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Challenges and Controversy in Determining UV Exposure as a Risk Factor for Cutaneous Melanoma in Skin of Color
Nkanyezi N. Ferguson, MD
doi : 10.1001/jamadermatol.2020.4615
JAMA Dermatol. 2021;157(2):151-153
Despite the lower prevalence of melanoma in people of color compared with the White population, there is increased morbidity and mortality as evidenced by more advanced stage at diagnosis and lower 5-year survival rates.1,2 This disparity persists in all racial minority groups with localized melanoma and increasingly in Hispanic patients with regional or distant disease.3 Exposure to UV radiation, especially high intermittent exposure during childhood, is a significant environmental risk factor for melanoma in individuals with fair skin.1 However, for populations of color, in which melanomas are commonly found in sun-protected locations, such as acral, subungual, and mucosal surfaces, the role of UV exposure as a risk factor is much less clear.1 This is a recognized gap in knowledge that highlights the need to further identify and stratify risk factors for melanoma in this population. Evidence is needed to inform meaningful recommendations regarding melanoma prevention, screening, and treatment to improve outcomes in this population.1,2
Reconsidering Named Honorifics in Medicine—the Troubling Legacy of Dermatologist Albert Kligman
Adewole S. Adamson, MD, MPP; Jules B. Lipoff, MD
doi : 10.1001/jamadermatol.2020.4570
JAMA Dermatol. 2021;157(2):153-155
Recently, a series of police killings of unarmed African Americans has renewed attention to the history of abuses and institutional racism in the United States. This national conversation has led to institutional name changes (eg, removing Woodrow Wilson’s name from the Princeton University School of Public and International Affairs) and removal of monuments (eg, John C. Calhoun in Charleston, South Carolina) whose namesakes supported white supremacy. In medicine, named lectureships, professorships, and other honorifics are used to solidify the legacies of individuals deemed important. In a moment with calls for diversity, inclusion, equity, and anti-racism, physicians can use this as an opportunity to reflect on who is honored and whether they speak to current values. One such example is the legacy of dermatologist Albert Kligman.
Advocating for Black Lives—A Call to Dermatologists to Dismantle Institutionalized Racism and Address Racial Health Inequities
Robert J. Smith, MD; Brittany U. Oliver, MD
doi : 10.1001/jamadermatol.2020.4392
JAMA Dermatol. 2021;157(2):155-156
As trainees in dermatology, we feel a great disconnect between our professional approach to skin color and the reality of the racially charged world around us. We describe phenotypic variation in skin color using concepts such as melanosome density and Fitzpatrick skin types. However, these clinical codes objectively distance us from the social concept of race and its influence on the lives of patients. In the wake of the recent killings of George Floyd, Breonna Taylor, Ahmaud Arbery, Rayshard Brooks, and Daniel Prude, there is renewed nationwide attention to the suffering of Black communities that has resulted from the United States’ 400-year legacy of systemic racism. We must expand our lens beyond the relative safety of our clinic walls and speak out against the racial inequities affecting the lives of Black patients. As resident physicians of different racial backgrounds, one of us Black (B.U.O.) and the other White (R.J.S), we have come together to issue a call to dermatologists to assume leadership in addressing racial health inequities. In this Editorial, we suggest strategies that dermatologists can embrace to dismantle the legacy of racial injustice against Black patients.
Association of a Proposed New Staging System for Folliculotropic Mycosis Fungoides With Prognostic Variables in a US Cohort
Yann Charli-Joseph, MD; Mohammed Kashani-Sabet, MD; Timothy H. McCalmont, MD
doi : 10.1001/jamadermatol.2020.4372
JAMA Dermatol. 2021;157(2):157-165
This cohort study assesses predictive factors associated with survival and evaluates the effectiveness of the newly proposed staging system for estimating overall and disease-specific survival in a US cohort of patients with folliculotropic mycosis fungoides.
Association of Histologic Regression With a Favorable Outcome in Patients With Stage 1 and Stage 2 Cutaneous Melanoma
Mary-Ann El Sharouni, MD; Karina Aivazian, MBBS; Arjen J. Witkamp, MD
doi : 10.1001/jamadermatol.2020.5032
JAMA Dermatol. 2021;157(2):166-173
This cohort study examines the association of histologically confirmed regression with survival in patients with primary cutaneous melanoma.
Rates of Vascular Occlusion Associated With Using Needles vs Cannulas for Filler Injection
Murad Alam, MD, MSCI, MBA; Rohit Kakar, MD; Jeffrey S. Dover, MD
doi : 10.1001/jamadermatol.2020.5102
JAMA Dermatol. 2021;157(2):174-180
This cohort study explores whether filler-associated vascular occlusion events of the face occur more often with injections performed with needles than with microcannulas.
Insurance Acceptance, Appointment Wait Time, and Dermatologist Access Across Practice Types in the US
Andrew Creadore, BS; Sheena Desai, BS; Sara J. Li, BS
doi : 10.1001/jamadermatol.2020.5173
JAMA Dermatol. 2021;157(2):181-188
This cross-sectional study examines appointment success and wait times for patients with various insurance types at clinics with and without private equity ownership.
