Nevus sebaceus is a congenital hamartoma that may undergo secondary neoplastic changes, most commonly benign adnexal tumors. Malignant transformation is rare, and the simultaneous occurrence of multiple neoplastic entities is exceedingly uncommon. We report a rare case of a 49-year-old man with a nevus sebaceus of the scalp harboring basal cell carcinoma, squamous cell carcinoma, and an adjacent apocrine adenoma, representing a rare triphasic transformation.

Skin cancer is the most common cancer globally, and the incidence and prevalence of both melanoma and non-melanoma skin cancers has been increasing in recent decades, representing a rising number of disability-adjusted life years. This narrative review explores the interplay between climate change and the development of skin cancer, highlighting potential mechanistic links including increased UV radiation, tumorigenic effects of air pollutants such as phthalates and polycylic aromatic hydrocarbons stemming from anthropogenic practices, and sociobehavioral changes related to increasing ambient temperatures. International efforts to mitigate ozone layer depletion, greenhouse gas emissions, and rising temperatures are summarized to explore the current state of global collaboration and success regarding climate protective policies. Timely strategies for dermatologists to engage in climate advocacy are compiled and discussed, including community- and practice-level actions, organizational involvement, and opportunities for improving personal and office sustainability. This review highlights the influence of climate change on cutaneous carcinogenesis given the observed annual increases in skin cancer incidence and the well-established link between UV radiation and skin cancer while presenting practical, easily adoptable strategies for dermatologists to reduce their carbon footprints and become climate advocacy leaders.

Denisse Cristina Porras Fimbres, BS; Alyssa P Quinn, BS; Benjamin R Cooper, BS; Colby L Presley, DO; Jennifer Jacobs, BS; Chandler W Rundle, MD; Robert P Dellavalle, MD, PhD, MSPH 1School of Medicine, Duke University, Durham, NC, United States 2College of Osteopathic Medicine, Rocky Vista University, Parker, CO, United States 3Division of Dermatology, Lehigh Valley Health Network, Allentown, PA, United States 4Department of Dermatology, Duke University Hospital, Durham, NC, United States 5Dermatology Service, US Department of Veterans Affairs Rocky Mountain Regional Medical Center, Aurora, CO, United States

Nirmatrelvir-ritonivir (Paxlovid) recently received emergency use authorization for the treatment of coronavirus disease 2019 (COVID-19). Literature has linked numerous cutaneous adverse effects to nirmatrelvir and ritonavir, the copackaged tablets within Paxlovid. A review and comparison of these adverse effects to the common cutaneous manifestations of COVID-19 is provided. Numerous drug-to-drug interactions exist between nirmatrelvir-ritonivir and commonly-used medications within dermatology.

UNSTRUCTURED Not applicable to JMIR Derm Research Letter format

Thousands of medical students apply for residency each year in the United States (US). The majority have graduated medical school and received a degree from a US based allopathic program (US MD), a US based osteopathic program (US DO), or are international medical graduates (IMG MD). The underrepresentation of US DO and IMG MD residents, compared with US MD residents, within the field of dermatology has been well documented in the literature. Numerous calls to action have both highlighted this disparity and advocated for an increase in representation of US DO and IMG MD residents within dermatology. To assess recent trends, we provide a ten year analysis of medical training background data of dermatology residents, compared to total Graduate Medical Education (GME) residents. For the academic years of 2011-2021, the total number of GME and dermatology residents were recorded. The residents' background medical training was determined through analysis of the Accreditation Council for Graduate Medical Education (ACGME) Data Resource Book. Our results demonstrate that from 2011-2021, 90.41% of dermatology residents were US MD, 6.16% US DO, and 3.41% IMG MD compared to 63.16% US MD, 11.94% US DO, and 24.84% IMG MD GME residents overall. Improvements have been made from 2011-2021, as the representation of US DO and IMG MD residents in dermatology increased from 2.0% to 10.7% for US DO's and from 3.0% to 3.5% for IMG MD's. While the percentage of US DO and IMG MD residents within dermatology has been increasing, attention should be directed towards making the representation of these two groups in dermatology similar to what is seen in other specialties. Future studies and endeavors should attempt to increase the representation of US DO and IMG MD physicians within the field of dermatology.

Recent efforts have been made to increase diversity in healthcare within the United States (US). Among physician specialties, dermatology was identified as one of the least ethnically diverse among residents and practicing dermatologists. Numerous calls of actions to increase diversity among dermatologists have been published in the literature. To evaluate recent trends and the current state of ethnic diversity within dermatology, this study provides a ten-year analysis of ethnicity data from dermatology residents, compared to total graduate medical education (GME) residents. For the academic years of 2011-2021, the total number of GME and dermatology residents were recorded, as well as the residents' self-reported ethnicity data. Data was obtained through analysis of the Accreditation Council for Graduate Medical Education (ACGME) Data Resource Book. Ethnic groups were defined as White, Asian or Pacific Islander, Hispanic, Black, and Native American or Alaskan. Our results showed that from 2011-2021, 56.38% of dermatology residents were white, compared to 44.17% of GME residents overall. The representation of all other individual ethnicities was lower among dermatology residents when compared to GME residents. The gap between minority ethnicities in dermatology and other medical specialties continues to persist, with little improvement over the last ten years. Our study shows only a 1.4% improvement of the gap between ethnic minority dermatology residents and ethnic minority GME residents. Diversity among physicians has been shown to improve health outcomes, particularly for ethnic minority patients. Future studies and efforts should be directed towards increasing ethnic minority representation within the dermatology physician workforce.

We explore the utility of social media platforms as educational tools in dermatology, providing a summary of how these sites are used by the public and dermatologists alike, and demonstrating ways these findings may be applied for educational purposes. Over half of the world’s population utilizes social media platforms. More recently, these platforms have increasingly been used for educational purposes. In the field of dermatology, a large portion of the educational content is coming from users with no formal medical or dermatologic training. Each of the top five social media platforms in the world (Twitter, Instagram, TikTok, YouTube, and Facebook) has unique qualities which people may utilize to educate fellow users. As more of the population seeks online health information and education, it is important that dermatologists, while taking ethical considerations into account, become more comfortable facilitating educational content on social media.