Research Publication Rates Are Age- and Era-Dependent for Radiation Oncologists From Highly Ranked NCI-Designated Cancer Centers.

PURPOSE: Quantitative bibliometrics are increasingly used to evaluate faculty research productivity. This study benchmarks publication rates for radiation oncologists from highly ranked National Cancer Institute-designated cancer centers and reveals how productivity changes over the arc of a career and of the field over time. METHODS AND MATERIALS: Peer-reviewed articles from 1970 to 2022 were obtained using Scopus for the 348 radiation oncologists listed as faculty for the top 10 cancer hospitals ranked by US News and World Report in 2022. Bibliometrics were analyzed for authorships (A˙), authorships where the individual was first or last author (F˙L), the monograph equivalent of authorships (M˙E), h-index, and ha-index (an analog to h-index using M˙E in place of publications). Career start was defined as the year of first publication. Bibliometric inflation was explored by analyzing authorship and bibliometric changes between 1990 and 2022. RESULTS: Publication rates peak, with as much as a 500% increase, 20 to 25 years from the start of a career before declining until retirement. At career ages of 1, 10, 20, and 30 years, the median bibliometrics were A˙ = (1.5, 4.1, 6.5, 7.0) year-1, F˙L = (0.5, 0.9, 1.2, 0.6) year-1, M˙E= (0.2, 0.5, 0.7, 0.8) year-1, h-index = (1, 12, 22, 47), and ha-index = (0.4, 4.4, 6.9, 18.4). With regards to authorship patterns across eras, the median number of authors listed per paper increased by 240% between 1990 and 2022. Meanwhile, research productivity per individual as measured by F˙L and M˙E was unchanged. CONCLUSIONS: The research publication rates of the median radiation oncologist change substantially over the course of their career. Productivity improves steadily for more than 2 decades before peaking and declining. The culture of authorship has also changed between 1990 and 2022. The number of authors listed per paper has trended upwards, which has an inflationary effect on the number of authorships and h-index. Meanwhile, the rate of manuscripts published per faculty has not changed.

Successful Treatment of Recalcitrant Mpox Lesions With Intralesional Cidofovir in a Patient With HIV/AIDS.

This case report describes a man in his 50s with HIV/AIDS who presented with widely scattered recalcitrant mpox lesions.

A Deep Dive Into Instagram's Top Skinfluencers.

We characterized skinfluencers from various training backgrounds and compared their posts on Instagram featuring skin care products.

Nickel release from metal tools in United States barbershops.

BACKGROUND: Hairdressers and barbers are among the top occupations to develop occupationally related nickel allergy. While nickel release has previously been detected in metal items in the hairdressing trade, metal items in the barber trade have not been specifically tested. This study screened for nickel release from metal tools in United States barber trade. METHODS: One hundred ninety-two metal tools from 12 barbershops in St. Paul, Minnesota, were tested with dimethylglyoxime test. An employee survey was conducted about each metal tool. RESULTS: Nickel release was detected in 10 of 192 metal tools (5.2%). Items with nickel release included one of 57 scissors (1.7%), one of 32 trimmers (3.1%), four of 13 barbershop chairs (30.8%), three of six cape clips, and one of one nail clippers. CONCLUSIONS: Nickel release was detected in items unique to the barber trade. These items should be considered when preventing and assessing occupational nickel allergy in barbers.

Inter-rater variability in patch test readings and final interpretation using store-forward teledermatology.

BACKGROUND: Data regarding teledermatology for patch testing are limited. OBJECTIVES: Compare patch test readings and final interpretation by two in-person dermatologists (IPDs) with eight teledermatologists (TDs). METHODS: Patch tested patients had photographs taken of 70 screening series of allergens at 48 hours and second readings. Eight TDs reviewed photos and graded reactions (negative, irritant, doubtful, +, ++, +++) at 48 hours and second readings; in addition, they coded a final interpretation (allergic, indeterminant, irritant, negative) for each reaction. TDs rated overall image quality and confidence level for each patient and patch test reaction, respectively. Percentage of TD-IPD agreement based on clinical significance (success, indeterminate, and failure) was calculated. Primary outcome was agreement at the second reading. RESULTS: Data were available for 99, 101, and 66 participants at 48 hours, second reading, and final interpretation, respectively. Pooled failure (+/++/+++ vs negative) at second reading was 13.6% (range 7.9%-20.4%). Pooled failure at 48 hours and final interpretation was 5.4% (range 2.9%-6.8%) and 24.6% (range 10.2%-36.8%), respectively. Confidence in readings was statistically correlated with quality of images and disagreement. CONCLUSION: For patch testing, teledermatology has significant limitations including clinically significant pooled failure percentages of 13.6% for second readings and 24.6% for final interpretation.

