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Background Objective Methods Results Conclusion There is a need for unified guidance in the management of acneiform rash induced by epidermal growth factor receptor inhibitors (EGFRi) among dermatologists.To establish unified international guidelines for the management of acneiform rash caused by EGFR inhibitors, based on an experts' Delphi consensus.The initiative was led by five members of the European Academy of Dermatology and Venereology Task Force ‘Dermatology for Cancer Patients’ who developed a questionnaire that was circulated to a group of 32 supportive oncodermatology experts in Europe, Canada, Argentina, the US States and Asia. The questionnaire consisted of 84 statements in total, regarding diagnosis and treatment of EGFRi‐induced acneiform rash. Experts responded to an anonymous 5‐point Likert scale survey. The coordinators collected the first‐round responses that were checked for consensus (≥75% agreement in positive [agree or strongly agree] or in negative [disagree or strongly disagree] vote). The statements that did not reach strong consensus in the first round were revised, according to experts' feedback, for a second‐round survey.Strong consensus was reached in 75/84 (89.3%) of the statements, whilst moderate consensus was achieved in 6/84 elements. Key points include consideration of low‐dose isotretinoin for refractory grade II/III acneiform rash, use of topical steroid‐sparing agents like topical pimecrolimus in the maintenance phase and use of doxycycline in either 100 or 200 mg per day as prophylactic treatment. Interestingly, experts did not recommend topical antibiotics, neither for prevention, nor for treatment. Consensus failure in 3/84 objects is mostly related to the lack of robust data on these topics.This consensus offers crucial insights often overlooked by radiotherapists, general practitioners, dermatologists and oncologists, and it is expected to improve the management of oncologic patients treated with EGFRi in different settings and continents. [ABSTRACT FROM AUTHOR]

Background: In the Nordic European Countries, cancer is the leading cause of death. The last decade has brought revolutionizing cancer treatments including immune checkpoint inhibitors (ICIs). Patients on ICIs have a high risk of developing cutaneous immune-related adverse events. Treating these side effects is of high importance to improve patient's quality of life (QoL) and continue the anti-cancer treatment., Methods: The Nordic European Cutaneous Oncodermatology Management (NECOM) project develops tools to prevent and treat cancer therapy-related cutaneous adverse events (cAEs). The first 2 NECOM papers presented various cAEs and skincare regimens involving hygiene, moisturization, sun protection, and camouflage products for preventing and managing cAEs. The NECOM 3 practical algorithm was on the prevention and treatment of acute radiation dermatitis. This NECOM 4 practical algorithm is intended to prevent and manage cutaneous immunotherapy-related adverse events (cirAEs), improving cancer patients' QoL and outcomes., Results: The NECOM advisors discussed the results of a systematic literature review and obtained consensus on the evidence and expert opinion-based practical algorithm for cirAEs to support all healthcare providers treating cancer patients in the Nordic European Countries. The algorithm starts with a simple skincare regimen of cleansing, moisturizing, and protection, followed by the exclusion of severe cutaneous adverse reactions, and then specific interventions to treat the most common cirAEs (pruritus, maculopapular eruption, eczematous eruption, psoriasis, lichenoid eruption, and bullous eruption)., Conclusions: CirAEs are the most common side effects induced by ICIs and may lead to cancer treatment interruption or even discontinuation. Patient education on the prevention of cirAEs using a skincare regimen and treatment recommendations given in the NECOM 4 algorithm may help prevent and manage cirAEs and improve the QoL and outcome of patients receiving ICIs. J Drugs Dermatol. 2024;23:8(Suppl 2):s4-10.

