Pruritic, Annular Plaques With Pustules on a Middle-aged Man
A Japanese man in his 50s presented with a 6-month history of worsening pruritic hand dermatitis that progressed to involve his face, trunk, upper extremities, and feet. What is your diagnosis? (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 13, 2019 Category: Dermatology Source Type: research

Antibiotics for Acne —A Pilot Study of Collateral Damage to the Skin Microbiome
A decade has passed since modern sequencing methods were first used to investigate the microbial communities present on healthy human skin. These studies of the skin microbiome, a term that broadly encompasses the skin ’s resident microorganisms (bacteria, archaea, fungi, viruses) as well as their genomic content and metabolic byproducts, have illuminated the diversity of microorganisms inhabiting the skin surface and invigorated research aimed at understanding their contributions to human health and disease. At tention by the lay media highlighting these investigations has heightened public awareness and interest in...
Source: JAMA Dermatology - February 13, 2019 Category: Dermatology Source Type: research

Antimalarial Therapy in Patients Who Are Hydroxychloroquine Hypersensitive
This study evaluates the use of antimalarial therapy in patients who are hydroxychloroquine hypersensitive. (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 13, 2019 Category: Dermatology Source Type: research

Quality of Life Following Surgical Excision of Early-Stage Melanoma of the Head and Neck
To the Editor We read with great interest the recent article inJAMA Dermatology by Mori et al, in which patient quality of life following surgical excision of early-stage melanomas of the head and neck was assessed; we believe that their findings have important clinical implications. Of concern, however, was the misleading statement in the abstract that melanoma in situ (Tis) and T1a melanomas are “typically slowly progressive and nonfatal melanomas,”(p85) and the introductory sentence of the article itself which stated “Tis and T1a melanomas of the head and neck have an excellent prognosis, with a more t...
Source: JAMA Dermatology - February 13, 2019 Category: Dermatology Source Type: research

Extensive Pigment Incontinence Mimicking Persistent Melanoma After Talimogene Laherparepvec Therapy
This case report describes extensive pigment incontinence mimicking persistent melanoma after talimogene laherparepvec therapy. (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 13, 2019 Category: Dermatology Source Type: research

Quality of Life Following Surgical Excision of Early-Stage Melanoma of the Head and Neck —Reply
In Reply We thank Thompson et al for their commentary and agree that the statement on survival of melanoma in situ (Tis) and T1a melanoma needs clarification. While Tis melanoma is considered nonfatal, we acknowledge that T1a melanomas can have varied disease-specific survival rates, with reported 5-year survival ranging from 96.7% to 99%, and 10-year survival ranging from 94.2% to 98%. In the updatedAmerican Joint Committee on Cancer Staging Manual 8th edition for melanoma, for example, there is improved T1 survival compared with the 7th edition, likely owing to inclusion of sentinel lymph node biopsy status. The long-ter...
Source: JAMA Dermatology - February 13, 2019 Category: Dermatology Source Type: research

Association of Systemic Antibiotic Treatment of Acne With Skin Microbiota Characteristics
This pilot study of 4 patients assesses the composition, diversity, and resilience of skin microbiota following systemic antibiotic administration to individuals with facial acne. (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 13, 2019 Category: Dermatology Source Type: research

Nonmelanoma Skin Cancer Incidence by Treatment Modality in Recipients of Multiple Kidney Transplants
This study uses Irish national registry data to characterize variation in nonmelanoma skin cancer incidence by treatment modality among patients receiving multiple kidney transplants. (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 6, 2019 Category: Dermatology Source Type: research

Gender Equity in Clinical Dermatology
It is not news that medicine struggles to achieve gender equity, particularly in leadership, academics, and research. In an analysis of more than 90  000 academics in 2014, only 12% of women were full professors compared with 29% of men. Even when accounting for experience, productivity, specialty, and age, women were still statistically significantly less likely to be full professors. Women are so scarce in senior leadership positions that ch airs of academic departments are more likely to be men with mustaches than to be women. Women in medicine also report high levels of discrimination. Junior faculty women receive le...
Source: JAMA Dermatology - February 6, 2019 Category: Dermatology Source Type: research

Trends in Gender of Speakers at the American Academy of Dermatology Annual Meeting, 2010-2018
This retrospective review of American Academy of Dermatology Annual Meeting data for even years between 2010 and 2018 was performed to identify the number of female speakers and associated presentation times. (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 6, 2019 Category: Dermatology Source Type: research

Percentage of Women in the Dermatology Workforce Presenting at American Academy of Dermatology Annual Meetings
This study assesses the percentage of female speakers at American Academy of Dermatology conferences from 1992 through 2017 and compares it with the overall percentages of board-certified female dermatologists. (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 6, 2019 Category: Dermatology Source Type: research

