BACKGROUND:Keloids are common in genetically predisposed individuals and in darker skin types, and treatment is especially challenging; the most commonly used therapeutic options return inconsistent results and often result in recurrence. Despite their prevalence and therapeutic challenges, keloids remain understudied and are often conflated with hypertrophic scars in the literature, though these conditions likely have distinct biomechanical etiologies. There remains a need for better optimization and comparison of existing treatment modalities to more effectively manage keloidal scarring. METHODS:Thirteen patients with two similar keloids or one large keloid completed four treatments of a fractionally ablative erbium YAG laser, followed by application of either triamcinolone 10 mg/mL solution to one keloid or one half of the keloid or 5-fluorouracil solution 50 mg/mL solution to the second keloid or the other half of the keloid. Photos and measurements of the keloids were taken at each visit. The Patient and Observer Scar Assessment Scale (POSAS) score was recorded by the participants and the blinded physician observer at each visit. Blinded dermatologist observers completed the Hamilton score based on the scar photographs. RESULTS:The overall POSAS scores improved after four treatments compared to the pre-treatment POSAS scores within both the TAC and 5-FU treatment arms. There was, however, no statistically significant difference in the change from the first to the final POSAS score between the arms (p = 0.53). There was also no statistically significant difference in the Hamilton Score at the final visit between the two arms (p = 0.30). Scar volume and surface area decreased in both arms. The 5-FU arm had a mean volumetric change from baseline of -368.7 cm3, and the TAC arm had a mean volumetric change from baseline of -310.7 cm3; there was not a statistically significant difference between the two (p = 0.06). The 5-FU arm had a mean surface area change from baseline of -38.3 cm2, and the TAC arm had a mean surface area change from baseline of -20.8 cm2; there was not a statistically significant difference between the two (p = 0.56). Ten out of 13 patients were Fitzpatrick skin types IV-VI. There were no serious adverse events reported. CONCLUSION:In this pilot study of keloid patients, POSAS scores significantly improved after both laser-assisted TAC delivery and laser-assisted 5-FU delivery, with no statistically significant difference between the two treatment arms. However, there was a noted discrepancy in patient reports of post-procedural hyperpigmentation, with more patients experiencing this adverse effect within the 5-FU arm than in the TAC arm. While fractionally ablative laser-assisted drug delivery with either 5-FU or TAC is a safe and effective method to treat keloids, special attention should be paid to hyperpigmentation as a possible adverse effect in patients with darker skin tones, who are disproportionately affected by both keloids and hyperpigmentation.

BACKGROUND:Human papilloma virus (HPV) is a prevalent sexually transmitted infection (STI) associated with malignancies and condyloma acuminata, with significant health care costs. Despite vaccine availability, vaccination rates remain low, highlighting the need for effective interventions to increase uptake. OBJECTIVE:To improve HPV vaccination rates among eligible individuals at a safety-net dermatology STI clinic. METHODS:A multiphase quality improvement program aimed to improve HPV education and vaccination rates was implemented in a dermatology STI clinic. The cohort included 175 patients with condyloma acuminata between August 2019 and December 2022. HPV vaccine education and immunization rates were measured. RESULTS:While counseling/education rates were high, vaccination initiation rates remained low before the onset of in-office HPV vaccine. In-office HPV vaccine administration demonstrated a 175% increase in vaccine initiation (P < .01). LIMITATIONS:This study had a relatively small sample size and was conducted in an urban, safety-net hospital; results may not be generalizable to smaller or rural practices. CONCLUSION:This quality improvement initiative successfully increased HPV vaccination rates at a safety-net dermatology STI clinic, demonstrating that in-office, same day vaccination for HPV was critical for the success. Our study highlights an effective approach toward improving vaccination rates for HPV and is a model for vaccine delivery.

