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Purpose: Gender disparities within academic promotion have been reported in several medical specialties. Female representationin association with research productivity has not been reported among academic dermatologists. As research productivity is a heavily weighted factor in determining promotion, we sought to determine whether gender disparities in academic rank and scholarly impact, measured by the h-index, exist in academic dermatology.Methods: In 2015, the authors determined gender and academic rank using academic dermatology department websites. H- index and publication range were determined using the Scopus database. Rank, h-index, and publication range were compared between male and female academic dermatologists.Results: The h-index of academic dermatologists increased with successive academic rank from Assistant Professor through Professor (p

* Context.--Histopathology is the current standard to diagnose skin disease. However, biopsy may not always be feasible, such as in patients with multiple nevi, a patient with a lesion on an aesthetically significant site, or in children. Recently, noninvasive techniques, including reflectance confocal microscopy (RCM), optical coherence tomography, and Raman spectroscopy, have enabled dermatologists to manage skin lesions in real time without the need for biopsy. Objective.--To report the updated diagnostic accuracy of RCM for equivocal skin lesions. Design.--In this study, we retrospectively reviewed our data of clinically suspicious lesions from 2010 to 2017 that were evaluated by RCM. Results.--Our results showed an overall sensitivity of 98.2% and specificity of 99.8%. Conclusions.--In conclusion, RCM is a noninvasive real-time tool with the potential to diagnose skin lesions with high accuracy and without biopsy. doi: 10.5858/arpa.2018-0124-OA), Histopathology is the current standard to diagnose skin disease. However, biopsy may not always be feasible, such as in patients with multiple nevi, a patient with a lesion on an [...]

Although there is evidence that gender-based disparities exist in salary, academic rank, and other factors in several areas in medicine, limited data exist on differences between male and female dermatologists. Existing studies have focused on academic dermatologists, not including the vast majority of dermatologists who work in solo and group private practices. A cross-sectional self-reported survey eliciting total annual income and other factors was performed in the fall of 2018 in the United States. A total of 397 board-certified dermatologists (MDs/DOs) participated in this study, including 53.63% female and 46.37% male respondents. A statistically significant difference existed within total annual income between male and female dermatologists (P<.0001). Several factors were identified that demonstrated statistically significant differences between male and female dermatologists, including productivity, practice area of focus, type of fellowship training, and faculty rank. However, despite controlling for these variations, gender remained a statistically significant predictor of income on both univariate and multivariate regression analyses (P=.0002/P<.0001), indicating that a gender-based income disparity exists in the field of dermatology that cannot be explained by other factors. [ABSTRACT FROM AUTHOR]

Background: Melasma is a common hyperpigmentation disorder with numerous, but often unsatisfactory treatment options. Aims: A pilot study to evaluate the efficacy and safety of a novel topical combination of 12% hydroquinone, 6% kojic acid, and 5% vitamin C cream for melasma. Patients and Methods: A pilot study of 6 women with melasma was conducted at an academic dermatology department and a private dermatology practice to evaluate the efficacy of a topical combination of 12% hydroquinone, 6% kojic acid, and 5% vitamin C cream, entitled the "Tam Formula." Two blinded evaluators calculated Melasma Area and Severity Index (MASI) Scores before and after treatment to evaluate change from baseline, and statistical analysis was performed. Results: Treatment with this combination topical cream resulted in an average 63.77 ± 22.10 percent reduction in MASI scores. Conclusions: While there is a need for further investigation, this pilot study indicates the Tam Formula may provide an alternative treatment option for melasma. [ABSTRACT FROM AUTHOR]

Risk factors associated with melanoma treatment delay (MTD) have been inadequately studied. To elucidate MTD associations based on patient and tumor characteristics, a retrospective cohort study was performed for cutaneous melanoma cases reported to the National Cancer Database (NCDB) between 2004 and 2015. We evaluated the number of days from diagnosis to treatment initiation, analyzing postponements more than 45 days as moderate MTD (mMTD) and postponements more than 90 days as severe MTD (sMTD). Greater MTD rates were independently associated with patients who are older than 50 years, female, nonwhite, not privately insured, and treated at an academic facility and who have more advanced tumor stage and head/neck primaries. [ABSTRACT FROM AUTHOR]

The article discusses Buccal fat pad reduction. Topics include buccal fat pad (Bichat fat pad) is a tubular shaped collection of adipose tissue that occupies a prominent position in the midface; Buccal fat pad reduction has become an increasingly popular technique for midface and lower face shaping to decrease the appearance of a round face; and complications associated with buccal fat pad reduction include inadvertent damage to surrounding structures.

The rim and deep margin MMS technique can be employed for cutaneous surgery of patients on anticoagulant or antithrombotic agents, with large tumors, or with tumors in highly vascular locations. A retrospective analysis of complication rates in Mohs micrographic surgery patients with clinically large tumors and tumors with aggressive subclinical extension. Tumor characteristics of Mohs surgery patients in Ottawa, Canada versus Houston, Texas-a consequence of access to care?. [Extracted from the article]

Objective: Patients increasingly use the internet to find medical information regarding their conditions and treatments. Physicians often supplement visits with written education materials. Online patient education materials from major dermatologic associations should be written at appropriate reading levels to optimize utility for patients. The purpose of this study is to assess online patient education materials from major dermatologic associations and determine if they are written at the fourth to sixth grade level recommended by the American Medical Association and National Institutes of Health. Design: This is a descriptive and correlational design. Setting: Academic institution. Participants/measurements: Patient education materials from eight major dermatology websites were downloaded and assessed using 10 readability scales. A one-way analysis of variance and Tukey's Honestly Statistically Different post hoc analysis were performed to determine the difference in readability levels between websites. Results: Two hundred and sixty patient education materials were assessed. Collectively, patient education materials were written at a mean grade level of 11.13, with 65.8 percent of articles written above a tenth grade level and no articles written at the American Medical Association/National Institutes of Health recommended grade levels. Analysis of variance demonstrated a significant difference between websites for each reading scale (p<0.001), which was confirmed with Tukey's Honestly Statistically Different post hoc analysis. Conclusion: Online patient education materials from major dermatologic association websites are written well above recommended reading levels. Associations should consider revising patient education materials to allow more effective patient comprehension. (J ClinAesthet Dermatol. 2016;9(9):23-28.). [ABSTRACT FROM AUTHOR]

Patients with skin conditions may apply or consume a wide variety of "remedies" with a similarly wide range of effects that may alter the clinical and/or dermatologic presentations of the lesion. Dermatologists or other clinicians should probe for this and carefully document such treatment, as well as any treatment administered by a health care professional or any other person. The dermatopathologist, however, cannot assume that this has been done or done successfully, and therefore must be on constant alert to recognize the effects of such "remedies."