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Competing Interests: Conflicts of interest Dr Bolotin reported serving as principal investigator on a clinical trial sponsored by Replimune outside the submitted work. Dr Cohen reported serving as a clinical investigator, consultant, or speaker or trainer for Accure, Allergan, Almirall/Athenex, Avuta, Biofrontera Bioscience, Biopelle, Brickell Biotech, Croma, Elta, Endo Pharmaceuticals, Ferndale, Galderma, InMode, IntraDerm, Lutronic, Merz, Novan, PCA, Pulse Biosciences, Raziel, Recros Medica, Revance, Revision, Sciton, and Sente outside the submitted work. Dr Council reported receiving personal fees from Sanofi Genzyme Regeneron, AbbVie, and Castle Biosciences outside the submitted work. Dr Riley has served as an advisory board member for Novartis Pharmaceuticals. The other authors have no conflicts of interest to declare.

Background: Sunscreen use is an important modifiable behavior to protect against skin cancer, photoaging, and sunburn. Product costs and characteristics may influence accessibility and usage of sunscreen. This study aims to determine preferences for sunscreen attributes and willingness to pay (WTP) for an ideal sunscreen product., Methods: Adult volunteers 18 years or older were contacted on ResearchMatch. Of 670 responses, 489 surveys were completed and 2 were excluded based on the inclusion criterion. Online survey responses were collected in REDCap from July-September 2019. The online survey queried sunscreen attribute preferences and then respondent preferences were compiled into individualized descriptions of ideal products. Respondents were then asked to make purchasing decisions on these products. WTP was determined by analyzing product attributes and purchasing decisions. Attribute preferences were reported as numerical ratings of Importance and Desirability. WTP was calculated by linear regression of purchasing decision data. Qualitative comments about sunscreen preferences were also collected., Results: The study involved 487 participants aged 18-85 years (mean 43.6, SD 15.7) and 84.4% (N = 411) female. The most popular attributes included complete prevention of skin cancer and sunburn. WTP for an ideal product was $30.10 ± 2.11 for one month of use., Conclusions: Consumers provide high values in WTP for sunscreen. Dermatologists should consider cost and variability in attribute preferences when recommending sunscreens to patients. Further study is required to determine the effects, if any, of cost and attributes on adherence to sunscreen use in specific populations., (© 2022. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

The extent to which the Ultraviolet (UV) index is associated with the prevalence of melanoma and keratinocyte cancer in the United States is not clear. We conducted a cross-sectional study using the Center for Disease Control and Prevention's (CDC) 2019 Behavioral Risk Factor Surveillance System (BRFSS) telephone interview survey to investigate the epidemiology of skin cancer in the US including age, household income, education, and marital and employment status. Of non-Hispanic white respondents, 9.6% (N = 29,925) reported a being told of a skin cancer diagnosis. The prevalence of skin cancer was significantly higher in high UV (> / = 8) states (11.8%, N = 36,575) than in medium UV (6-7) (9.0%, N = 27,812) and lower UV (< / = 5) (7.8%, N = 24,083) states (p < .0001). Respondents from a medium UV or high UV state had higher odds (1.21 [1.15-2.27], 1.55[1.47-1.63], respectively) of reporting a skin cancer diagnosis than those from a low UV state. The association of UV index with lifetime skin cancer prevalence reinforces the importance of educating patients on preventive practices such as avoidance of tanning beds and usage of UV protection with clothing and sunscreen., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Knowledge regarding skin tone preferences and their influence on skincare behaviors among people of color is limited. The objective of this study was to determine whether there is a difference between ideal and actual skin tone among people of color and whether this difference is associated with tanning and sunscreen use. This was a one-time, voluntary, anonymous, electronic survey designed in REDCap and delivered through ResearchMatch, a national electronic, recruitment tool. Eligible participants were at least 18 years old and self-identified as Black, Asian, Latinx, American Indian/Alaskan Native or Mixed Race. In total, 548 completed survey results were analyzed using SAS. Only the Latinx population was found to have a significant preference for tanner skin (p < 0.05). The Latinx population had significantly more subjects that participated in outdoor tanning than both the Black (p < 0.0001) and Asian population (p < 0.05). Latinx participants who indicated a preference for tanner skin were 2.8 times more likely to never use sunscreen than those without this preference (OR = 2.821, CI = 1.029-7.732, p < 0.05). Our findings have implications for how dermatologists screen, treat, and educate Latinx and skin of color populations., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: While the incidence of skin cancers continues to rise, there remains a disproportionate lack of introductory training on skin cancer screening and identification of modifiable behaviors in medical curricula. Trainees and students have cited low confidence in their ability to counsel patients and lack of instruction as barriers., Methods: To address this need, we created a 1-hour didactic lecture based on a cognitive teaching framework for third-year medical students during their core primary care clerkship. The session highlighted visual identification of different skin cancers, factors increasing individual risk, and photoprotective behaviors. Session content was based on American Academy of Dermatology recommendations for skin cancer prevention. An assessment of knowledge, behaviors, and attitudes given before, immediately following, and at 6 months after the session was used to determine efficacy., Results: One hundred eight students before and immediately after the session demonstrated significantly improved knowledge (mean correct: 71% presession vs. 99% postintervention, p < .0001). Based on 39 participants completing 6-month follow-up, knowledge remained improved (mean answered correctly: 80%, p < .0001). Confidence in patient counseling on preventive behaviors, risk assessment, and reported likelihood of counseling significantly increased across the three time points ( p < .0001 for all attitude questions). Specific topics included appropriate referral to a dermatologist, sunscreen application, and dangers of indoor tanning bed usage., Discussion: Our session on skin cancer screening and prevention demonstrated improvements in medical student knowledge, confidence, and patient counseling likelihood. This introductory curriculum could be adapted for multiple core clerkships or specialties., (© 2020 Compres et al.)