Representation of Women Among Physician Authors of Perspectives in High-Impact Dermatology Journals
This cross-sectional, descriptive study analyzes the number of women among physician first authors of articles published in theJournal of the American Academy of DermatologyandJAMA Dermatology across a 5-year period. (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 6, 2019 Category: Dermatology Source Type: research

Mohs Appropriate Use Criteria for Superficial Basal Cell Carcinoma
To the Editor We read with interest the Viewpoint by Steinman and colleagues suggesting a reevaluation of appropriate use criteria for Mohs micrographic surgery (MMS) with respect to primary superficial basal cell carcinoma (sBCC). We must note that MMS is only 1 means of margin control of skin cancers, and perhaps the Viewpoint title would more accurately read “Reevaluation of Excisional Surgery for Primary Basal Cell Carcinoma.” (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 6, 2019 Category: Dermatology Source Type: research

Mohs Appropriate Use Criteria for Superficial Basal Cell Carcinoma
To the Editor I read with great interest the Viewpoint by Steinman and colleagues on treating superficial basal cell carcinoma (sBCC) with Mohs surgery. The authors rightly point to the paucity of evidence regarding sBCC management, though this limitation applies not just to sBCC but to most other nonmelanoma skin cancers as well. (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 6, 2019 Category: Dermatology Source Type: research

Mohs Appropriate Use Criteria for Primary Superficial Basal Cell Carcinoma
To the Editor Appropriate patient care relies on many factors, including data and judgment. Steinman and colleagues contend that the biological behavior of superficial basal cell carcinomas (sBCCs) should lead to their reclassification by the Mohs surgery appropriate use criteria (MAUC) as “uncertain” or “inappropriate” for Mohs surgery (MS). This type of discussion of hypotheses is essential to optimizing patient care. At its inception, the MAUC were intended to evolve as increasing empirical evidence became available. (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 6, 2019 Category: Dermatology Source Type: research

Mohs Appropriate Use Criteria for Superficial Basal Cell Carcinoma —Reply
In Reply We thank Drs Montuno and Coldiron, Kantor, and MacFarlane and Perlis for their comments on our Viewpoint. As our colleagues understand, the Mohs appropriate use criteria (MAUC) were created to limit use of Mohs surgery (MS) when simpler treatments would be more appropriate. Our Viewpoint was written with this in mind, reinforcing the importance of MS for more complex tumors, while emphasizing that primary superficial basal cell carcinoma (sBCC) can generally be treated more efficiently and less expensively with simple excision and curettage alone or combined with other modalities. (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 6, 2019 Category: Dermatology Source Type: research

Pityriasis Rubra Pilaris
This Patient Page describes pityriasis rubra pilaris (Source: JAMA Dermatology)
Source: JAMA Dermatology - February 6, 2019 Category: Dermatology Source Type: research

February 2019 Issue Highlights
(Source: JAMA Dermatology)
Source: JAMA Dermatology - February 1, 2019 Category: Dermatology Source Type: research

JAMA Dermatology
Mission Statement:JAMA Dermatology publishes information concerning the skin, its diseases, and their treatment. Its mission is to explicate the structure and function of the skin and its diseases and the art of using this information to deliver optimal medical and surgical care to the patient. We attempt to enhance the understanding of cutaneous pathophysiology and improve the clinician ’s ability to diagnose and treat skin disorders. This journal has a particular interest in publishing clinical and laboratory studies that reveal new information pertinent to the interests and needs of the medical dermatologist, derm...
Source: JAMA Dermatology - February 1, 2019 Category: Dermatology Source Type: research

Association Between Hidradenitis Suppurativa and Lymphoma
This cohort analysis evaluates the risk of lymphoma in adult patients with hydradenitis suppurativa in the United States. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 30, 2019 Category: Dermatology Source Type: research

Further Consideration of the Pigmented Lesion Assay
To the Editor We read with interest the article by Hornberger and Siegel, which suggested that the pigmented lesion assay (PLA) may reduce costs and improve the care of patients with skin lesions suspicious for melanoma. The noninvasive sampling of RNA is a promising approach for the diagnosis of melanoma, especially considering the intrinsic limitations of visual inspection and the cost and morbidity of histologic evaluation. It is important that we continue to develop and test instruments, such as the PLA, that have potential to decrease unnecessary biopsies of benign pigmented skin lesions. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 30, 2019 Category: Dermatology Source Type: research

Decreased Anti-DSG3, Not Anti-DSG1 Antibody, After Cessation of Sitagliptin Treatment for Pemphigus Vulgaris
This case report describes the occurrence of a decrease of anti-DSG3, but not anti-DSG1, after cessation of sitagliptin treatment in a patient with pemphigus vulgaris. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 30, 2019 Category: Dermatology Source Type: research