Allergic Contact Dermatitis to Pramoxine (Pramocaine).

Prescription and over-the-counter topical anesthetics are commonly used. Although allergy to amide and ester anesthetics is known, little has been reported on the nonamide, nonester pramoxine (pramocaine). This article briefly reviews allergy to topical anesthetics, provides detailed information on pramoxine, and describes characteristics of multiple patients with positive, relevant reactions to pramoxine.

Allergenic Ingredients in Health Care Hand Sanitizers in the United States.

BACKGROUND: Health care workers with occupational contact dermatitis often attribute their symptoms to frequent use of alcohol-based hand sanitizers. However, ingredient lists are difficult to obtain, and safe alternatives typically must accommodate brands utilized by a particular hospital system. OBJECTIVE: The aims of this study were to investigate allergenic ingredients present within health care hand sanitizers and to provide a comprehensive product list to assist with allergen avoidance. METHODS: Five major hospitals in Minnesota and 20 hospitals across the United States were called to obtain a product list. The National Library of Medicine's DailyMed Web site was searched to retrieve ingredients. Ingredients were compared with the American Contact Dermatitis Society 2017 Core Allergen Series and cross-reactors. RESULTS: The most common brands included Purell, Ecolab, DebMed, and Avagard. Active ingredients consisted of ethyl alcohol (85.0%), benzalkonium chloride (8.8%), or isopropyl alcohol (2.5%). Top 5 allergens included tocopherol (51.3%), fragrance (40.0%), propylene glycol (27.5%), benzoates (25.0%), and cetyl stearyl alcohol (12.5%). Four sanitizers were free of all American Contact Dermatitis Society allergens; 15 products contained only tocopherol or propylene glycol as allergens. CONCLUSIONS: We identified 19 low-allergen hand sanitizers within the most common brands utilized by US hospital systems. This product list will be useful for patients and health care workers seeking allergen avoidance.

Wearable Woes: Allergens in Diabetic Devices.

Novel diabetic devices are being developed to help manage diabetes and improve the quality of life of patients with diabetes. Both insulin pumps and glucose monitors are becoming increasingly convenient, long-lasting, and discrete for patients, but this often requires the use of strong external cutaneous adhesives and increased contact time with the skin. As a consequence, these devices have been associated with a variety of dermatologic reactions, namely, irritant and allergic contact dermatitis. Some of these reactions can be severe, precluding the use of these devices, which puts patients' long-term health at risk. Herein, we review the history of diabetic devices and reported cutaneous reactions to diabetic devices and commonly cited allergens.

Patch Testing: The Patient Experience.

BACKGROUND: Data regarding patient-reported symptoms during patch testing are limited. OBJECTIVE: To provide frequency of symptoms (pain, sleep difficulty, medication need, site itching, itch elsewhere, and worsening rash) experienced by patients undergoing extensive patch testing and to determine association of these symptoms with patient characteristics. METHODS: This was a retrospective chart review of patients who underwent patch testing at a tertiary referral, contact dermatitis clinic over 15 months. Demographics, number of patches placed, patch location(s), and number of reactions (total and ++/+++) were extracted by chart review. Frequency of symptoms reported on a questionnaire administered at the 48-hour (48H) and final (F) visits was tabulated, and associations were evaluated using χ2 and Fisher exact tests. RESULTS: Six hundred forty-one patient records were accessed. The most common symptom was patch site itching (48H, 77.4%; F, 76.5%). Frequency of pain and sleep difficulty were significantly higher at 48H compared with F (P < 0.0001). Worsening of rash was significantly higher at F compared with 48H (P < 0.0001). The number of patches was significantly associated with all symptoms except sleep difficulty (P ≤ 0.0141). Patch location was significantly associated with pain, medication need, itch elsewhere, and worsening rash but not sleep difficulty or site itch (P ≤ 0.0257). The number of reactions (total and ++/+++) was significantly associated with all symptoms except itch elsewhere (total P ≤ 0.0316; ++/+++: P ≤ 0.0445). CONCLUSIONS: Most patients reported symptoms during patch testing, most commonly itching (at patch site and elsewhere), sleep difficulty, and need for medication. The number of positive patch test reactions (total and ++/+++) was the most common characteristic associated with the symptoms.

