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Dermatology is one of the least diverse medical specialties. Although there have been studies addressing barriers faced by underrepresented in medicine (UIM) applicants to dermatology, there is little information about how UIM applicants approach and fare in the dermatology residency match process. This study aimed to assess differences between UIM and non-UIM applicants in the dermatology match process. A survey was administered to 2020-2021 dermatology applicants (N=232) to evaluate applicant characteristics, approaches, and outcomes in the match process. Survey responses were analyzed to determine if differences between variables were statistically significant. An additional survey was administered to dermatology residency program directors to evaluate their approach to the 2020-2021 application process. Our findings are important in identifying interventions to improve equity in the dermatology application process and to improve diversity in the dermatology workforce.

Since dermatologists routinely perform surgery in an outpatient setting, ensuring that dermatology trainees are provided with opportunities to develop sufficient proficiency in excisional surgery and suture technique is paramount. The objectives of this study are to assess trainee preference for silicone-based synthetic skin compared with porcine skin as a surgical training medium and to assess the ability of trainees to successfully demonstrate basic surgical skills using the simulated skin model. Participants were a convenience sample of dermatology residents from the greater Chicago area, who were asked to perform an elliptical excision and bilayered repair on a silicone-based synthetic skin model. Residents were then surveyed regarding their satisfaction with the model. Four blinded dermatologist raters evaluated digital photographs obtained during the performance of the procedures and graded the execution of each maneuver using a surgical task checklist. Nineteen residents were enrolled. Residents were more likely to prefer pig skin to simulated skin for overall use (p = 0.040) and tissue repair (p = 0.018), but the nominal preference for tissue handling was nonsignificant (p = 0.086). There was no significant difference between satisfaction with pig skin versus synthetic skin with regard to excision experience (p = 0.82). The majority of residents (10/19) performed all surgical checklist tasks correctly. Of those residents who did not perform all steps correctly, many had difficulty obtaining adequate dermal eversion and wound approximation. Synthetic skin may be conveniently and safely utilized for hands-on surgical practice. Further refinement may be necessary to make synthetic skin comparable in feel and use to animal skin.

The COVID-19 pandemic has accelerated discussions about reforms needed in the dermatology residency application process. We sought to evaluate the perspectives of dermatology program directors (PDs) and applicants regarding changes implemented during the 2020-2021 application cycle and measure support for potential reforms. Two online surveys were distributed to PDs and applicants who participated in the 2020-2021 dermatology residency match. Responses were collected from a total of 79 PDs (73.8% response rate, 83.5% complete responses) and 232 applicants (83.6% complete responses). The top 3 reforms supported by PDs were application caps (89.4% in favor), interview caps (86.4% in favor), and token preference signaling (81.8% in favor). The top 3 reforms supported by applicants were coordinated interview invite release (89.7% in favor), national webinars with PDs and/or faculty to discuss the application process (86.6% in favor), and formalized mentorship programs with PDs and/or faculty (78.4% in favor). This study was limited by the inability to capture responses from more dermatology applicants, possibly affecting the generalizability of the results. We identified broad support for multiple proposed reforms to the dermatology residency application process, particularly to improve the efficiency of application review and strengthen communication between programs and applicants.

Background Researchers in all medical specialties increasingly use social media to educate the public, share new publications with peers, and diversify their audiences. Objective Given Cochrane Skin Group’s expanded use of social media in the past years, we aimed to characterize Cochrane Skin Group's international social media audience and identify themes that result in increased content engagement. Methods Cochrane Skin Group's Facebook, Instagram, and Twitter analytics data were extracted for follower demographics and the most viewed posts within a 3-year span (June 2019 to June 2022). Results Overall, Cochrane Skin Group had the highest number of followers on Facebook (n=1037). The number of Instagram and Twitter followers reached 214 and 352, respectively. The greatest numbers of Facebook followers were from Brazil, Egypt, and India, with 271, 299, and 463 followers, respectively. Facebook’s most viewed post about Cochrane Skin Group’s annual meeting received 1041 views. The top post on Instagram, which introduced Cochrane Skin Group’s social media editors, received 2522 views. Conclusions Each of the social media platforms used by Cochrane Skin Group reached varying audiences all over the world. Across social media platforms, posts regarding Cochrane Skin Group meetings, members, and professional opportunities received the most views. Overall, Cochrane Skin Group's multiplatform social media approach will continue to grow an international audience, connecting people interested in skin disease.