To the Editor: Keratinocyte carcinoma (KC) is one of the most prevalent conditions among the Veterans Health Administration population.1Mansouri B. Bicknell L.M. Hill D. Walker G.D. Fiala K. Housewright C. Mohs micrographic surgery for the Management of Cutaneous Malignancies.Facial Plast Surg Clin North Am. 2017; 25: 291-301Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar Although Mohs micrographic surgery (MMS) is the standard-of-care for treating certain KCs, it has not been uniformly accessible to veterans.2Siegel D. Joo J.S. Cortez R.A. Furlong T.A. Isseroff R.R. Access to Mohs micrographic surgery through the veterans choice program of the United States Department of Veterans Affairs.J Am Acad Dermatol. 2020; 83: 949-950Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar Standard excision has been utilized for more timely treatment of KCs when MMS is not easily accessible. Prior studies have shown that standard excision can lead to higher rates of re-excision and recurrence due to inadequate margin control.3Johnson T.M. Smith N.R. Mohs surgery versus standard local excision for basal cell carcinoma, squamous cell carcinoma, and melanoma skin cancer.Facial Plast Surg. 2020; 36: 133-140Crossref PubMed Scopus (4) Google Scholar We aim to demonstrate how the implementation of on-site MMS at the VA New York Manhattan Harbor Healthcare System (VA) eliminated re-excision and re-repair of Mohs-appropriate KCs and decreased time to treatment. A retrospective and prospective cohort study was conducted at a single VA medical center for patients with Mohs-appropriate KCs that underwent MMS and standard excision from 2015 to 2022. Institutional Review Board (IRB) approval was obtained. Data extracted included demographics, tumor characteristics, treatment, and outcomes. The Wilcoxon rank sum test was used to compare tumor stages pre- and post-MMS. Linear regression was used to compare treatment times across years. Prior to the initiation of on-site MMS, patients with KCs that met Mohs Appropriate Use Criteria either underwent standard excision at the VA or were referred to a community Mohs micrographic surgeon. In the 3 years prior to the implementation of on-site MMS, 264 tumors underwent standard excision at the VA. Tumors were comprised of basal cell carcinomas (46.2%) and squamous cell carcinomas (53.8%). Re-excision and re-repair due to positive margins occurred in 8.3% of standard excision cases. Following initiation of on-site MMS, MMS was performed on 423 keratinocytic carcinomas in a weekly dermatologic surgery clinic at the VA from 2017 to 2022 (Tables I and II) (basal cell carcinomas: 44.2%; squamous cell carcinomas: 55.8%). Re-excision and rerepair due to positive margins occurred in 0% of cases that underwent MMS. Therefore, on-site MMS at the VA resulted in a decrease in the burden of procedures for an already vulnerable population.Table IDemographic features and tumor characteristics of Mohs micrographic surgery casesVariablen (%)Age, mean y (range)83 (45-104)Sex Male421 (99.5) Female2 (0.5)Immunosuppression38 (9) Organ transplant1 (0.2) HIV10 (2.4) Hematologic malignancy12 (2.8) Medications15 (3.5)Antibiotic prophylaxis262 (61.9)Anticoagulation247 (58.3)Lesion area by Mohs AUC Area H206 (48.7) Area M180 (42.5) Area L37 (8.8)Mohs AUC Score 62 (0.5) 7129 (30.5) 8211 (49.9) 981 (19.2)AJCC8 Preop staging for SCC Tis64 (26.7) T1162 (67.5) T212 (5) T32 (0.8)BWH Preop staging for SCC T064 (26.7) T1160 (66.7) T2a15 (6.3) T2b1 (0.4)AUC, Appropriate Use Criteria; SCC, squamous cell carcinomas. Open table in a new tab Table IISurgery and outcome characteristics of Mohs micrographic surgery casesVariablen (%)Resident involvement423 (100)Stages of Mohs required 1227 (53.7) 2159 (37.6) 329 (6.9) 47 (1.7) 51 (0.2)AJCC 8 postop staging for SCC Tis62 (25.8) T1123 (51.3) T250 (20.8) T35 (2.1)BWH postop staging for SCC T064 (26.7) T1118 (49.2) T2a52 (21.7) T2b4 (1.7) T32 (0.8)Type of repair Flap (advancement, rotation, transposition, interpolation)79 (18.7) Second intent72 (17) Xenograft23 (5.4) Linear207 (48.9) Graft28 (6.5) Referral to a different specialty14 (3.3)Poor outcome Nodal metastasis1 (0.2) In-transit metastasis1 (0.2)AJCC, American Joint Committee on Cancer; BWH, Brigham and Women's Hospital; SCC, Squamous cell carcinomas. Open table in a new tab AUC, Appropriate Use Criteria; SCC, squamous cell carcinomas. AJCC, American Joint Committee on Cancer; BWH, Brigham and Women's Hospital; SCC, Squamous cell carcinomas. The implementation of MMS at the VA also decreased time to treatment, defined as the time interval from the date of the biopsy to the surgical removal of the malignancy. In the 6 months preceding on-site MMS, 20 Mohs appropriate KCs were referred to community surgeons, and the average time to treatment was 89.8 days. Comparatively, following the initiation of on-site MMS, 423 tumors underwent MMS at the VA, and the average time to treatment was 53 days. This resulted in a statistically significant decrease in treatment time by 36.8 days (P < .001). All procedures at the VA were supervised by a fellowship-trained Mohs surgeon. The rates of common MMS complications (bleeding: 2.1%; infection: 1.2%) remained similar to those reported in the literature.4Rutkowski D. Littlewood Z. Touyz S.J.J. et al.Prevalence of wound complications following Mohs micrographic surgery (MMS): a cross-sectional study of 1000 patients undergoing MMS and wound repair in a UK teaching hospital.Clin Exp Dermatol. 2022; 47: 1536-1542Crossref PubMed Scopus (3) Google Scholar In summary, the implementation of on-site MMS, even at a once weekly frequency, enhanced access to standard-of-care treatments for Mohs-appropriate KCs among veterans. On-site MMS eliminated the need for re-excision and re-repair as well as decreased time to treatment by 41%. There were low rates of complications, demonstrating enhanced quality of care for veterans, without compromising safety. None disclosed.

