Chronic noninfectious necrotizing granulomas in a child with Nijmegen breakage syndrome.

Nijmegen breakage syndrome (NBS) is a chromosomal breakage disorder with characteristic physical features, chromosomal instability, and combined immunodeficiency. It is closely related to other chromosomal breakage disorders like ataxia telangiectasia. Noninfectious granulomatous inflammation refractory to treatment is a relatively common feature in ataxia telangiectasia. Herein we report a patient with NBS who developed chronic refractory necrotizing granulomatous ulcerations and review the pathophysiology of NBS and noninfectious granulomas in primary immunodeficiency syndromes.

Analysis of dermatology resident self-reported successful learning styles and implications for core competency curriculum development.

BACKGROUND: There are different teaching styles for delivering competency-based curricula. The education literature suggests that learning is maximized when teaching is delivered in a style preferred by learners. AIMS: To determine if dermatology residents report learning style preferences aligned with adult learning. METHOD: Dermatology residents attending an introductory cutaneous biology course completed a learning styles inventory assessing self-reported success in 35 active and passive learning activities. The 35 learning activities were ranked in order of preference by learners. RESULTS: Mean overall ratings for active learning activities were significantly higher than for passive learning activities (P = 0.002). CONCLUSIONS: Trends in dermatology resident learning style preferences should be considered during program curriculum development. Programs should integrate a variety of curriculum delivery methods to accommodate various learning styles, with an emphasis on the active learning styles preferred by residents.

Glandular congenital lymphadenoma.

Cutaneous lymphadenoma is known to occur over a broad age range, from 14 to 72 years of age. We report the unique clinical and histologic presentation of a cutaneous lymphadenoma from the suprapubic abdomen of a neonate which may represent a novel subtype, glandular congenital lymphadenoma. Cutaneous lymphadenoma is a rare tumor with a distinct histologic triad of epithelial nodules, dense fibrous stroma, and intense intranodular lymphocytic infiltrate. Typically, it is a slow growing, skin colored papule, nodule, or plaque, clinically resembling a basal cell carcinoma and often occurring in the head and neck region or lower extremities.

Assessment of residents' loss of interest in academic careers and identification of correctable factors.

OBJECTIVE: To quantify interest in an academic career at the dermatology resident and residency applicant level. DESIGN: Cross-sectional survey. PARTICIPANTS: Dermatology residents attending a basic science course and residency applicants applying to a single residency program. MAIN OUTCOME MEASURES: Self-reported level of interest in an academic dermatology career, reasons for losing interest in academics, and area of desired primary academic contribution. RESULTS: One hundred nine of 230 dermatology applicants and 130 of 190 dermatology residents completed the survey. Seventy-nine applicants (72.5%) and 48 residents (36.9%) were interested in an academic career. Thirty-three of 47 residents (70.2%) and 63 of 79 applicants (79.8%) interested in an academic career hoped to make their primary academic contribution as teacher-clinicians, while only 7 residents (14.9%) and 15 applicants (19.0%) planned to primarily contribute through basic or clinical research. Thirty-eight resident respondents (29.2%) reported losing interest in academics for the following primary reasons: bureaucracy, 24 (63.2%); salary differential/financial issues, 20 (52.6%); lack of effective mentorship, role model, or professional guidance, 19 (50.0%); and location or practice environment, 10 (26.3%). CONCLUSIONS: Many residents report losing interest in pursuing a career in academic dermatology. Many reasons for this are not easy to correct. However, half of those residents primarily lose interest because of a lack of mentors, role models, and career guidance. Methods to improve this perception and experience should be sought. Strategies should also be developed to cultivate future teacher-clinicians, where most of the interest lies.