Subcutaneous metastasis from an atypical pulmonary carcinoid tumor.

Pulmonary carcinoid tumors are uncommon neuroendocrine tumors that rarely metastasize to the skin. We report the case of a 71-year-old woman with a longstanding history of primary atypical pulmonary carcinoid tumor who presented with a new tender cutaneous nodule. Immunostaining of the nodule was consistent with metastatic atypical carcinoid tumor of the skin including positive staining for neuroendocrine markers chromogranin and synaptophysin. Dermatologists should consider cutaneous neuroendocrine metastasis when evaluating new nodules in patients with stable pulmonary carcinoid tumors or in those with concomitant concerning respiratory symptoms.

Effectiveness of an Educational Intervention to Improve Medical Student Comfort and Familiarity With Providing Gender-Affirming Hormone Therapy.

BACKGROUND AND OBJECTIVES: Gender-affirming hormone therapy (GAHT) is a key component in the primary care of transgender and gender-nonconforming (TGNC) people. However, physicians are hesitant to initiate GAHT, citing a lack of knowledge. We developed an educational program for medical students and sought to investigate whether medical students' comfort and familiarity with GAHT could increase after a short interactive program. METHODS: Second-year medical students (N=54) at the University of Minnesota were recruited to attend an hour long interactive lecture on GAHT. We calculated mean change in pre- and postintervention 5-point Likert scale scores from a survey assessing comfort and familiarity with key concepts of GAHT to assess the effectiveness of the intervention. RESULTS: Mean response score change increased significantly after the intervention around the use of chosen names (0.4±0.13, P<.017), the use of informed consent to initiate GAHT (1.8±0.20, P<.001), initiating and managing GAHT in the primary care setting (1.4±0.19, P<.001), medications used in GAHT (2.3±0.21, P<.001), and dosing (2.5±0.60, P<.001). CONCLUSIONS: GAHT can be initiated and managed in a primary care setting. There is a push to introduce GAHT in the preclinical years. After participating in a short interactive lecture on GAHT, second-year medical students reported increased comfort and familiarity with GAHT. Inclusion of GAHT in the preclinical curriculum does not require significant teaching time and is important knowledge for all future physicians.

Energy-based Devices for Hair Loss.

Treatment options for hair loss have traditionally been limited to topical and systemic therapies. Systemic therapies for inflammatory hair disorders are often immunosuppressive, and systemic treatment of androgenetic hair loss can cause undesired effects on sexual and reproductive health. Topical agents have a favorable side effect profile compared with systemic therapies, but many topicals have poor transcutaneous absorption, limiting their concentration and action at follicular targets in the dermis.