Systemic comorbidities of rosacea: practice gaps among dermatologists.

Rosacea is a chronic inflammatory skin condition that is associated with multiple systemic comorbidities, with the strongest evidence linking rosacea to hypertension, dyslipidemia, inflammatory bowel disease, and anxiety and depression. To assess dermatologists' awareness of and screening practices for rosacea comorbidities, we developed a survey that was distributed to attendings and residents across four academic dermatology departments in Massachusetts. A total of 73 dermatologists with varying experience participated in the study. Findings demonstrated significant knowledge and practice gaps among academic dermatologists in managing systemic comorbidities in rosacea. In addition, dermatologists' awareness of rosacea comorbidities was negatively correlated with number of years out of residency training, highlighting the need to address this knowledge gap through increased continuing medical education. Importantly, we observed a low screening frequency despite a high awareness of the association between rosacea and ocular comorbidities, suggesting that additional financial, institutional, or practice barriers likely contribute to the low screening rate.

Moving forward with teledermatology: Operational challenges of a hybrid in-person and virtual practice.

Since the COVID-19 outbreak, teledermatology services have become an integral part of our daily practice. In this study, we compared three practice models of an academic department in an urban setting: 1) in-person only, 2) teledermatology only, and 3) hybrid of in-person and teledermatology. Our study demonstrated that older patients prefer in-person visits over teledermatology visits, while non-English-speaking patients prefer teledermatology visits over in-person visits. In addition, teledermatology services can be better utilized for evaluation of acne and psoriasis, as these diagnoses do not require in-person reevaluation, unlike the evaluation of concerning lesions. Considering these findings, our study highlights the need to continuously examine our practice models to understand patient preferences, overcome practice-driven barriers, and ensure the sound allocation of limited health care resources.

Painful scrotal dermatitis secondary to topical 5-fluorouracil.

5-Fluorouracil (5-FU) is an antineoplastic agent that is used topically to treat actinic keratoses. Although topical 5-FU frequently causes irritant contact dermatitis at the site of application, distant skin reactions are rare and could relate to accidental transfer or systemic absorption of the drug. We present a patient who developed a painful scrotal dermatitis after applying the topical cream to actinic keratoses on his chest. Upon discontinuation of topical 5-FU, the reaction resolved over a four-week period with oral prednisone and topical betamethasone ointment. The patient was re-challenged with topical 5-FU one year later and again developed scrotal pain and erythema similar to the initial reaction. Scrotal dermatitis is a rare adverse effect of topical 5-FU therapy that can be associated with significant distress and disruption of daily activities.