Further Consideration of the Pigmented Lesion Assay —Reply
In Reply We appreciate the comments by Beatson and Weinstock on our analysis of the pigmented lesion assay (PLA). We agree that it is important to develop tools that have the potential to help decrease biopsies of benign pigmented skin lesions such as the PLA, a gene expression melanoma rule-out test based on obtaining skin samples noninvasively via adhesive patches. We believe that it is important to view the PLA ’s performance relative to the performance of histopathologic diagnosis. In a large and recent study based on data from 10 US states, the sensitivity of standard histopathologic assessment in comparable in ...
Source: JAMA Dermatology - January 30, 2019 Category: Dermatology Source Type: research

Methotrexate for Chinese Adults With Psoriasis With and Without Psoriatic Arthritis
This cohort study compares the effectiveness and adverse effects of methotrexate in Chinese patients with psoriasis with and without psoriatic arthritis. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 30, 2019 Category: Dermatology Source Type: research

Narrowband UV-B vs Psoralen –UV-A for Early-Stage Mycosis Fungoides
This systematic review and meta-analysis compares response and adverse effects of psoralen –UV-A with narrowband UV-B phototherapy in patients with early-stage mycosis fungoides. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 30, 2019 Category: Dermatology Source Type: research

Prevalence and Disclosure of Conflicts of Interest in Dermatology Patient Advocacy Organizations
This cross-sectional study uses the Kaiser Health News database to examine the current state of industry-related conflicts of interest and disclosure practices among patient advocacy organizations with dermatology. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 30, 2019 Category: Dermatology Source Type: research

Assessment of Clinical Response to JAK Inhibition in Patients With Familial Chilblain Lupus and TREX1 Mutation
This case series evaluates the clinical response to the Janus kinase inhibitor baricitinib in 3 individuals with familial chilblain lupus and assesses the effect of cold on fibroblasts. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 23, 2019 Category: Dermatology Source Type: research

Arthropathy and Cutaneous Eruption in a Patient With Cystic Fibrosis
A girl with cystic fibrosis presented with a 2-year history of a relapsing-remitting, evanescent, salmon-pink maculopapular cutaneous eruption that was associated with joint pain. What is your diagnosis? (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 23, 2019 Category: Dermatology Source Type: research

Targeted Treatment of TREX1 Chilblain Lupus and Other Interferonopathies
Targeted, or pathogenesis-based, therapies are revolutionizing medicine. For the past decade and a half, as science has honed in on the primary events in psoriasis pathogenesis, treatment has evolved from that of a hammer to that of a laser. The discovery that helper T-cell subtype 17 (TH17) immunity (and related cytokines interleukin-17 [IL-17] and IL-23) plays a central role in psoriasis pathogenesis has led to the development of effective treatments with agents targeting IL-17 and IL-23 (eg, secukinumab and guselkumab, respectively). More recently our understanding of atopic dermatitis pathogenesis has advanced and we n...
Source: JAMA Dermatology - January 23, 2019 Category: Dermatology Source Type: research

Systemic Treatment for Clinically Amyopathic Dermatomyositis at 4 Tertiary Care Centers
This study investigates the use of systemic treatment for clinically amyopathic dermatomyositis using natural language queries andICD codes for amyopathic and hypomyopathic dermatomyositis. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 23, 2019 Category: Dermatology Source Type: research

Flexural Eruption Associated With Arsenic Trioxide Treatment of Acute Promyelocytic Leukemia
This case report describes a patient with acute promyelocytic leukemia who developed a flexural eruption associated with arsenic trioxide therapy. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 23, 2019 Category: Dermatology Source Type: research

Association of HLA Antigen Mismatch With Risk of Posttransplant Skin Cancer
This secondary analysis of a large cohort study analyzes the HLA antigen mismatches and molecular mechanisms that affect the incidence of posttransplant skin cancer among solid-organ transplant recipients. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 23, 2019 Category: Dermatology Source Type: research

Evaluation of Compendia for Part D Coverage Determinations in Dermatology
This cross-sectional study examines the 2 clinical compendia used for Medicare part D to evaluate the inclusion of evidence-based off-label uses of treatments for dermatologic diseases. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 23, 2019 Category: Dermatology Source Type: research

Assessment of the Association Between Major Depressive Disorder and Alopecia Areata
This cohort study of over 6 million patients uses data from The Health Improvement Network in the United Kingdom to assess the bidirectional association between major depressive disorder and alopecia areata. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 16, 2019 Category: Dermatology Source Type: research