Dermoscopy Proficiency Expectations for US Dermatology Resident PhysiciansResults of a Modified Delphi Survey of Pigmented Lesion Experts
Lauren J. Fried, BS; Andrea Tan, MD; Elizabeth G. Berry, MD
doi : 10.1001/jamadermatol.2020.5213
JAMA Dermatol. 2021;157(2):189-197
This survery study examines consensus-based learning constructs that represent an appropriate foundational proficiency in dermoscopic image interpretation for dermatology resident physicians.
Psoriasis Flares Following Systemic Glucocorticoid Exposure in Patients With a History of Psoriasis
Anna R. F. Gregoire, MD; Britt K. DeRuyter, MD; Erik J. Stratman, MD
doi : 10.1001/jamadermatol.2020.4219
JAMA Dermatol. 2021;157(2):198-201
This cohort study examines the rates and types of psoriasis flares during or within 3 months after concluding systemic corticosteroid administration in adult patients with a known history of psoriasis.
Clinical, Laboratory, and Interferon-Alpha Response Characteristics of Patients With Chilblain-like Lesions During the COVID-19 Pandemic
Thomas Hubiche, MD; Nathalie Cardot-Leccia, MD; Florence Le Duff, MD
doi : 10.1001/jamadermatol.2020.4324
JAMA Dermatol. 2021;157(2):202-206
This retrospective case series describes a systematic assessment of 40 patients with chilblain-like lesions durring the coronavirus 2019 pandemic and examines the association of these lesions with a viral-induced type I interferonopathy.
Mucocutaneous Manifestations of Multisystem Inflammatory Syndrome in Children During the COVID-19 Pandemic
Trevor K. Young, BS; Katharina S. Shaw, MD; Jinal K. Shah, MPH
doi : 10.1001/jamadermatol.2020.4779
JAMA Dermatol. 2021;157(2):207-212
This case series describes the mucocutaneous findings seen in children with multisystem inflammatory syndrome in children during the height of the coronavirus disease 2019 (COVID-19) pandemic in New York City in 2020.
UV Exposure and the Risk of Cutaneous Melanoma in Skin of ColorA Systematic Review
Fabiana C. P. S. Lopes, MD; Marc G. Sleiman, BS; Kate Sebastian, RN, MPH
doi : 10.1001/jamadermatol.2020.4616
JAMA Dermatol. 2021;157(2):213-219
This systematic review critically assesses and synthesizes the published data regarding the association between UV exposure and the risk of cutaneous melanoma in skin of color.
Neonatal Pemphigus Vulgaris
Mallory L. Foster, BS; Robert T. Spaulding, MD; Courtney R. Schadt, MD
doi : 10.1001/jamadermatol.2020.3990
JAMA Dermatol. 2021;157(2):220
This case report describes superficial annular erosions with central granulation tissue and desquamating borders on the occipital scalp, postauricular region, nape, and right calf.
Linear Immunoglobulin—A Bullous Dermatosis
Calogero Pagliarello, MD, PhD; Claudio Feliciani, MD; Carlo Renè Girardelli, MD
doi : 10.1001/jamadermatol.2020.4006
JAMA Dermatol. 2021;157(2):221
This case report describes expanding concentric vesicles and bullae on the trunk and extremities.
Leonine Facies and Madarosis in a Man With Shortness of Breath
Carolyn M. Stull, MD; Luke Wallis, MD; Claudia Hernandez, MD
doi : 10.1001/jamadermatol.2020.5090
JAMA Dermatol. 2021;157(2):222-223
A man in his 60s presented for evaluation of lesions on the face, chest, back, and arms that were gradually increasing in size and number. What is your diagnosis?
Annular Plaques in a Woman Receiving Systemic Immunotherapy
Jessica Wu, BA; Mengjun Hu, MD; Suzanne M. Sachsman, MD
doi : 10.1001/jamadermatol.2020.4810
JAMA Dermatol. 2021;157(2):224-225
A woman in her 70s with recurrent primary peritoneal carcinoma receiving pembrolizumab and ipilimumab presents with pruritic rash. What is your diagnosis?
Burden of Ocular Comorbidities in Patients With Hidradenitis Suppurativa
Rosalynn R. Z. Conic, MD, PhD; Gabriella Fabbrocini, MD; Claudio Marasca, MD
doi : 10.1001/jamadermatol.2020.5087
JAMA Dermatol. 2021;157(2):226-227
This case-control study examines the burden of ocular comorbidities in patients with hidradenitis suppurativa.
Pregnancy in Hidradenitis Suppurativa—Patient Perspectives and Practice Gaps
Ademide A. Adelekun, MD; Natalie M. Villa, MD; Jennifer L. Hsiao, MD
doi : 10.1001/jamadermatol.2020.5162
JAMA Dermatol. 2021;157(2):227-230
This survey study reports on patients’ concerns about the implications of hidradenitis suppurativa for sexual and reproductive health, heritability of the condition, and pregnancy and childbirth as well as the inadequate information and support from clinicians.