Effectiveness of Support Groups for Patients With Contact Dermatitis: A Pilot Study.

BACKGROUND: Contact dermatitis can be difficult to manage and overwhelming for patients, often requiring significant lifestyle changes. OBJECTIVE: The aim of the study was to investigate whether a contact dermatitis support group could help patients find community and learn from others who share similar experiences. METHODS: Hour-long, monthly support group meetings facilitated by a social worker, research fellows, and a faculty dermatologist were held for approximately 1.5 years. A 32-question, cross-sectional survey was administered to assess perception of contact dermatitis and overall usefulness of the group. RESULTS: Between 2 and 5 patients attended each group session; 9 participants completed the survey. Most were female (77.8%) and white (77.8%), with an average age of 68.8 years. Eight participants (88.9%) reported that it was important or somewhat important to socialize with others affected by contact dermatitis. Three group members (33.3%) had met with attendees outside of the monthly sessions. The majority (77.8%) reported that the support group had a positive effect on their understanding of contact dermatitis and would recommend the group to others (88.9%). CONCLUSIONS: Support groups may be helpful for patients learning to cope with the challenges associated with contact dermatitis. Although preliminary feedback is promising, further investigation is warranted to determine whether these groups are effective on a larger scale.

Tolerability of hair cleansing conditioners: a double-blind randomized, controlled trial designed to evaluate consumer complaints to the U.S. Food and Drug Administration.

Importance: Consumers have reported skin rash/irritation and hair loss/breakage with Wen by Chaz Dean Sweet Almond Mint Cleansing Conditioner (WCDSAMCC), however epidemiologic, toxicologic and clinical hair loss studies have not provided an explanation. Contact dermatitis has been hypothesized.Objective: To assess the tolerability of six products: WCDSAMCC, three other hair cleansing conditioners, and two controls [salicylic acid shampoo (SAS) and baby shampoo (BS)].Design: Double-blind, randomized, controlled trial.Setting: Single-site study.Population: General population volunteers.Intervention: Standard semi-open patch tests (SOPTs) and duration-escalation repeat open application tests (ROATs) over 5 weeks.Main Outcome Measures: Primary outcome measure was "stopping point" [ROAT total component score ≥6 (maximum 10) or global ≥4 (maximum 5)]. Secondary outcomes included "any reaction" (ROAT component score ≥1) and SOPT ≥ doubtful.Results: Two hundred of 298 volunteers were enrolled. There were no significant differences in the tolerability of WCDSAMCC and any of the other three hair cleansing conditioners as assessed by SOPT or ROAT. WCDSAMCC was significantly better tolerated than SAS ("stopping point", or "any reaction", p values<0.0001) as well as BS (p = 0.01). The frequency of doubtful SOPT reactions was lowest for WCD (2.2%) and highest for SAS (7.1%, p = 0.04).Conclusions: As assessed by both ROAT and SOPTs, WCDSAMCC was similar in tolerability to three other hair cleansing conditioners and significantly better tolerated than both controls (SAS and BS).Summary: This double-blind, randomized, controlled study found that WCDSAMCC was similar in tolerability to three other HCCs and was significantly better tolerated than both SAS and BS. This study provides critical clinical evidence on the comparative lack of cutaneous effects with use of WCDSAMCC.Trial Registration: NCT03483025 ClinicalTrials.gov.