Background. According to the Center for Disease Control and Prevention (CDC), half of the 20 million new sexually transmitted infections (STIs) occur annually in youth aged 15 to 24. It is critical for dermatologists to be able to provide young patients with accessible education about how to identify, prevent, and treat these conditions. Our pilot study sought to assess the impact of a live presentation about STIs in high school students and to evaluate students’ baseline and acquired knowledge about common STIs using a before and after survey. Methods. This survey study was conducted as part of the health education curriculum at a suburban high school. An interactive scenario-based presentation about STIs was given to participants. Identical, deidentified preintervention and postintervention surveys were completed by subjects to assess their baseline and acquired knowledge of STIs. Each question was worth 1 point, for a total of 8 points. Results. 74 high school students were surveyed. Overall, there was a mean improvement of 1.85 points in the posttest score in comparison to pretest score with a standard deviation of 1.58 ( p < 0.0001 ). Among all participants, the mean pretest score was 1.07 (SD = 0.75) and the mean posttest score was 2.92 (SD = 1.59). Conclusions. This study demonstrated that many young adults are unaware of the common types of STIs, symptoms, and potential complications. While our scenario-based presentation was effective at providing understandable content to help improve students’ knowledge regarding STIs, additional educational resources in varied formats could likely further these gains.

Background: Patients presenting with a site-specific skin complaint may receive a total body skin examination (TBSE) or a more focused examination. A TBSE may be time-consuming but can potentially detect unsuspected or early stage skin cancers. The purpose of this study was to assess the detection of skin cancers associated with dermatologist-initiated TBSE performed immediately after a focused skin examination on the same patients. Methods: The dermatology records of patients with biopsy-proven melanoma, basal cell carcinoma (BCC), or squamous cell carcinoma (SCC) during a 2-year period were reviewed. Generalized linear mixed-effects models were used to estimate the odds of a lesion being identified by a dermatologist (rather than the patient or the patient's primary health care provider). Results: A total 1563 biopsy-proven cutaneous malignancies were found on 1010 patients. Of these, 797 cancers (51%) were first identified by a dermatologist on TBSE and 764 (48.9%) by the patient or the referring provider. Among tumors first identified by dermatologists (n = 797), 553 (69%) were BCCs, 220 (28%) were SCCs, and 24 (3%) were melanomas. The mean Breslow depth was 0.53 mm (standard deviation: 0.31 mm) for melanomas found on TBSE versus 1.04 mm (standard deviation: 1.68 mm) if identified by patients or referring providers. BCCs were more likely to be identified by a dermatologist during a TBSE (n = 553 [56%] vs. n = 434 [44%]; odds ratio: 1.79; p < .001). Tumors ultimately diagnosed as SCCs were more often identified by patients or patients’ primary care providers (n = 302 [58%]; odds ratio: 0.56; p < .001). However, 220 otherwise undetected SCCs were found during dermatologist-performed TBSE. Conclusion: Dermatologist-performed TBSEs identified numerous cutaneous malignancies that might otherwise have remained undiagnosed. Early detection of melanoma or nonmelanoma skin cancer by TBSEs may spare patients significant morbidity and mortality.

Since dermatologists routinely perform surgery in an outpatient setting, ensuring that dermatology trainees are provided with opportunities to develop sufficient proficiency in excisional surgery and suture technique is paramount. The objectives of this study are to assess trainee preference for silicone-based synthetic skin compared with porcine skin as a surgical training medium and to assess the ability of trainees to successfully demonstrate basic surgical skills using the simulated skin model. Participants were a convenience sample of dermatology residents from the greater Chicago area, who were asked to perform an elliptical excision and bilayered repair on a silicone-based synthetic skin model. Residents were then surveyed regarding their satisfaction with the model. Four blinded dermatologist raters evaluated digital photographs obtained during the performance of the procedures and graded the execution of each maneuver using a surgical task checklist. Nineteen residents were enrolled. Residents were more likely to prefer pig skin to simulated skin for overall use (p = 0.040) and tissue repair (p = 0.018), but the nominal preference for tissue handling was nonsignificant (p = 0.086). There was no significant difference between satisfaction with pig skin versus synthetic skin with regard to excision experience (p = 0.82). The majority of residents (10/19) performed all surgical checklist tasks correctly. Of those residents who did not perform all steps correctly, many had difficulty obtaining adequate dermal eversion and wound approximation. Synthetic skin may be conveniently and safely utilized for hands-on surgical practice. Further refinement may be necessary to make synthetic skin comparable in feel and use to animal skin.

