Dermatology resident comfort level treating hair conditions related to patients with skin of color.

Background: Although recent studies demonstrated resident satisfaction in the treatment of skin of color (SOC) related disease, comfort levels treating hair specific to populations within the SOC spectrum is unclear. Objective: The purpose of this study is to assess dermatology residents comfort level in recognizing and treating various common hair conditions with a focus on those specific to SOC. Methods: An Institutional Review Board-approved survey was distributed to United States residents of Accreditation Council for Graduate Medical Education-accredited dermatology programs. Data pertaining to hair care knowledge and treatment comfort levels were collected. Analysis was completed using equal variance 2-sample t tests and analysis of variance F tests, P < .05. Results: Dermatology residents were relatively comfortable with common conditions such as androgenetic alopecia and alopecia areata, but uncomfortable with creating healthy hair regimens, discussing natural hair care products, and treating trichorrhexis nodosa. Resident self-identification as underrepresented in medicine significantly impacted resident knowledge of hair care and treatment in patients with SOC. Limitations: This study was limited due to small sample size and potential recall bias. Conclusion: This study highlights knowledge gaps in understanding hair-related care for patients with SOC, affirming the continued importance of diversifying dermatology programs as well as hair-specific training for residents.

The evolution of leadership: analyzing the presidents of American Dermatology Societies overtime.

Within organized dermatology, it is imperative that leaders embody a diverse group of individuals, reflective of the dermatologists they represent and the greater U.S. population. Despite women constituting more than half of the dermatologic workforce, they represent a leadership minority in dermatology society higher level positions. This gap is evident by fewer women holding presidency positions within prominent dermatological societies; however, a comprehensive comparison across multiple societies has yet to be made. Our study analyzes and compares demographic as well as academic metrics of presidents from 16 prominent dermatology societies spanning 22 years, 2000-2021. Data were collected using organization websites, which demonstrated 247 unique presidents over 22 years. Of these presidents, 175 (70.9%) were male and 72 (29.1%) were female. Surgically focused societies had 63 (87.5%) male presidents and nine (12.5%) female presidents, while clinically focused societies had 112 (64.0%) male presidents and 63 (36.0%) female presidents (P < 0.0002). The publication h-index, academic rank, chairmanship, and number of advanced degrees, and total number of years in practice prior to election did not significantly differ between male and female leaders. There was no statistically significant difference in the proportion of female presidents across all societies between 2000 and 2021 by Cochran Armitage Trend Test. However, between 2016 and 2021, 35% of presidents were female and a general trend toward more gender balance may be noticed. This equality goal should continue to be emphasized in organized medicine.

Basal Cell Carcinoma With Perineural Invasion: A Systematic Review and Pooled Survival Analysis.

BACKGROUND: Perineural invasion (PNI) is considered a high-risk histopathologic feature in many skin cancers. Perineural invasion is a well-known poor prognostic factor of squamous cell carcinoma, but is poorly understood in the context of basal cell carcinoma (BCC). OBJECTIVE: To analyze available demographic, clinical, and treatment data for BCC with PNI and the effect of these variables on recurrence patterns, disease progression, and cancer-specific mortality (CSM). METHODS: A systematic review and pooled-survival analysis was performed using case reports and series of patients with perineural BCC. RESULTS: This review included 159 patients from 49 publications. Of these cases, 57 patients reported at least one recurrence. Where reported, median follow-up time was 31 months for patients without recurrence ( n = 79) and 21 months for patients with recurrence ( n = 32). The cumulative incidence of CSM at 5 years was 8.5% (95% confidence interval [CI] 0.028-0.186) and the overall five-year survival was 90.9% (95% CI 0.796-0.961). CONCLUSION: Male gender, multifocal nerve involvement, presence of clinical symptoms, and PNI detected on imaging are associated with poor prognosis of BCC with PNI. The high rate of disease recurrence and suboptimal cumulative incidence of CSM highlights the importance of early clinical detection, before the onset of symptomatic PNI and multifocal nerve involvement.

The Impact of Supplements on Recovery After Peripheral Nerve Injury: A Review of the Literature.

Peripheral nerve injury (PNI) can result from trauma, surgical resection, iatrogenic injury, and/or local anesthetic toxicity. Damage to peripheral nerves may result in debilitating weakness, numbness, paresthesia, pain, and/or autonomic instability. As PNI is associated with inflammation and nerve degeneration, means to mitigate this response could result in improved outcomes. Numerous nutrients have been investigated to prevent the negative sequelae of PNI. Alpha-lipoic acid, cytidine diphosphate-choline (CDP Choline), curcumin, melatonin, vitamin B12, and vitamin E have demonstrated notable success in improving recovery following PNI within animal models. While animal studies show ample evidence that various supplements may improve recovery after PNI, similar evidence in human patients is limited. The goal of this review is to analyze supplements that have been used successfully in animal models of PNI to serve as a reference for future studies on human patients. By analyzing supplements that have shown efficacy in animal studies, healthcare providers will have a resource from which to guide decision-making regarding future human studies investigating the role that supplements could play in PNI recovery. Ultimately, establishing a comprehensive understanding of these supplements in human patients following PNI may significantly improve post-surgical outcomes, quality of life, and peripheral nerve regeneration.

Improving Breast Surgery Outcomes Through Alternative Therapy: A Systematic Review.

Enhanced recovery after surgery (ERAS) protocols are the current standard of care when it comes to improving post-surgical outcomes in breast cancer patients. Compliance with all protocol items is required in order for patients to experience significant benefits. Given that the ERAS protocols involve numerous medications which each have unique side effect profiles and medication interactions, this is often difficult to accomplish. Additionally, breast cancer patients are often left with a large psychological burden, which ERAS protocols fail to address. This review aims to determine the role that alternative therapies can play in improving both the emotional and physical strains patients experience during the post-operative stage of recovery. A PubMed search was conducted using the following search terms ("alternative medicine" or "complementary medicine" or "integrative medicine" or "holistic medicine" or "natural medicine" or "mediation" or "aromatherapy" or "music" or "art" or "reiki" or "massage") and ("surgery") and ("pain"). Studies selected for this review include articles published or translated in English that addressed alternative medical interventions affecting pre-, peri-, or post-operative outcomes in breast biopsies, surgeries, or breast-related procedures. Eighteen articles fit the inclusion criteria, with seven addressing music, five addressing meditation, yoga, and guided imagery, five addressing massage, one addressing myofascial release, four addressing aromatherapy, two addressing acupuncture, and three addressing hypnosis. Most forms of alternative therapies offered some benefit to patients following breast-related procedures, many resulting in improvements in post-operative outcomes including pain, fatigue, energy, stress, anxiety, mood, and depression. The reviewed studies demonstrated numerous benefits to integrating alternative medicine into standardized therapy to improve postoperative outcomes. Most studies analyzed did not include placebo controls as including proper placebos was often not feasible. Future studies with larger sample sizes are needed to better quantify the benefits patients receive from these noninvasive, low-risk complementary therapies.