites. Hispanic men had higher incidence of NHL than Hispanic women. Incidence rates of NHL in Hispanics were inversely associated with estimated amount of UVR as an increase in NHL was observed with decreasing UV index (r = −0.7 in men; r = −0.41 in women) or increasing latitude of residency (r = 0.59 in men; r = 0.48 in women). This trend, although it did not reach statistical significance, was also observed in whites and blacks. Our findings do not support previous reports of a positive association between solar radiation and NHL. The inverse relationship between UVR and incidence of NHL is unexplained but presents the need for generation of hypotheses regarding the epidemiology of causal factors for NHL in the United States. Additional studies should be conducted to clarify whether sunlight exposure contributes to the development of NHL.

Non-melanoma skin cancer (NMSC) has been associated with several other conditions, including melanoma and non-Hodgkin's lymphoma (Hjalgri et al., 2000; Hu et al., 2005). In addition, the risk of NMSC has been found to be greater in various chronic disease groups (Frisch and Melbye, 1995; Frisch et al., 1996). It is uncertain whether this association is related to the treatments for those chronic diseases (such as radiation therapy or immunosuppressant therapy) rather than the disease itself (Karagas et al., 2001; Saladi and Persaud, 2005). Moreover, using a Danish nationwide cohort of patients with NMSC, Jensen et al. (2006) found a lower mortality in basal cell carcinoma (BCC) patients compared with the general population, reflecting what the authors suggested to be a selection bias to that data set.

Recessive dystrophic epidermolysis bullosa (RDEB) is a severe mechanobullous disease characterized at the molecular level by mutations in the COL7A1 gene, leading to reduced type VII collagen and defective anchoring fibrils at the dermal–epidermal junction (DEJ) (Fine et al., 2000). Patients who inherit this condition suffer from recurrent blistering, cutaneous ulcers, severe scarring, and deformities, and they are at high risk for developing life-threatening squamous cell carcinoma (Mallipeddi, 2002). Currently, there is no treatment for RDEB.