Flexural Hyperpigmentation With Reticulation in an Adolescent Girl
An adolescent girl with polycystic ovarian syndrome presented with hyperpigmented skin lesions on her neck, upper limbs, and trunk, which had begun 6 months previously as recurrent pruritic erythematous papules that subsided leaving brownish-bluish black hyperpigmentation. What is your diagnosis? (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 16, 2019 Category: Dermatology Source Type: research

Updating Dermatologists ’ Prescribing Habits for Antibiotics
(Source: JAMA Dermatology)
Source: JAMA Dermatology - January 16, 2019 Category: Dermatology Source Type: research

Systemic Amyloidosis
This case report describes a patient with systemic amyloidosis. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 16, 2019 Category: Dermatology Source Type: research

Sex and Ethnic Diversity of US Medical Students and Their Exposure to Dermatology Programs
This study characterizes sex and racial/ethnic discrepancies in exposure to dermatology among US medical students. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 16, 2019 Category: Dermatology Source Type: research

A Case of Pansclerotic Morphea Treated With Tocilizumab
This case report describes a patient with pansclerotic morphea treated with tocilizumab. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 16, 2019 Category: Dermatology Source Type: research

Trends in Oral Antibiotic Prescription in Dermatology, 2008 to 2016
This repeated cross-sectional analysis of antibiotic prescribing by dermatologists characterizes the use of antibiotics in dermatology, including changes over time, from 2008 to 2016. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 16, 2019 Category: Dermatology Source Type: research

Cutaneous Suture Spacing During Linear Wound Closures and the Effect on Wound Cosmesis
This randomized clinical trial uses a split-wound/split-scar model to compare the outcomes and wound cosmesis achieved with running cutaneous sutures spaced 2 vs 5 mm apart. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 16, 2019 Category: Dermatology Source Type: research

Evaluation of Unresectable Primary Cutaneous Melanoma Response to Immunotherapy Using Reflectance Confocal Microscopy
This case report study describes 2 patients with locally advanced primary melanomas and the use of reflectance confocal microscopy for imaging of cutaneous involvement and disease monitoring. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 9, 2019 Category: Dermatology Source Type: research

Diagnostic Criteria and Phenotypes of Pemphigoid and the Association With Gliptins
In this issue, there are 2 excellent large retrospective studies from single centers in Groningen, The Netherlands, and Haifa, Israel of patients referred for possible bullous pemphigoid (BP). In addition, there is a nationwide population-based study from Korea evaluating the risk of BP in patients with diabetes receiving dipeptidyl peptidase 4 inhibitors (gliptins). (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 9, 2019 Category: Dermatology Source Type: research

Supplementing Resident Education in Vasculitis and Autoimmune Connective Tissue Disease
This prospective study examines the influence of an online curriculum in residents ’ knowledge of cutaneous manifestations of vasculitis and autoimmune connective tissue diseases. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 9, 2019 Category: Dermatology Source Type: research

Understanding Perceived Barriers of Minority Medical Students Pursuing a Career in Dermatology
This survey study evaluates the perceived barriers of minority medical students pursuing a career in dermatology. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 9, 2019 Category: Dermatology Source Type: research

Endemic Human Cutaneous Leishmaniasis Incidence in the United States
To the Editor The recently published article by McIlwee and colleagues provides valuable insight into a protozoal disease the transmission of which within the United States (predominantly Texas) has been largely underrecognized by the US medical community. We would like to commend the authors for publishing this work and briefly expand on some topics presented that we believe warrant clarification and further discussion. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 9, 2019 Category: Dermatology Source Type: research

Endemic Human Cutaneous Leishmaniasis Incidence in the United States —Reply
In Reply We appreciate the comments of Mr Kipp and Dr Hergert and thank them for their observations regarding our study. Specifically, when discussing endemic human cutaneous leishmaniasis in the United States, we concur with the importance of making a distinction between anthropophagic and non-anthropophagic sand flies. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 9, 2019 Category: Dermatology Source Type: research

Assessment of Diagnostic Strategy for Pemphigoid
This study analyzes the direct immunofluorescence and serologic data from 1125 consecutive patients for diagnosing pemphigoid, a cutaneous autoimmune disease that primarily affects older people. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 9, 2019 Category: Dermatology Source Type: research

Bullous Pemphigoid and Dipeptidyl Peptidase-4 Inhibitors in Patients With Diabetes
This case-control study examines the association between the use of dipeptidyl peptidase 4 inhibitors and the risk of developing bullous pemphigoid in patients with diabetes. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 9, 2019 Category: Dermatology Source Type: research

Assessment of the Prevalence of Mucosal Involvement in Bullous Pemphigoid
This cohort study examines the prevalence and distribution of mucosal involvement among patients with bullous pemphigoid. (Source: JAMA Dermatology)
Source: JAMA Dermatology - January 9, 2019 Category: Dermatology Source Type: research