Evaluation of Etanercept for Treatment of Reactive Infectious Mucocutaneous Eruption
Melanie M. Miller, MD; Sonia Kamath, MD; Meagan Hughes, MD
doi : 10.1001/jamadermatol.2020.5166
JAMA Dermatol. 2021;157(2):230-232
This cohort study evaluates the association of etanercept treatment with outcomes of reactive infectious mucocutaneous eruption in hospitalized children and adolescents.
Mucocutaneous Adverse Events Associated With Oral Sirolimus for the Treatment of Vascular Anomalies
Pierre-Olivier Grenier, MD; Lindsay McCormack, BA; Shomoukh A. Alshamekh, MD
doi : 10.1001/jamadermatol.2020.5180
JAMA Dermatol. 2021;157(2):233-235
This case series examines the clinical spectrum and frequency of mucocutaneous adverse events related to oral sirolimus in populations with vascular anomalies.
Treatment of Xanthoma Disseminatum With Narrowband UV-B Phototherapy
Marta Garc?a-Legaz Mart?nez, MD; ?lvaro Mart?nez-Doménech, MD; Jorge Magdaleno-Tapial, MD
doi : 10.1001/jamadermatol.2020.4092
JAMA Dermatol. 2021;157(2):235-237
This case report describes xanthoma disseminatum that was successfully treated with narrowband ultraviolet B phototherapy.
Association of Programmed Cell Death 1 Inhibitor With Circumorificial Plasmacytosis
Abraham M. Korman, MD; Kelley Zyniewicz, MD; Gabriel Tinoco, MD
doi : 10.1001/jamadermatol.2020.4273
JAMA Dermatol. 2021;157(2):237-238
This case report describes diffusively enlarged, erythematous, and cobblestoned maxillary and mandibular buccal gingivae.
Emerging Evidence of the Direct Association Between COVID-19 and Chilblains
Esther E. Freeman, MD, PhD; Devon E. McMahon, BA; Lindy P. Fox, MD
doi : 10.1001/jamadermatol.2020.4937
JAMA Dermatol. 2021;157(2):238-239
To the Editor Herman et al1 reported 31 patients with chilblains/pernio who had negative results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) testing and antibodies, a phenomenon noted by several articles in JAMA Dermatology. The authors hypothesize that pernio during the coronavirus disease 2019 (COVID-19) pandemic “may be caused by lifestyle changes brought on by containment.”1
Emerging Evidence of the Direct Association Between COVID-19 And Chilblains—Reply
Marie Baeck, MD, PhD; Anne Herman, MD
doi : 10.1001/jamadermatol.2020.4655
JAMA Dermatol. 2021;157(2):239-240
In Reply We thank Freeman et al for their comment in reference to our recently published article in JAMA Dermatology.1 The authors rightly point out the limitations of this study in 31 patients with regard to early antibody testing and the imperfect sensitivities and specificities of these tests. However, we later reported updated data, including an additional 23 patients with chilblains.2 In this total series of 54 patients, only 2 had positive serum anti–severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibodies (12.75 and 135.5 AU [absorbance units]/mL, respectively). Moreover, repeated serologic testing 3 weeks after the first (39 patients) ruled out late seroconversion. Therefore, SARS-CoV-2 infection can be excluded with relative certainty, even after accounting for possible lower immunization in mildly symptomatic or asymptomatic patients and for some differences in sensitivity/specificity between the tests used.
Error in Author Name
doi : 10.1001/jamadermatol.2021.0069
JAMA Dermatol. 2021;157(2):240
in the Research Letter entitled “Burden of Ocular Comorbidities in Patients With Hidradenitis Suppurativa,”1 the fifth author’s name was listed as “Watad Abdulla” but should be “Abdulla Watad.” This article was corrected online.
JAMA Dermatology
doi : 10.1001/jamadermatol.2020.3860
JAMA Dermatol. 2021;157(2):143
Mission Statement: JAMA Dermatology publishes information concerning the skin, its diseases, and their treatment. Its mission is to explicate the structure and function of the skin and its diseases and the art of using this information to deliver optimal medical and surgical care to the patient. We attempt to enhance the understanding of cutaneous pathophysiology and improve the clinician’s ability to diagnose and treat skin disorders. This journal has a particular interest in publishing clinical and laboratory studies that reveal new information pertinent to the interests and needs of the medical dermatologist, dermatologic surgeon, and all those concerned with state-of-the-art care of cutaneous disease. We believe that knowledge derived from well-designed clinical trials and studies of cost-effectiveness are especially important for improving the practice of dermatology. Studies that increase the understanding of the outcome of treatment or the means by which the burden of dermatologic disease can be measured and reduced to promote the health of patients with skin disease will receive special priority. The journal regularly publishes reports on clinical investigations, editorials, and reviews. It also features reports and discussions on clinicopathologic correlations; clinical disorders of unique didactic value; pharmacologic, medical and surgical therapeutics; and ethical, moral, socioeconomic, and political issues.
