Patients' Body Image Improves After Mohs Micrographic Surgery for Nonmelanoma Head and Neck Skin Cancer.

BACKGROUND: Most skin cancers occur on the head and neck, areas of the body that are significant to an individual's body image (BI) perception. Poor BI is a robust risk factor for depression and decreased quality of life. Thus, patients with nonmelanoma head and neck skin cancer (NMHNSC) may be more vulnerable to BI disturbance and the negative sequelae of poor BI. OBJECTIVE: Describe the nature of BI concerns in patients diagnosed with NMHNSC and assess how BI changes with treatment. METHODS AND MATERIALS: Patients undergoing Mohs micrographic surgery (MMS) for NMHNSC completed assessments of BI and well-being before (N = 239) and 6 months after (N = 80) treatment with MMS. Demographic and tumor data were gathered through retrospective chart review. RESULTS: Body image improved significantly 6 months after MMS, and the magnitude of this change was large (η = 0.18). Repair length (length of final scar irrespective of repair type) >4 cm predicted poorer BI at 6-month follow-up. CONCLUSION: Patients' BI improves after treatment with MMS for NMHNSC.

A Novel, Disease-Specific Self-Report Instrument to Measure Body Image Concerns in Patients With Head and Neck Skin Cancer.

BACKGROUND: Skin cancer commonly occurs on areas that are salient to body image perception (i.e., head and neck). Patients with head and neck skin cancer (HNSC) may experience negative body image perceptions related to their disease, which is concerning, given the numerous negative sequelae of poor body image. However, there are no existing disease-specific measures of body image concerns in HNSC. OBJECTIVE: To develop and examine the psychometric properties of a brief self-report, disease-specific measure of body image concerns in patients with HNSC-the Body Image Questionnaire (BIQ). MATERIALS AND METHODS: Patients with HNSC completed the BIQ before (n = 239) and 6 months after (n = 80) treatment with Mohs micrographic surgery. Analyses examined the internal consistency, convergent validity, and factor structure of the BIQ. RESULTS: Internal consistency reliability was acceptable, and the measure demonstrated convergent validity with well-being. Four dimensions underlie the BIQ: appearance satisfaction, appearance avoidance, head/neck/skin-specific dissatisfaction, and perceived change. CONCLUSION: The BIQ is a valid and internally reliable disease-specific instrument that measures body image concerns in patients with HNSC.

A 30-Minute, Monthly, Live, Webinar-Based Journal Club Activity Alters the Self-Reported Behaviors of Dermatologic Surgeons.

BACKGROUND: Journal clubs provide a way to communicate advances in recent literature. In outpatient surgical subspecialties, such as dermatologic surgery, physicians may face challenges in finding or attending meetings pertinent to their practice. OBJECTIVE: To assess the utility of a live web-based journal club in dermatologic surgery. MATERIALS AND METHODS: Monthly 30-minute journal club sessions covering 5 to 6 scholarly articles. Anonymous surveys were used to evaluate the utility and self-reported learning associated with each meeting. RESULTS: From December 2012 to February 2015, 117 articles were reviewed. Survey data were acquired monthly, apart from 5 months of missing data. On average, the survey response rate was 37% (range: 7%-82%), with an average of 17 participants per monthly session (range: 9-25). The mean monthly usefulness score was 83.7 (101-point scale), with participants scoring their likelihood of returning in the future as 96.2 (0 = not likely, 100 = extremely likely). At each session, a mean of 68% of participants felt that at least one article would change their practice of medicine. CONCLUSION: A monthly online and telephonic journal club may be a practical and effective way to inform dermatologic surgeons of new developments in high impact literature and may influence improvements in individual practice.