A gender-based comparison of promotion and research productivity in academic dermatology.

PURPOSE: Gender disparities within academic promotion have been reported in several medical specialties. Female representationin association with research productivity has not been reported among academic dermatologists. As research productivity is a heavily weighted factor in determining promotion, we sought to determine whether gender disparities in academic rank and scholarly impact, measured by the h-index, exist in academic dermatology. METHODS: In 2015, the authors determined gender and academic rank using academic dermatology department websites. H- index and publication range were determined using the Scopus database. Rank, h-index, and publication range were compared between male and female academic dermatologists. RESULTS: The h-index of academic dermatologists increased with successive academic rank from Assistant Professor through Professor (p<0.001), although no significant difference existed between Chairs and Professors. Publication range also increased with each successive rank from Assistant Professor through Professor (p<0.001), with no statistical significant difference between publication range of Chairs and Professors. Overall, men had higher h-indices than female colleagues (p<0.001). This difference was maintained when controlling for academic rank among Assistant Professors, Professors, and Chairs and when controlling for publication range in years. CONCLUSION: Women in academic dermatology are underrepresented among senior academic ranks. The difference in scholarly productivity between male and female academic dermatologists may contribute to this disparity. Recommendation for earlyinvolvement in research activities may help minimize this gap.

Periocular sebaceous cell carcinoma following chemical burn: a unique case of a Marjolin ulcer.

This study reports a unique case of a Marjolin ulcer in a patient who presented with periocular sebaceous cell carcinoma 16 years after a lye chemical burn. A 68-year-old woman presented with a long history of irregular and tender right upper and lower eyelid margins, periocular erythema, madarosis, trichiasis, ptosis, and chemosis, occurring many years after chemical burn to the area. After eyelid biopsy established the diagnosis of sebaceous cell carcinoma, subsequent map biopsies of the conjunctival surface revealed extensive sebaceous cell carcinoma with pagetoid spread, necessitating anterior exenteration for definitive treatment. This report describes the first case in which a sebaceous cell carcinoma has arisen in the area of a chemical burn. Sebaceous cell carcinomas should be included in the spectrum of Marjolin ulcers, and ophthalmologists should be aware of this entity when evaluating patients with a history of a burn to the eyelids.

How to cope with potential malfeasance using artificial intelligence: Call to action.

Just as fire and electricity can be, and in many ways are, of great benefit to humanity, and as the contributions elsewhere in this issue of Clinics in Dermatology have shown, artificial intelligence (AI) can be used for the ill and help in medicine. We offer several suggestions to counter some of the more egregious and obvious ones: AI-generated material that purports to be caused by humans and AI-generated material that purports to show actual people doing things that these people would not normally do. Both suggestions rely on methods already in existence to ensure public safety.

Remembering Edmund Klein: the Father of Immunotherapy.

Edmund Klein's seminal research in oncology transformed medicine. He would now be 100 years old. This extraordinary physician-scientist has been dubbed the Father of Immunotherapy and was honored with the highest American recognition in medicine, the Lasker Award, often a prelude to the Nobel Prize.

Birt-Hogg-Dubé syndrome: Another mTOR phenomenon.

Birt-Hogg-Dubé syndrome is an uncommon autosomal dominant systemic disorder with cutaneous findings notable for fibrofolliculomas or trichodiscomas on the scalp, face, neck, and trunk. These cutaneous signs are associated with bilateral renal cell carcinoma, benign renal cysts, pulmonary cysts, and spontaneous pneumothorax. Given its autosomal dominant inheritance pattern, the successful diagnosis of Birt-Hogg-Dubé syndrome (BHDS) may elucidate a diagnosis in family members. BHDS results from a mutation in the FLCN gene encoding the folliculin protein, a transcriptional regulator of the mammalian target of rapamycin signaling pathway. Like tuberous sclerosis, BHDS's clinical features may subside with the use of oral rapamycin for mammalian target of rapamycin inhibition, a theoretical concept meriting exploration. Although its prevalence in the general population has been estimated at 2 cases per million, BHDS has been detected in a few patients from the nearby Portuguese-lineage quarter of the city of Newark, a disproportionate prevalence possibly explained by the founder effect.

Hidradenoma Papilliferum: Everyone Else's Diagnosis.

A 52-year-old female presented with an asymptomatic cyst-like lesion on her right labia majora present for several years. Excision revealed a 3-mm cystic lesion containing complex networks of thin fronds of clear apocrine cells and basaloid cells, features characteristic of hidradenoma papilliferum (HP). In contrast to the medical literature, the lesion was connected to the overlying epithelium by a straight duct, a feature characteristic of apocrine glands. Searching of six different dermatopathology study sets revealed 11 cases diagnosed as HP. Histological review of the eight available cases for review revealed none that were diagnosed correctly. Six were syringocystadenoma papilliferum and two were trichoepithelioma. HP is a fascinating lesion that needs further study and requires better diagnostic criteria.

Dermatosis papulosa nigra: a clinically and histopathologically distinct entity.

Dermatosis papulosa nigra was first described by Aldo Castellani (1874-1971) more than 90 years ago, and it has since been presumed to be a variant of seborrheic keratosis. Despite their morphologic similarities both macroscopically and microscopically, key differences have yet to be explained. These lesions also exhibit different demographics, with dermatosis papulosa nigra having a predilection for dark-skinned individuals and a female predominance. No studies to date have investigated this, but studies assessing the mechanisms of similar dermatologic conditions may yield significant clues. The additional impact of environmental factors may also be important, but much controversy exists. Further investigations into dermatosis papulosa nigra are necessary to determine its pathogenesis and whether it should be regarded as a distinct entity.

Assessment of Online Patient Education Materials from Major Dermatologic Associations.

Objective: Patients increasingly use the internet to find medical information regarding their conditions and treatments. Physicians often supplement visits with written education materials. Online patient education materials from major dermatologic associations should be written at appropriate reading levels to optimize utility for patients. The purpose of this study is to assess online patient education materials from major dermatologic associations and determine if they are written at the fourth to sixth grade level recommended by the American Medical Association and National Institutes of Health. Design: This is a descriptive and correlational design. Setting: Academic institution. Participants/measurements: Patient education materials from eight major dermatology websites were downloaded and assessed using 10 readability scales. A one-way analysis of variance and Tukey's Honestly Statistically Different post hoc analysis were performed to determine the difference in readability levels between websites. Results: Two hundred and sixty patient education materials were assessed. Collectively, patient education materials were written at a mean grade level of 11.13, with 65.8 percent of articles written above a tenth grade level and no articles written at the American Medical Association/National Institutes of Health recommended grade levels. Analysis of variance demonstrated a significant difference between websites for each reading scale (p<0.001), which was confirmed with Tukey's Honestly Statistically Different post hoc analysis. Conclusion: Online patient education materials from major dermatologic association websites are written well above recommended reading levels. Associations should consider revising patient education materials to allow more effective patient comprehension. (J ClinAesthet Dermatol. 2016;9(9):23-28.).

The impact of fellowship training on scholarly productivity in academic dermatology.

An increasing number of dermatology residents are pursuing postresidency fellowships to augment their knowledge in dermatology subspecialties. The purpose of this study was to determine whether fellowship training affects the scholarly impact of academic dermatologists, as measured by the h-index. A secondary objective was to compare scholarly productivity among different dermatology subspecialties. Overall, fellowship training is associated with increased scholarly impact; however, when stratifying for academic rank and years of publication activity, this difference does not exist.