The Impact of teledermatology during the COVID-19 pandemic.

Teledermatology has been widely adopted during the COVID-19 pandemic as virtual patient care promotes social distancing and decreases viral exposure risk. As teledermatology has become more prominent during this period, it is essential to assess whether virtual visits allow for adequate patient care. To assess perceptions of advantages and disadvantages of teledermatology, a survey was sent to academic dermatologists through the Association of Professors of Dermatology (APD) listserv. Of the physicians surveyed, 94% reported their departments had implemented teledermatology during the COVID-19 pandemic. The majority (64%) described teledermatology as an effective tool for patient care because of improved access to care, decreased risk of COVID-19 exposure, and convenience. Frequently cited limitations of teledermatology were image quality, technical difficulties, and inability to perform a comprehensive skin examination. Thirty-seven percent of respondents reported teledermatology as a contributor to their professional burnout. Although teledermatology has become more prevalent as a result of the pandemic, its role moving forward is uncertain given its limitations.

The impact of the coronavirus disease 2019 pandemic on dermatologist burnout: a survey study.

Burnout in dermatology is on the rise, with 36% of U.S. dermatologists experiencing burnout in 2020. The coronavirus disease 2019 (COVID-19) pandemic may exacerbate this problem with healthcare workers reporting increased anxiety, depression, and insomnia. To assess the rate, severity, and causes of burnout before and during the pandemic, a survey was sent to academic dermatologists through the Association of Professors of Dermatology (APD) listserv and compared to a similar survey administered to the same population prior to the pandemic. Burnout rates have increased from 2018, with 53% of participants experiencing burnout once a week or more and 17% experiencing burnout daily during the pandemic. The most common COVID-related burnout factors involve uncertainty about the future, teledermatology, fear of exposing loved ones to COVID-19, and compensation reduction. The challenges posed by the COVID-19 pandemic compound existing burnout within dermatology, warranting consideration by academic institutions.

Photodamage spares the distal digits owing to primate-like hand flexion.

Sun-exposed areas of the body - including the face, neck, and extensor forearms - are chronically exposed to UV light and display signs of photoaging. The skin distal to the proximal interphalangeal (PIP) joint is, however, typically spared owing to the natural rest position of the hand. The inward curvature of the fingers, termed the finger flexion cascade, orients the skin distal to the PIP joint toward the ground as in knuckle-walking primates. The near constant protection of this area of skin from sun may reflect our primate ancestry, the daily activities of which included swinging through trees and knuckle-walking. Primates have elongated, inward curved fingers that were once advantageous for gripping branches during arboreal locomotion. Although natural selection has favored shorter, straighter fingers, the human hand continues to assume a natural shape of flexion at rest. The UV untouched, healthy skin at the ends of the fingers is a reminder of our primate heritage. This finding may provide a colorful, memorable means to reinforce to patients how photoaging is a manifestation of sun exposure rather than age.

Skin Cancer Detection Technology.

Skin cancer is the most common malignancy in the United States. Health care providers and patients alike are tasked with identifying suspicious skin lesions in order to diagnose skin cancers early and treat them quickly. The normal pathway to skin cancer diagnosis is visual, with dermoscopic assessment of the lesion followed by biopsy and histopathologic evaluation. Recently, many innovative skin cancer detection technologies have been developed to increase diagnostic accuracy for skin cancers. These noninvasive technologies offer benefits over biopsy but are limited by expense, training, and poor specificity. The skin cancer detection techniques are reviewed in this article.