TikTok and Black Skin: Is This a Missed Opportunity for Dermatologists?

BACKGROUND: A study by Villa-Ruiz et al (2021) found that educational videos dominate the content of dermatologic videos on TikTok with 25.8% of the videos being posted by board-certified dermatologists. We sought to examine if these results would differ when the search is adjusted to hashtags specific to black skin.  Methods: On October 12th, 2021, an investigator input #BlackSkinCare, #BlackSkinTreatment, #BlackSkinAdvice, and #BlackSkinCareTips in TikTok. #SkinOfColor was not searched as this term is used almost exclusively by dermatologists and could skew the results. After the total of 200 videos was obtained, the videos were then classified into categories regarding their content, and the skin concern and creator were recorded. RESULTS: Most of the videos were of educational content (57.1%), followed by personal experiences (23.2%). Clinical demonstrations/live procedures, business/advertisement, and entertainment/humor followed with 9.6%, 5.6%, and 4.5%, respectively. 54.5% of posts were about general skin care. 22.7% of posts addressed dark spots followed by acne (12.1%). Ingrown hair/razor bumps and skin texture/open pores followed, both with 3.5% each. 54% of videos were posted by vloggers or personal accounts. Board-certified dermatologists followed with 18.7% of the videos posted. Estheticians accounted for 16.2% and, lastly, business/industry comprised 8.6% of the videos analyzed. CONCLUSIONS: When searching black skin, TikTok posts are mostly educational and were less likely to have been created by a board-certified dermatologist. The top skin concern specified was dark spots. These findings suggest that there is an opportunity for dermatologists to increase educational content relating to black skin on TikTok. Campbell JR, Woolery-Lloyd H, Williams K. TikTok and black skin: is this a missed opportunity for dermatologists? J Drugs Dermatol. 2023;22(7):698-700. doi:10.36849/JDD.7061.

DermTok: How TikTok Is Changing the Landscape of Dermatology Patient Education.

BACKGROUND: TikTok gives its users a platform to share and view short videos on a wide range of topics, including dermatology related topics. This project sought to analyze the sources of TikTok videos associated with the treatment of four dermatologic conditions and to report the percentage of videos posted by board-certified dermatologists. METHODS: On July 16th, 2021, an investigator input the following hashtags into the TikTok application’s search bar: #AcneTreatment, #EczemaTreatment, #PsoriasisTreatment, and #RosaceaTreatment. After the total of 400 videos was obtained, the videos were then classified into the following categories based on the user posting the video: dermatologist, dermatology resident, non-dermatologist physician, physician assistant, nurse practitioner, registered nurse, esthetician, patient, beauty blogger, and other. Videos that were not in English, paid advertisements or by a business page, and/or unrelated to treatment or education of a dermatologic condition were excluded. RESULTS: The top posters of all the videos analyzed were patients (40.8%) followed by dermatologists (16.8%). Of all the videos analyzed, 37.3% were posted by licensed professionals and the remaining 62.7% were posted by non-licensed posters. The licensed professionals mostly posted about acne (52.4%) out of the four conditions. Non-professional posters mostly posted about psoriasis (86.7%) and eczema (66.7%) out of the four conditions. CONCLUSIONS: There is a need for more dermatologist-created, educational content on TikTok and other platforms to increase the likelihood that users will interact with dermatologic content posted by board-certified dermatologists. J Drugs Dermatol. 2023;22(3): doi:10.36849/JDD.6676.

Diversity, Equity, and Inclusion in Dermatology Residency.

Improving diversity, equity, and inclusion (DEI) in dermatology is a critical aim for the specialty to improve the workforce, clinical care, education, and research. This article outlines a framework for DEI initiatives at the residency training level: improving mentorship and residency selection process to improve representation of dermatology trainees; curricular development to train residents to provide expert care to all patients and to better understand principles of health equity and social determinants of health as they pertain to dermatology; establishing inclusive learning environments and mentoring structures that support residents to become successful future clinicians and leaders of the specialty.

The Leaky Pipeline: A Narrative Review of Diversity in Dermatology.

Dermatology remains the second least diverse specialty in medicine. This lack of diversity has important implications for the future of the specialty. This narrative review provides updated evidence on barriers at different stages of medical education training that impede academic advancement for underrepresented minority (URM) learners pursuing careers in dermatology.

Patch/plaque mycosis-fungoides-like presentations of DUSP22-translocated T-cell lymphomas.

The DUSP22-IRF4 gene rearrangement results in downregulation of DUSP22, a presumed tumor suppressor in T-cell lymphomagenesis. It has been described in some cases of primary cutaneous and systemic anaplastic large-cell lymphoma, lymphomatoid papulosis, and transformed mycosis fungoides. Here we describe two patients with clinical lesions resembling patch/plaque mycosis fungoides that did not meet WHO criteria for large-cell transformation on histopathology yet showed a DUSP22 translocation. One patient who had a history of systemic anaplastic large-cell lymphoma with DUSP22 translocation presented with cutaneous involvement by his systemic lymphoma along with lymphomatoid papulosis and mycosis-fungoides-like lesions, all showing an identical immunophenotype and T-cell clone. These cases expand the spectrum of DUSP22-rearranged lymphomas to include mycosis-fungoides-like presentations without large-cell transformation.