Background: Although melanoma is more common in non-Hispanic Whites, ethnic minorities face a greater risk of melanoma-related mortality, which may be partially attributed to presentation at atypical sites and a lack of awareness., Objective: Our objective was to assess the effectiveness of a melanoma educational intervention targeted towards people of color., Design: Participants received one of two scripted melanoma educational interventions in the summer of 2015. They completed surveys before the intervention, immediately post-intervention, and 2 months post-intervention., Setting: Dermatology clinic at an academic hospital., Participants: A consecutive sample of 100 participants who self-identified as African American, Asian, or Hispanic were recruited following their dermatology visit. In total, 70 participants completed the 2-month follow-up questionnaire., Intervention: The comparison intervention group received an educational intervention using a conventional pamphlet on the 'ABCDEs' (Asymmetry, Borders, Color, Diameter, Evolution) of melanoma. The targeted intervention group received a modified pamphlet that included a skin of color section, the nomenclature "melanoma skin cancer", and an image of an individual performing a skin self-examination with the help of a friend., Main Outcomes and Measures: Melanoma knowledge, perceived risk for developing melanoma, and skin self-examination practices were assessed through self-reported questionnaires., Results: Among the 100 participants, 78% self-identified as African American, 11% as Asian, and 11% as Hispanic. Both groups experienced a similar increase in melanoma knowledge that was retained at 2 months. Perceived personal risk for developing melanoma increased more in the targeted intervention group immediately post-intervention (p = 0.015), but this difference no longer existed between the groups at the 2-month follow-up. The targeted intervention group also demonstrated a greater increase in skin self-examinations (p = 0.048) and knowledge of warning signs to look for when examining the skin (p = 0.002) at the 2-month follow-up., Conclusions and Relevance: The educational intervention targeted towards people of color resulted in increased skin self-examinations. Educational material that is relevant to ethnic minorities may better promote early detection and help to decrease the disparity in melanoma-related morality rates., Trial Registration: Clinicaltrials.gov registration number NCT02437305.

Skin cancer is less prevalent in people of color than in the white population. However, when skin cancer occurs in non-whites, it often presents at a more advanced stage, and thus the prognosis is worse compared with white patients. The increased morbidity and mortality associated with skin cancer in patients of color compared with white patients may be because of the lack of awareness, diagnoses at a more advanced stage, and socioeconomic factors such as access to care barriers. Physician promotion of skin cancer prevention strategies for all patients, regardless of ethnic background and socioeconomic status, can lead to timely diagnosis and treatment. Public education campaigns should be expanded to target communities of color to promote self-skin examination and stress importance of photoprotection, avoidance of tanning bed use, and early skin cancer detection and treatment. These measures should result in reduction or earlier detection of cutaneous malignancies in all communities. Furthermore, promotion of photoprotection practices may reduce other adverse effects of ultraviolet exposure including photoaging and ultraviolet-related disorders of pigmentation., (Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.)

