Evaluating the Cost Burden of Alopecia Areata Treatment: A Comprehensive Review for Dermatologists.

Alopecia areata (AA) is managed with prolonged medical treatments and cosmetic therapies, whose cost can be burdensome. We sought to identify the costs of AA treatment and consolidate the available data for the practicing dermatologist by performing a PubMed search of articles indexed for MEDLINE. Ten studies including approximately 16,000 patients with AA across a range of Oxford Centre for Evidence-Based Medicine Levels of Evidence were included. Studies showed that despite the limited efficacy of many AA therapies, patients incurred substantial expenses to manage their AA.

Telemedicine Alopecia Assessment: Highlighting Patients With Skin of Color.

Alopecia has been one of the more common concerns reported at teledermatology (TD) visits during the COVID-19 pandemic. In light of the growing use of TD, a team of experts were consulted to develop workflows for virtual hair and scalp examinations, with particular consideration for skin of color patients.

Coronavirus Disease 2019 and Race in Dermatology.

Coronavirus Disease 2019 disproportionately affects Black and Hispanic/Latino populations. Racial disparities inherently exist in dermatology because of underrepresentation of skin of color populations in literature, reduced access to care for minority populations, and low diversity within the specialty of dermatology itself. Lack of imagery in dermatology can have detrimental consequences for patients of color. Dermatologists should note and disseminate cutaneous manifestations of patients of color to combat current racial imbalances.

The Alopecia Areata Consensus of Experts (ACE) study part II: Results of an international expert opinion on diagnosis and laboratory evaluation for alopecia areata.

BACKGROUND: We previously reported the Alopecia Areata Consensus of Experts study, which presented results of an international expert opinion on treatments for alopecia areata. OBJECTIVE: To report the results of the Alopecia Areata Consensus of Experts international expert opinion on diagnosis and laboratory evaluation for alopecia areata. METHODS: Fifty hair experts from 5 continents were invited to participate in a 3-round Delphi process. Consensus threshold was set at greater than or equal to 66%. RESULTS: Of 148 questions, expert consensus was achieved in 82 (55%). Round 1 consensus was achieved in 10 of 148 questions (7%). Round 2 achieved consensus in 47 of 77 questions (61%). The final face-to-face achieved consensus in 25 of 32 questions (78%). Consensus was greatest for laboratory evaluation (12 of 14 questions [86%]), followed by diagnosis (11 of 14 questions [79%]) of alopecia areata. Overall, etiopathogenesis achieved the least category consensus (31 of 68 questions [46%]). LIMITATIONS: The study had low representation from Africa, South America, and Asia. CONCLUSION: There is expert consensus on aspects of epidemiology, etiopathogenesis, clinical features, diagnosis, laboratory evaluation, and prognostic indicators of alopecia areata. The study also highlights areas where future clinical research could be directed to address unresolved hypotheses in alopecia areata patient care.

Cultural competence for the 21st century dermatologist practicing in the United States.

Significant health disparities exist among under-represented minorities in the Unites States, which can partially be accounted for by the quality of patient-physician interaction. A distinguishing factor of this interaction is the ability of the provider to demonstrate cultural competence, or address the social, cultural, and community influences on healthcare behaviors and incorporate these elements into patient care. However, this practice has yet to be universally implemented in our healthcare system. These factors become even more important as the racial, ethnic and cultural distribution of the United States population changes. Multiple studies have suggested that cultural competence of the health care provider and staff leads to improved patient adherence, satisfaction, and ultimately, health outcome. Cultural competence in the workplace also leads to efficient and cost-effective healthcare and better community integration into healthcare systems. The purpose of this review is to help dermatologists understand the benefits of culturally competent care for their patients and themselves and identify methods and resources to achieve this goal.

Diversity in dermatology: a society devoted to skin of color.

The US Census Bureau predicts that more than half of the country's population will identify as a race other than non-Hispanic white by the year 2044. Racial disparities also exist in the physician population where black individuals and Latinos are underrepresented. The Skin of Color Society (SOCS) was established to address the need for parity among dermatology patients with skin of color. The society provides educational support on dermatologic health related to skin of color and functions through committees that represent the multifaceted aspects of the organization. This column highlights the ongoing efforts of SOCS and its impact since its inception. We also chronicle the society's approach to broadening the scope of the specialty of dermatology.

Hair care practices as a barrier to physical activity in African American women.

OBJECTIVE: To characterize the influence of hair style maintenance on exercise behavior in African American women. DESIGN: A 40-item survey with questions concerning hair care practices, physical activity, and the relationship between the two. SETTING: University-affiliated dermatology department at an academic medical center in Winston-Salem, North Carolina. PARTICIPANTS: A total of 123 African American women from 21 to 60 years of age were surveyed; 103 women completed the questionnaire. MAIN OUTCOME MEASURES: The statistical significance of relationships between hair care practices and physical activity was determined. RESULTS: Fifty percent of African American women surveyed have modified their hair style to accommodate exercise and nearly 40% (37.9%) avoid exercise at times owing to hair-related issues. Respondents who exercised less owing to hair concerns were 2.9 times less likely to exercise more than 150 min/wk (95% CI,0.9-9.4; P=.08). CONCLUSION: Dermatologists can discuss hair management strategies during exercise that facilitate routinely performing exercise.

Patient knowledge and attitudes on laser hair removal: a survey in people of color.

BACKGROUND: It is now widely accepted that dark-complexioned skin individuals can be safely treated with laser hair removal (LHR). However, some people are still concerned about the side effects or have been told that hair removal laser is not possible in darkly pigmented skin. AIMS: To measure the knowledge and attitudes of African Americans about LHR and assess the need for additional education focusing on LHR. PATIENTS/METHODS: A cross-sectional survey with questionnaire was administered to African American subjects between the ages of 21-70 years. Questions comprised attitudes and knowledge about LHR. Demographic characteristics, attitudes, and knowledge were assessed by descriptive statistics. Results were considered statistically significant if P <0.05. RESULTS: The survey was completed by 221 African American subjects. There were only 122 subjects (55.2%) who knew that dark-skinned individuals can be treated with LHR. Only 44.3% of subjects believed that dark-skinned people are more prone to develop hyperpigmentation from LHR. Female subjects and subjects with higher educational background have a higher tendency to consider LHR as a treatment choice (P < 0.05). CONCLUSIONS: This study shows that many African Americans still have negative attitudes and lack knowledge about LHR. The results of this study provide information that can lead to better informed dermatology providers who can then better educate patients of color regarding LHR knowledge.

Helping patients cope with chronic alopecia areata.

Helping a patient cope with a frustrating and unpredictable disease like alopecia areata can be a difficult task for many dermatology nurses. Five dermatology nurses who practice in the United States and Canada say that one important resource that should not be overlooked during the course of treatment of alopecia areata is the patient support group. Another major resource is the referral of patients to the National Alopecia Areata Foundation, which coordinates the patient support groups.