Racial/Ethnic Variations in Skin Barrier: Implications for Skin Care Recommendations in Skin of Color.

BACKGROUND: Genetic and environmental factors influence stratum corneum (SC) barrier properties and function. Researchers increasingly focus on biophysical studies that may help clinicians provide their patients with an informed choice on tailormade skincare. This literature review on skin barrier properties comparing different ethnic populations aims to offer insights into the information's clinical relevance. METHODS: A literature review followed by panel discussions and an online review process aimed to answer the questions: Are there racial/ethnic differences in the SC barrier structure and healthy skin barrier function? Is there a need for specific cleansers and moisturizers? RESULTS: Ethnic categories based on race and ethnicity are often not well defined and inconsistent across different studies. Studies comparing ethnic groups' physical and biochemical skin barrier properties have reported differences in transepidermal water loss (TEWL), skin lipid levels, pH, and mast cell granule size. However, these studies frequently had methodological flaws, mainly were small, and demonstrated conflicting results. The literature suggests racial/ethnic variations in ceramide content, SC structure, and filaggrin mutations. Furthermore, studies have shown a greater burden of pruritus and atopic dermatitis among Black populations. Data on barrier properties in Hispanic/LatinX and South Asian populations are lacking. CONCLUSION: Robust comparative studies are needed to understand these basic concepts to help tailor skincare and skin of color patients' education. J Drugs Dermatol. 2021;20(9):932-938. doi:10.36849/JDD.6312.

Racial/Ethnic Variations in Acne: Implications for Treatment and Skin Care Recommendations for Acne Patients With Skin of Color.

BACKGROUND: Acne vulgaris is among the most common dermatologic diagnoses observed, including skin color (SOC) populations. This project sought to help clarify the existing published data and provide consensus statements on acne presentation, prevention, treatment, and maintenance in SOC populations to help improve patient outcomes. METHODS: Six SOC dermatologists convened for a virtual meeting and used a modified Delphi process to address: 1) Are there racial/ethnic differences in the clinical presentation and sequela of acne? 2) Are there racial/ethnic differences in the therapeutic endpoint of acne treatment and patient expectations? 3) Is there a need for specialized approaches to therapeutic options and skincare in acne patients with SOC? The results of a literature review and the outcome of discussions, coupled with the panel's expert opinion and experience, are intended for health care providers caring for acne patients and clinician-researchers. RESULTS: Racial/ethnic differences in the clinical presentation, sequelae, and desired treatment outcomes for acne have been reported. Notwithstanding limitations in the number, size, and methodologies of studies to date, the available data suggest that strategies that improve outcomes in acne patients with SOC include: Early initiation and maintenance of treatment regimens and careful consideration of tolerability of active ingredients, vehicles, and dosing. Using pH-balanced, non-irritating cleansers and non-comedogenic ceramides containing moisturizers help minimize irritation or dryness. CONCLUSIONS: There a need for specialized approaches to therapeutic options and skincare in acne patients with SOC. OTC skincare products are recommended before and during prescription therapy and as part of a maintenance regimen. J Drugs Dermatol. 2021;20(7):716-725. doi:10.36849/JDD.6169 THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE SCROLL DOWN TO ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.

Evaluation and management of the patient with multiple syringomas: A systematic review of the literature.

Syringomas are benign adnexal tumors with distinct histopathologic features, including the characteristic comma ("tadpole") shaped tail comprised of dilated, cystic eccrine ducts. Clinically, syringomas typically present in adolescent females predominantly in the periorbital region. They may present as solitary or multiple lesions, and more rare sites of involvement include the genitals, palms, scalp, and the chest. Over the past 50 years, there have been >800 reported cases of syringoma either alone or in conjunction with a systemic syndrome, most commonly Down syndrome. The primary aim of this systematic review is to discuss the clinical features and associations of syringomas with a focus on the patient with multiple syringomas. Its secondary aims are to explore pathophysiology with a focus on multiple syringomas and provide comprehensive data on both traditional and novel treatments. Importantly, multiple syringomas present across a broad clinical spectrum. Though noted in many textbooks to be related to tumor syndromes, the association of syringomas with inherited tumor syndromes is only rarely reported in the literature. Despite multiple reported cases of syringoma, the pathophysiology remains poorly understood and treatment continues to pose a significant challenge.

Voriconazole-associated cutaneous malignancy: a literature review on photocarcinogenesis in organ transplant recipients.

This article synthesizes the current data regarding the implication of voriconazole in the development of skin cancer in organ transplant recipients (OTRs) and offers suggestions for additional research. According to Organ Procurement and Transplantation Network data, 28 051 solid organ transplants were performed in 2012. Due to advancements in immunosuppression and management of infectious diseases, survival of OTRs has substantially increased. Voriconazole is a widely prescribed antifungal medication used for prophylaxis and for treatment of invasive fungal infections in OTRs. Case reports describing skin cancer associated with voriconazole exposure emerged shortly after US Food and Drug Administration approval of the drug, and it is now established that voriconazole is an independent risk factor for the development of cutaneous malignancy in lung transplant recipients. The mechanism of voriconazole-induced skin cancer is still unknown and may involve its primary metabolite, voriconazole N-oxide. Here we discuss the current data and potential mechanisms of voriconazole-associated photosensitivity and carcinogenesis and identify areas that require further research.