Allergic Contact Dermatitis Associated With Religious Practices: Review of the Literature.

Allergic contact dermatitis (ACD) may occur secondary to devotional practices in various religions. A systematic review of PubMed was conducted from inception of database to September 9, 2022. Key terms were "contact dermatitis" or "devotional dermatosis" in association with major world religions including "Christianity," "Islam," "Hinduism," "Buddhism," "Sikhism," and "Judaism." Inclusion criteria were determined by presence of a religious practice and associated ACD. Articles referencing other cutaneous reactions such as chemical leukoderma were excluded. In total, 36 of 102 unique articles identified met inclusion criteria. Twenty-two articles referenced Hinduism, 8 referenced Judaism, 5 referenced Islam, 3 referenced Christianity, and 1 article each mentioned Buddhism and Sikhism. Four articles referenced multiple religions. Para-phenylenediamine was the most common contact allergen overall and is found in blackening ingredients mixed with henna for temporary tattoos. Henna tattooing is a cultural practice associated with Hinduism, Islam, and Judaism. Nine unique contact allergens associated with religious practices were identified. Increasing awareness of religious practices that cause ACD will facilitate culturally competent dermatological care.

Characteristics of medical professional liability claims against dermatologists: data from 2704 closed claims in a voluntary registry.

BACKGROUND: The Physician Insurers Association of America established a voluntary registry in 1985 that contains 239,756 closed claims. The registry is maintained for educational programs to reduce patient injury and medical professional liability (MPL) claims. OBJECTIVE: This report provides a description of MPL claims against dermatologists. METHODS: Descriptive techniques are used to present summary information for the dermatologic claims in the registry. RESULTS: Of 239,756 closed claims, 2704 (1.1%) involve dermatologists. Of the 2704 closed claims, 775 (28.7%) resulted in an average indemnity payment of $137,538. The most common allegation was improper procedure performance. The most prevalent procedure was operative procedures on the skin. Error in diagnosis was the next most common allegation. The most common diagnosis was malignant melanoma. Malignant melanoma claims were paid in 42.2% of cases with an average indemnity payment of $436,843. LIMITATIONS: The data are subject to selection and reporting biases. In addition, the registry does not contain exposure data, so incidences and prevalences are not calculable. CONCLUSIONS: MPL issues are important to all practicing dermatologists. The most common allegation against dermatologists in this study was improper performance of operative procedures on the skin, excluding skin grafts. Error in diagnosis of malignant melanoma was the next most common allegation. Malignant melanoma claims were paid in 42.2% of cases with an average indemnity payment of $436,843. By focusing on the risk management of these procedures and this diagnosis, dermatologists can have the largest impact on reducing patient injuries and consequent MPL claims.

Assessing the role of race in quantitative measures of skin pigmentation and clinical assessments of photosensitivity.

BACKGROUND: Given the increasing demographic diversity in the United States, clarifying relationships between race, color, ethnicity, and disease processes is critical. OBJECTIVES: We sought to examine the correlation between objective measures of skin pigmentation, racial identification, and physician-diagnosed and self-reported skin phototypes. METHODS: A total of 558 participants (76 nonwhite) were evaluated. A subset underwent spectrometric readings and digital photography of the upper aspect of the inner arm. Self-identified race was compared with 7 measures of pigmentation. RESULTS: Race correlates best with physician-diagnosed skin phototype (r = 0.55, P < .01), whereas self-reported skin phototype, spectrometry, and colorimetry correlate poorly with race (r = 0.28, < 0.40, and r > -0.31, respectively, P < .01). Associations between race and subjective measures strengthen among patients with darker skin. CONCLUSION: Objective measures of pigmentation fail to correlate well with race, whereas race correlates moderately with physician-diagnosed skin phototype. Including objective methods of analyzing skin color may reduce subjective influences of race in assessing photosensitivity and potential risk for skin cancer.

The changing face of cutaneous biology as seen from the National Institutes of Health.

Over the past 50 y, research in skin biology and diseases has changed dramatically. These changes include (i) who is doing the research, from M.D. clinician dermatologists to predominantly Ph.D. research scientists and full-time or nearly full-time M.D. and M.D.-Ph.D. scientists, (ii) where, from small laboratories in the U.S.A. to large laboratories and multiinvestigator collaborations worldwide, (iii) what, from a focus on common skin diseases to an emphasis on understanding basic processes in skin, both in normal and disease states, and (iv) how, from patient observations, histology, and clinical immunology to cell and tissue culture, molecular biology and genetics, genomics and proteomics. Financing of this research has also changed, from the use of clinical surplus funds supplemented by U.S. government (National Institutes of Health, Veterans Administration, and other) monies to a greater dependence on government and private (pharmaceutical industry and philanthropy) funding. The future, funding issues aside, promises great advances with translation of basic knowledge to the diagnosis, prevention, and treatment of skin diseases.