With an increasing number of patients eligible for immune checkpoint inhibitors, the incidence of immune-related adverse events (irAEs) is on the rise. Dermatologic immune-related adverse events (D-irAEs) are the most common and earliest to manifest, often with important downstream consequences for the patient. Current guidelines lack clarity in terms of diagnostic criteria for D-irAEs. The goal of this project is to better define D-irAE for the purposes of identification, diagnosis, and future study of this important group of diseases.The objectives of this project were to develop consensus guidance for an approach to D-irAEs including disease definitions and severity grading. Knowing that consensus among oncologists, dermatologists, and irAE subspecialists would be critical for usability, we formed a Dermatologic irAE Disease Definition Panel. The panel was composed of 34 experts, including oncologists, dermatologists, a rheumatologist, and an allergist/immunologist from 22 institutions across the USA and internationally. A modified Delphi consensus process was used, with two rounds of anonymous ratings by panelists and two virtual meetings to discuss areas of controversy. Panelists rated content for usability, appropriateness, and accuracy on 9-point scales in electronic surveys and provided free text comments. A working group aggregated survey responses and incorporated them into revised definitions. Consensus was based on numeric ratings using the RAND/UCLA Appropriateness Method with prespecified definitions.Following revisions based on panelist feedback, all items received consensus in the second round of ratings. Consensus definitions were achieved for 10 core D-irAE diagnoses: ICI-vitiligo, ICI-lichen planus, ICI-psoriasis, ICI-exanthem, ICI-bullous pemphigoid, ICI-Grover's, ICI-eczematous, ICI-eruptive atypical squamous proliferation, ICI-pruritus without rash, and ICI-erosive mucocutaneous. A standard evaluation for D-irAE was also found to reach consensus, with disease-specific exceptions detailed when necessary. Each disorder's description includes further details on disease subtypes, symptoms, supportive exam findings, and three levels of diagnostic certainty (definite, probable, and possible).These consensus-driven disease definitions standardize D-irAE classification in a useable framework for multiple disciplines and will be the foundation for future work. Given consensus on their accuracy and usability from a representative panel group, we anticipate that they can be used broadly across clinical and research settings., Competing Interests: Competing interests: MS: Consulting with Amgen, AbbVie, Arcutis, Bausch Health, Boehringer Ingelheim, Bristol-Myers-Squibb, Eli Lilly Canada, Fresenius Kabi Canada, Galderma, Incyte, Janssen, L’Oreal Canada, LEO Pharmaceuticals, Merck, Novartis, Pierre Fabre, Pfizer, Sanofi, Sun Pharmaceuticals, UCB Canada.LCC: Research funding- Bristol-Myers Squibb, Consulting- AmgenAM: Research Funding: Amryt Pharma, Incyte Corporation, Kintara Therapeutics, Novartis, Novocure Consulting: ADC Therapeutics, Alira Health, AstraZeneca, Blueprint Medicines, Protagonist Therapeutics, OnQuality, and Janssen Royalties: UpToDateCAN: CAN has received research grants from Boehringer Ingelheim and participated in an advisory board for work related to pustular psoriasis and palmoplantar pustulosis.VH: Royalties from UpToDateML: Research funding: Onquality, Novartis, AZ, Lutris, Novocure; Consulting: Onquality, Novartis, AZ, Lutris, Novocure, La Roche Posay, JanssenMC: PI for Blueprint, Cogent, Author for UpToDateNRL: Consultant for or has received honoraria from Seattle Genetics, Sanofi, Bayer, Seattle Genetics, Sanofi, Silverback and Synox Therapeutics outside the submitted work., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

In light of research that shows the importance of effective sexual communication for healthier sexual relationships, less unwanted sexual activity, and less sexual violence, this article explores how both dominant and alternative sexual scripts influence sexual communication. Drawing on 51 in-depth interviews with adults in heterosexual, queer, non-monogamous, and kink sex communities about their actual communication and consent practices in sexual interactions, we asked 1) In what ways do dominant sexual scripts affect communication and consent in sexual interactions? 2) What factors encourage people to diverge from these dominant scripts? and 3) How do alternative scripts produce new forms of communication and consent? We found that traditional scripts remain common, especially among those with less sexual experience, and that adherence to these scripts is more likely to correspond to coercive or unwanted sex. Conversely, exposure to alternative sexual scripts via sexual experience, education, or communities often encourages sexual agency and communication. We conclude by discussing the implications of these insights about communicative consent negotiations for sexual violence prevention.

The recent public release of generative artificial intelligence (GenAI) has brought fresh excitement by making access to GenAI for medical education easier than ever before. It is now incumbent upon both students and faculty to determine the optimal role of GenAI within the medical school curriculum. Given the promise and limitations of GenAI, this study aims to assess the current capabilities of a GenAI (Chat Generative Pre-trained Transformer, ChatGPT), specifically within the framework of a pre-clerkship case-based active learning curriculum. The role of GenAI is explored by evaluating its performance in generating educational materials, creating medical assessment questions, answering medical queries, and engaging in clinical reasoning by prompting it to respond to a problem-based learning scenario. Our results demonstrated that GenAI addressed epidemiology, diagnosis, and treatment questions well. However, there were still instances where it failed to provide comprehensive answers. Responses from GenAI might offer essential information, hint at the need for further inquiry, or sometimes omit critical details. GenAI struggled with generating information on complex topics, raising a significant concern when using it as a 'search engine' for medical student queries. This creates uncertainty for students regarding potentially missed critical information. With the increasing integration of GenAI into medical education, it is imperative for faculty to become well-versed in both its advantages and limitations. This awareness will enable them to educate students on using GenAI effectively in medical education., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Sauder et al.)