Skin of color traditionally refers to that of persons of African, Asian, Native American, Middle Eastern, and Hispanic backgrounds. Differences in cutaneous structure and function can result in skin conditions with distinct presentations and varying prevalence that require unique treatment. Skin cancers have different presentations in these populations. The ability to recognize and diagnose skin cancer in a timely manner is important for reducing morbidity and mortality. Basal cell carcinoma often is pigmented, squamous cell carcinoma occurs in areas of chronic scarring and inflammation, and melanoma presents in non-sun-exposed areas, such as the soles and nail beds. Diagnosis requires biopsy, with the technique depending on size and location of the lesion. Treatment options range from topical to surgical. Acne commonly results in postinflammatory hyperpigmentation and keloids. Combination therapy with topical antibiotics and benzoyl peroxide is generally more effective than monotherapy for treating acne. Use of retinoids at lower concentrations and at less frequent dosing can help prevent postinflammatory hyperpigmentation., (Copyright © 2013 American Academy of Family Physicians.)

Objectives: To assess the level of melanoma awareness and risk perception among ethnic minorities and to identify ways to enhance the relevance of melanoma educational materials for ethnic minorities.  , Methods: Twelve focus groups composed of participants from a single ethnicity [African-American (n=40), Hispanic (n=40), and Asian (n=40)], participated in a 2 h discussion on melanoma and skin cancer and commented on an educational brochure by the American Cancer Society and reacted to photographs of melanoma on ethnic skin. Participants also evaluated the ability to sunburn and tan and the skin cancer risk of images of celebrities before and after the discussion. Additionally, participants assessed the skin tone of celebrities as very fair, fair, olive, light brown, dark brown, and very dark. The audiotape recordings of the 12 focus groups were transcribed and analyzed with the Non-numerical Unstructured Data Indexing Searching and Theorizing software for common themes., Results: The common themes were (1) lack of relevance of skin cancer to ethnic people, (2) understanding of skin cancer risk terminology is based on personal experience and what is acquired from the media, and (3) sources of health information for ethnic minorities are fragmented and physicians are not the primary source of information. Celebrity images representing the six skin tones were selected., Conclusions: Relevance of melanoma education to ethnic people may be improved by using 'melanoma skin cancer', photographs of early melanoma in people with dark skin, and providing guidance on how to inspect hands and feet for suspicious moles., (Copyright © 2010 John Wiley & Sons, Ltd.)

Background: Among patients with melanoma, ethnic minorities are 1.96 to 3.01 times as likely to die from melanoma as Caucasians of the same age and sex., Objective: We sought to assess the effectiveness of a melanoma early detection educational intervention among those with ethnic skin., Methods: A consecutive convenience sample of patients received instruction on the ABCDEs of melanoma and skin self-examination. Self-report questionnaires assessing knowledge, attitudes, and behaviors were completed before, and immediately and 3 months after, the intervention., Results: Among the 71 participants, 21% reported a skin phenotype with at least sometimes burning. Knowledge that melanoma is a skin cancer and of the warning signs of melanoma significantly increased after the intervention and was retained at 3 months. The perception of being at risk to develop a melanoma significantly increased after the intervention and was retained at 3 months (P < .001). Monthly checking of the skin, especially acral sites (palms, soles, periungual), increased significantly immediately after the intervention., Limitations: A limitation is accrual from dermatology patients, who may be more inclined to perform skin self-examination compared with the general minority population., Conclusions: People of color benefit from specific physician recommendations explaining their risk to develop melanoma and which anatomic sites to check. Acral lentiginous melanoma among ethnic minorities tends to present in non-sun-exposed but visible areas, particularly volar and subungual sites; therefore, skin self-examination educational materials for minority populations should incorporate these anatomic sites., (Copyright 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.)