Treatment of Angiosarcoma of the Head and Neck: A Systematic Review.

Primary cutaneous angiosarcoma (cAS) of the head and neck is a rare sarcoma with a poor prognosis and limited treatment options. We conducted a systematic review of treatments used for head and neck cAS and determined the treatment modalities that offer the longest mean overall survival (OS). Forty publications totaling 1295 patients were included. Both surgical and nonsurgical modalities have shown potential efficacy in the treatment of cAS; however, limited data preclude definitive recommendations. Multidisciplinary management of cAS should be considered to tailor treatment on a case-by-case basis.

A Multi-Site Survey Study of Patient Satisfaction with Teledermatology.

Introduction: Telemedicine has been of heightened focus due to spikes in usage during the COVID-19 pandemic. Disparities in health care may affect patient satisfaction with this resource depending on factors such as patient race, age, or socioeconomic background. The purpose of this study was to analyze patient satisfaction with teledermatology to identify any differences in satisfaction based on race, age, and income during the COVID-19 pandemic period. Methods: A 21-question, IRB-approved survey was administered to patients at two academic dermatology clinics in Kansas City. Patient satisfaction was measured using a five-point Likert scale. Results: A total of 64 completed surveys were analyzed (17.8% response rate). Most of the participants were female (n = 48, 75%), age 45 to 60 (n = 17, 26.6%), and reported White for race (n = 55, 85.9%). Overall, 73.4% (n = 47) of patients reported being satisfied with their visit. However, only 38.7% (n = 24) of participants were likely to choose a video over an in-person visit. Reasons for low patient satisfaction included concerns regarding ability to perform an accurate physical exam with a video visit (n = 9, 14.1%), receiving inadequate care (n = 4, 6.3%), protected privacy (n = 3, 4.7%), and provider understanding the patient (n = 2, 3.1%). Conclusions: Our findings were similar to prior studies stating no difference in patient satisfaction with regards to age, income, or race and patients reporting high satisfaction with teledermatology appointments despite a preference for in-person dermatology visits. Future studies with a larger diverse cohort of participants are needed to elucidate and address possible disparities associated with teledermatology use.

The Utility of Frequent Laboratory Monitoring for Patients on Tumor Necrosis Factor-Alpha Inhibitors in Dermatology.

Introduction: Tumor necrosis factor-alpha inhibitors (TNF-ai) are becoming increasingly common to use among patients with skin disease. To safely take these medications, it is recommended to monitor laboratory values routinely; however, the utility of this practice and the risk-benefit of frequent laboratory monitoring has not been explored fully in patients with skin disease. The purpose of this study was to evaluate the necessity of routine laboratory monitoring in patients taking a TNF-ai with a dermatological disease. Methods: Retrospective chart review evaluated laboratory abnormalities (complete blood counts and liver function tests) in adult patients who took a TNF-ai for a dermatologic disease at The University of Kansas Hospital. Results: There were 27 patients included for a total of 45 entries. The most common skin disease was hidradenitis suppurativa (23/45) and infliximab (22/45) was most the commonly used medication. Of the 45 entries, there were only seven patients that developed abnormal monitoring laboratory values related to initiation of TNF-ai. These abnormalities were transient and most frequently occurred after 12 months, with 2 of the 45 resulting in no discontinuation or dose reduction of TNF-ai. One patient discontinued medication due to anemia that did not improve after medication withdrawal. Conclusions: Laboratory abnormalities due to TNF-ai were infrequent and when they did occur were transient and mild. The study was limited by the small sample size of patients, and larger prospective studies are needed to evaluate these findings fully. However, dermatologists may be able to employ less frequent laboratory monitoring safely for patients on TNF-ai.