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The attitudes of patients toward resident participation in a university-based dermatology outpatient clinic were evaluated. Of 206 patients asked to participate, 191 patients completed the self-administered questionnaire (92.7%). The overwhelming majority of patients (99.5%) were satisfied (81.8% "very satisfied" and 17.7% "satisfied") with the resident's participation in their care. Many more patients expressed a willingness to allow residents to take histories (93.6%), perform physical examinations (87.2%), and counsel on preventive measures (74.5%), than to allow surgical excisions of skin cancers (19.7%), perform skin biopsies (43.6%), or prescribe medications (44.7%). Of respondents to the questionnaire, 83.2% self-reported an understanding of the difference between "resident" and "attending" physicians. However, only 31.3% (95% confidence interval 24.5-38.1) were able to broadly categorize the amount of training completed by dermatology residents. Dermatology resident participation in outpatient clinics is essential to quality dermatologic education. Consistent with the results of prior studies in other medical disciplines, our study demonstrated an overwhelming patient satisfaction with the participation of dermatology residents in their care.

Despite an incomplete understanding of the pathogenesis of rosacea, therapeutic modalities continue to expand. The principal subtypes of rosacea include erythematotelangiectatic rosacea, papulopustular rosacea, phymatous rosacea, and ocular rosacea. These phenotypic expressions are probably caused by divergent pathogenic factors and consequently respond to different therapeutic regimens. A subtype-directed approach to therapy is discussed in part II of this review. We provide an overview of the available topical, oral, laser, and light therapies in the context of these cutaneous subtypes, review the evidence that supports their use, and outline their therapeutic approach. Suggestions for future areas of study also are provided. Learning objective At the completion of this learning activity, participants should be familiar with the subtype-directed approach to therapy for rosacea including available topical, oral, laser, and light therapies.

Rosacea is one of the most common conditions dermatologists treat. Rosacea is most often characterized by transient or persistent central facial erythema, visible blood vessels, and often papules and pustules. Based on patterns of physical findings, rosacea can be classified into 4 broad subtypes: erythematotelangiectatic, papulopustular, phymatous, and ocular. The cause of rosacea remains somewhat of a mystery. Several hypotheses have been documented in the literature and include potential roles for vascular abnormalities, dermal matrix degeneration, environmental factors, and microorganisms such as Demodex folliculorum and Helicobacter pylori. This article reviews the current literature on rosacea with emphasis placed on the new classification system and the main pathogenic theories. Learning objective At the conclusion of this learning activity, participants should be acquainted with rosacea's defining characteristics, the new subtype classification system, and the main theories on pathogenesis.

Background: Problems with statistical methods and reporting have been noted in articles published in dermatology journals. Conclusions presented in published reports may be misleading if based on inappropriate or misinterpreted statistical analysis., Objective: We sought to assess dermatology journal editors' policies and perceptions regarding statistical review of submitted manuscripts., Design: We mailed and e-mailed a questionnaire survey., Participants: A total of 43 dermatology journal editors, representing 35 dermatology journals from the United States and abroad, participated in this study., Results: In all, 32 editors (74.4%), representing 30 journals (85.7%), returned questionnaires. A total of 24 editors (75%) reported having requested statistical reviews on less than 5% of published manuscripts containing original quantitative analysis (ie, excluding reviews and case reports), whereas 3 editors (9.4%) reported having requested statistical reviews on more than 75% of such manuscripts. Most editors reported requesting statistical reviews on a case-by-case basis either after initial favorable review by subject-matter (nonstatistical) reviewers (12 editors; 37.5%) or at the same time that subject-matter review was requested (6 editors; 18.8%). A total of 4 editors (12.5%) reported requesting statistical review for all manuscripts at the same time they are sent for subject-matter review. Another 10 editors (31.3%) said their journals had no general policy on statistical reviewing, and statistical review is almost never needed. For 15 editors (46.9%), ideal statistical reviewing policy was identical to their current policy, whereas 13 (40.6%) favored a more rigorous and 3 (9.4%) a less rigorous policy., Conclusions: Dermatology journals infrequently perform statistical reviews of submitted manuscripts. Dermatology journal editors' statistical review policies range from no general policy to (most frequently) requesting reviews on a case-by-case basis to reviewing all submitted manuscripts. Many editors favor more rigorous statistical reviewing policies for their journals. Increased use of statistical reviewing may increase the reliability of conclusions published in dermatology journals.

Background: For nearly 2 decades clinicians have been treating cutaneous T-cell lymphoma (CTCL) with regimens that combine interferon alfa with retinoid compounds. In December 1999 a new retinoid, bexarotene, was approved by the US Food and Drug Administration for the treatment of CTCL. At the manufacturer's recommended dose of bexarotene (300 mg/m(2) of body surface area), it has proven to be a highly effective therapy for all stages of CTCL. Nevertheless, this dose is typically associated with adverse effects including severe hyperlipidemia. Furthermore, there appears to be no standardization of dosing among physicians who treat CTCL., Observations: We present 3 representative patients, 2 with erythrodermic CTCL and 1 with follicular mycosis fungoides, who experienced the rapid clearing of skin disease while being treated with a combination of low-dose bexarotene and low-dose recombinant interferon alfa., Conclusions: Combining low-dose bexarotene with low-dose interferon alfa was well tolerated and led to rapid improvement in our patients. We review the clinical and biologic basis for this approach.