Congenital Erythropoietic Porphyria: A Case of Hepatic Failure and Angioedema Following Ferrous Sulfate Supplementation.

This report describes an unusual case of a young anemic female who experienced acute hepatic insufficiency and angioedema after ferrous sulfate consumption. Her primary diagnosis of congenital erythropoietic porphyria (CEP) was revealed after a detailed dermatologic examination and laboratory data. The patient was treated with IV methylprednisolone along with red blood cell transfusion, vitamin supplementation, and wound care. Our case report emphasizes the importance of physician awareness of CEP since it is a rare disease that tends to mimic other chronic porphyrias, various drug reactions, and collagenopathies.

Ethical Implications of Mentor Influence on Career Choices in Dermatology.

Mentorship is a critical aspect of personal and professional development throughout anyone's life. Unlike many other fields, a medical career is a long multistep process that can begin in high school and continue throughout a physician's career. When considering competitive specialties such as dermatology, mentors are increasingly crucial in helping students successfully match to programs of their choice, but the variability and extent of mentorship can raise ethical concerns. We discuss the evolution of mentorship in dermatology and the potential ethical issues involved. We propose possible solutions to the ethical conflict between mentor and mentee.

Ethics of Residency Candidates Using Application Consulting Services.

While the prevalence is still being determined, more medical students are utilizing application consulting companies when applying to competitive residencies such as dermatology. We outline the structure of these companies, the scope of services provided, and the costs associated. We also discuss the ethical implications for the use in the residency application process of such firms and the impact of these practices on the candidate selection process. Finally, we offer possible solutions and measures that mitigate the impact of the use of consulting firms in residency applications. Application consulting services are meant to assist clients in maximizing their chances for a successful application cycle. Many companies cater to both prospective residency and pre-medical candidates, including "Med School Insiders," "BeMo Academic Consulting," and "Elite Medical Prep." The scope of application consulting services is vast. Clients can request services such as personalized school selection, application advising, document preparation review [e.g., curriculum vitae (CV), personal statements, and essays), electronic residency application service (ERAS)], and interview coaching. Another service offered is residency match advising, which details specific requirements programs desire. Prospective clients would gain a significant advantage, mainly when used at the outset of medical school training when planning a trajectory for competitive specialties. We review the ethical issues associated with using these consulting services.

Ethics of dynamic and differential pricing for cosmetic procedures.

Patient demand for procedures has increased in the evolving landscape of cosmetic dermatology. This has been fueled, in part, by social media and the growing normalization of cosmetic enhancements, developments that have led some patients to have potentially unrealistic expectations and place undue pressure on dermatologists to meet these often unrealistic demands. This pressure is exacerbated further by patients who are seen as difficult, demanding, and time-consuming and who may require extensive counseling. Physicians may adopt dynamic or differential pricing strategies to offset the additional time and effort that these patients require. We discuss the ethical concerns surrounding these pricing strategies in the cosmetic sphere, highlight the importance of transparency in pricing, and offer suggestions to promote clarity and fairness in cosmetic dermatology practices.

Children with hemoglobin C or S trait have low serologic responses to a subset of malaria variant surface antigens.

Children with hemoglobin AC or AS have decreased susceptibility to clinical malaria. Parasite variant surface antigen (VSA) presentation on the surface of infected erythrocytes is altered in erythrocytes with hemoglobin C (Hb AC) or sickle trait (Hb AS) mutations in vitro. The protective role of incomplete or altered VSA presentation against clinical malaria in individuals with Hb AC or AS is unclear. Using a high-throughput protein microarray, we sought to use serological responses to VSAs as a measure of host exposure to VSAs among Malian children with Hb AC, Hb AS, or wildtype hemoglobin (Hb AA). In uncomplicated malaria, when compared to Hb AA children, Hb AC children had significantly lower serological responses to extracellular Plasmodium falciparum erythrocyte membrane protein-1 (PfEMP1) domains but did not differ in responses to intracellular PfEMP1 domains and other VSAs, including members of the repetitive interspersed family (RIFIN) and subtelomeric variable open reading frame (STEVOR) family. Healthy children with Hb AC and Hb AS genotypes recognized fewer extracellular PfEMP1s compared to children with Hb AA, especially CD36-binding PfEMP1s. These reduced serologic responses may reflect reduced VSA presentation or lower parasite exposure in children with Hb AC or AS and provide insights into mechanisms of protection.

Ethics of residency programs and fellowships that electively withdraw from the National Resident Matching Program.

The National Resident Matching Program, known as "The Match" facilitates the placement of medical graduates into residency and fellowship programs in the United States. Programs may opt out of The Match for various reasons. The selective and intermittent withdrawal of programs from The Match raises ethical concerns surrounding fairness, transparency, beneficence, autonomy, and justice for applicants. We discuss these issues, present the history behind The Match, and offer suggestions to promote fairness.