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.

Analyzing disparities in access to teledermatology compared with dermatology clinic visits before, during, and after COVID-19 quarantine.

The COVID-19 pandemic has caused significant changes in dermatologic care, likely exacerbating health disparities for specific minority populations. The use of teledermatology has also become more prevalent during this period. The aim of this study was to determine if the proportion of teledermatology versus office-based visits varied significantly during three study periods of the COVID-19 pandemic. The secondary objective was to determine whether there are significant differences in the use of office-based dermatology versus teledermatology care across the following demographic subgroups: insurance type, race/ethnicity, age, and language during the same periods. A chart review of dermatology visits in electronic medical records at a tertiary referral center in Washington, DC, was conducted. The overall telehealth visit rate was 0% in the prequarantine period, 61.12% during the quarantine period, and 10.59% in the postquarantine period. After assessing telehealth utilization rates among the demographic subgroups, we noted that Medicaid users, Black patients, 64-year-olds or older, and English speakers may benefit the least from telehealth services. Teledermatology use necessitated by the COVID-19 pandemic may have promoted health care disparities for specific marginalized populations.

Assessing the potential for bias in direct observation of adult commuter cycling and helmet use.

OBJECTIVES: Bicycling and helmet surveillance, research, and programme evaluation depend on accurate measurement by direct observation, but it is unclear whether weather and other exogenous factors introduce bias into observed counts of cyclists and helmet use. METHODS: To address this issue, a time series was created of cyclists observed at two observation points in Washington, DC, at peak commuting times and locations between September 2012 and February 2013. Using multiple linear regression with Newey-West SEs to account for possible serial correlation, the association between various factors and cyclist counts and helmet use was investigated. RESULTS: The number of cyclists observed per 1 h session was significantly associated with predicted daily high temperature, chance of rain, and actual rain. Additionally, fewer cyclists were observed on Fridays. Helmet use was significantly lower during evening commutes than morning and also lower on Fridays. Helmet use was not associated with weather variables. Controlling for observable cyclists characteristics weakened the association between helmet use and the time of day and day of the week, but it did not eliminate that association. CONCLUSIONS: Direct observation to measure commuter cycling trends or evaluate interventions should control for weather and day of week. Measurement of helmet use is unlikely to be meaningfully biased by weather factors, but time of day and day of week should be taken into account. Failing to control for these factors could lead to significant bias in assessments of the level of, and trends in, commuter cycling and helmet use.