Many pediatric skin conditions can be safely monitored with minimal intervention, but certain skin conditions are emergent and require immediate attention and proper assessment of the neonate, infant, or child. We review the following pediatric dermatology emergencies so that clinicians can detect and accurately diagnose these conditions to avoid delayed treatment and considerable morbidity and mortality if missed: staphylococcal scalded skin syndrome (SSSS), impetigo, eczema herpeticum (EH), Langerhans cell histiocytosis (LCH), infantile hemangioma (IH), and IgA vasculitis.

Ipilimumab was the first FDA-approved agent for advanced melanoma to improve survival and represents a paradigm shift in melanoma and cancer treatment. Its unique toxicity profile and kinetics of treatment response raise novel patient education challenges. We assessed patient perceptions of ipilimumab therapy across the treatment trajectory. Four patient cohorts were assessed at different time points relative to treatment initiation: (1) prior to initiation of ipilimumab (n = 10), (2) at weeks 10–12 before restaging studies (n = 11), (3) at week 12 following restaging studies indicating progression of disease (n = 10), and (4) at week 12 following restaging studies indicating either a radiographic response or disease stability (n = 10). Patients participated in a semistructured qualitative interview to assess their experiences with ipilimumab. Quality of life was assessed via the Functional Assessment of Cancer Therapy-General and its Melanoma-specific module. Perceived quality of life was comparable across cohorts, and a majority of the sample understood side effects from ipilimumab and the potential for a delayed treatment response. Patients without progression of disease following restaging studies at week 12 held more positive views regarding ipilimumab compared to patients who had progressed. Patients generally regarded ipilimumab positively despite the risk of unique toxicities and potential for delayed therapeutic responses; however, those with progression expressed uncertainty regarding whether taking ipilimumab was worthwhile. Physician communication practices and patient education regarding realistic expectations for therapeutic benefit as well as unique toxicities associated with ipilimumab should be developed so that patients can better understand the possible outcomes from treatment.

Objective: We sought to evaluate the efficacy of a Spanish-language educational video in teaching primary Spanish speaking patients to recognize benign and malignant lesions and to increase their awareness about skin cancer. Materials and Methods: Thirty-seven subjects were enrolled in study. An instructional video was developed to increase knowledge of benign and malignant lesions, skin cancer awareness, and prevention among Spanish-speaking patients. Two examples each of six common skin lesions (e.g., malignant melanoma, cherry angioma, seborrheic keratosis, benign melanocytic nevus, basal cell carcinoma, and squamous cell carcinoma) were presented as high-quality images to the participants before and after watching the two-minute educational video. A pre- and postvideo survey was used to assess competency. Results: The prevideo baseline median score was six points (interquartile range [IQR]: 5–6 points); postviewing median score improved to 11 points (IQR: 11–12 points), which was statistically significant (Median=5 points, IQR: 4–6 points; p

In July 2020 the National Dermatology Interest Group Association (DIGA) co-hosted the first national dermatology webinar with the Association of Professors of Dermatology to address the residency application process during COVID-19, with over 996 students in attendance Prior to the webinar, students anonymously submitted 54 questions through a google survey Program directors addressed these questions during the webinar Attendees could ask questions (99) during the webinar anonymously via Zoom’s “Chat” function Following the webinar, attendees completed a survey The topics of the anonymous questions submitted included application logistics (41 12%, 63/153), USMLE board scores & grades (21 57%, 33/153), demonstrating interest (14 38%, 22/153), away rotations (12 42%, 19/153), special applicant groups (11 11%, 17/153), research (5 88%, 9/153), and letters of recommendation (4 58%, 7/153) 96% percent of survey-responders rated the webinar as “helpful,” 93% were satisfied with the content, and 84% found the webinar to be stress-relieving Application logistics as the top category is pertinent given this unique application cycle Students responded well to the webinar as indicated by the positive post-webinar survey results This could be related to the opportunity to anonymously query program directors without fear of retribution Furthermore, this qualitative analysis may guide programs to increase transparency on their websites Regardless of the landscape of future application cycles, we advocate for continued use of online platforms annually to assist applicants