Travel Distance and Time to Pulsed Dye Laser Treatment for Port-Wine Birthmark in the Pediatric Population.

Prior research has demonstrated that early treatment of port-wine birthmark (PWB) with pulsed dye laser (PDL) yields optimal patient outcomes. Given the known variations in practice patterns among dermatologists offering PDL, we conducted a cross-sectional analysis in order to determine the travel distance and time to practice locations offering PDL therapy for PWB among the pediatric population. We determined the travel time and distance from each county population center in the United States to the nearest PDL site using ArcGIS and linked the data to demographic characteristics in each census tract. 1,243 practice sites were identified that offer PDL treatment for PWB for patients under the age of 18. Children living in urban areas were found to have a significantly shorter median travel time and distance to PDL sites (6.1 miles, 11.8 minutes) compared to children living in rural areas (60.9 miles, 66.7 minutes). Additionally, uninsured children were found to travel longer average distances (32.2 miles) than insured children (24.2 miles). These findings suggest that certain socioeconomically disadvantaged groups have increased travel burden when obtaining PDL treatment for PWB. Transportation resources and support may need to be given to certain patients to ensure timely and effective PDL treatment.

Practice Characteristics of Self-Identified Black Dermatologists in the United States.

There is a documented shortage of Black dermatologists in the United States, with little known about their practice characteristics. We analyzed the practice patterns (e.g., location, group setting, beneficiary characteristics, local geographic characteristics) of 221 self-identified Black dermatologists in the Black Dermatologist Directory through analysis of publicly available Medicare datasets. Compared to non-Black dermatologists, Black dermatologists were more likely to be female (80.1% vs. 51.1%), practice in the South (49.8% vs. 34.9%), work in solo practices (35.8% vs. 19.8%) or academic centers (18.1% vs. 15.5%), and practice in counties with a higher proportion of non-Hispanic Black individuals (21.0% vs. 13.2%). Black dermatologists treated a higher proportion of non-Hispanic Black Medicare beneficiaries (21.7% vs. 2.7%) and dual Medicare-Medicaid beneficiaries (15.0% vs. 9.7%). Major limitations include reliance on public data which may incompletely capture all practicing Black dermatologists. Overall, the findings support the important role of Black dermatologists in treating minority and Medicaid beneficiaries; increased representation of Black dermatologists may ultimately allow for improved patient access and promote awareness and knowledge of specific dermatologic needs of Black patients among the broader dermatology community.

Dermatology workforce in the United States - Part I: Overview, transformations, and implications.

The dermatology workforce continues to evolve to meet the growing and diversified demands of the US population. Part 1 of this continuing medical education series is designed to provide an overview of the dermatology workforce as well as delineate the motivators and socioeconomic implications of significant workforce transformations which are impacting dermatologic health care. Part 2 of the series will consider the impact of workforce challenges on patient outcomes and discuss potential actions that may help to optimize workforce organization and care delivery.

Dermatology workforce in the United States - Part II: Patient outcomes, challenges, and potential solutions.

This continuing medical education (CME) series assesses key features and ongoing transformations within the dermatology workforce. Part 1 of this series described precipitants and implications of recent workforce changes. Part 2 reviews the influence that these workforce dynamics have had on patient access, outcomes, and satisfaction. Additionally, it assesses potential solutions for optimizing care for underserved groups and the broader dermatologic patient population.

Contact dermatitis and nutrition.

There is a worldwide increase in food and nutrition-related contact dermatitis, including irritant contact dermatitis, allergic contact dermatitis, systemic contact dermatitis, protein contact dermatitis, and photocontact dermatitis. A wide range of patients is affected by this condition, from those who consume certain foods as part of their diet to workers who handle food occupationally. Patch testing, analytical chemistry, and reporting may help in timely recognition of contact allergens. Elimination of exposure to the known food or supplement is imperative for treatment. Currently, more research is needed in order to better define the role that nutrition plays in contact dermatitis.

Emerging therapeutics in the management of connective tissue disease. Part II: Dermatomyositis and scleroderma.

The management of connective tissue diseases is dramatically evolving with the advent of biologics and novel oral systemic therapeutics. Despite involvement in the care of these complex patients, there is a knowledge gap in the field of dermatology regarding these emerging agents. The second article in this continuing medical education series discusses new and emerging therapeutics for dermatomyositis and scleroderma that target cells, intracellular signaling pathways, and cytokines.

Employment and Migration Patterns of Recent Micrographic Surgery and Dermatologic Oncology Fellowship Graduates.

BACKGROUND: There is currently an uneven distribution of the Mohs surgery workforce, with a dearth in nonurban areas. The relationship between training and employment locations of Mohs surgeons has not been studied. OBJECTIVE: To analyze the employment location of recent micrographic surgery and dermatologic oncology (MSDO) graduates in reference to residency and fellowship locations. MATERIALS AND METHODS: Data collection of training and practice locations of 421 MSDO fellowship graduates from 2012 to 2017. RESULTS: Thirty-two percent (n = 136) and 53% (n = 225) of MSDO fellowship graduates' first employment locations were located within 10 and 100 miles of either their residency or fellowship locations. Ninety-six percent of graduates were employed in a metropolitan location. Female graduates worked closer to training sites than male graduates, with 62% (n = 124) versus 46% (n = 102) working within 100 miles of either training site. Analysis by fellowship census region showed that graduates clustered around training sites in all regions, with 45% to 60% of graduates working within 100 miles of either training site. CONCLUSION: The majority of graduates chose to work in a metropolitan area. Training location strongly predicts employment location. More than 45% of graduates in any region worked within 100 miles of their residency or fellowship site, and a sizeable portion worked within 10 miles.