All types of alopecia, including androgenetic alopecia, alopecia areata, and lichen planopilaris/frontal fibrosing alopecia, affect over half of men and women. Though a common dermatological experience, many patients with visible hair loss report significant psychological and social distress and, consequently seek treatment. Current existing therapeutic regimens have proven to be efficacious, though may result in various adverse effects and require lifelong use. Laser and light-based therapies have been emerging in the current literature as a safe and alternative treatment, but their utilization for treating alopecia is poorly understood. This review evaluates the existing evidence regarding the use of lasers in the treatment of various forms of alopecia. Overall, there has been promising evidence for potential alopecia treatment efficacy: low-level light therapy for androgenetic alopecia, fractional laser for androgenetic alopecia, and excimer laser for alopecia areata.

The treatment of primary scarring alopecias is challenging and patients may be susceptible to koebnerization. This predisposes cicatricial alopecia patients to worsening of their disease following procedural treatments or interventions. Research and recommendations surrounding the risk for koebnerization within scarring alopecias is extremely limited. Using a comprehensive literature review, we summarized the risks of procedures in potentially koebnerizing alopecias. We evaluated the risk not only with procedural treatments, but also with common elective cosmetic procedures and potentially trauma-inducing hairstyling techniques. Although additional studies are needed to better elucidate the risks of procedural treatments within primary scarring alopecia, we believe this review of the current evidence and expert insight will benefit healthcare providers and patients alike to help guide treatments in this challenging patient population. J Drugs Dermatol. 2023;22(1):29-34. doi:10.36849/JDD.6849.

To the Editor: Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are forms of primary lymphocytic cicatricial alopecia characterized by inflammation and fibrosis of the follicular unit causing irreversible hair loss if untreated. 1 Sundberg J.P. Hordinsky M.K. Bergfeld W. et al. Cicatricial Alopecia Research Foundation meeting, May 2016: progress towards the diagnosis, treatment and cure of primary cicatricial alopecias. Exp Dermatol. 2018; 27: 302-310https://doi.org/10.1111/exd.13495 Crossref PubMed Scopus (20) Google Scholar Epidemiologic studies of LPP/FFA are lacking but it is thought that the incidence is increasing globally. 2 Tosti A. Bergfeld W.F. Christiano A.M. et al. Response from the American Hair Research Society to “sunscreen and frontal fibrosing alopecia: a review“. J Am Acad Dermatol. 2020; 82: 729-730https://doi.org/10.1016/j.jaad.2019.10.032 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar Men with LPP/FFA are increasingly reported in the literature, challenging the paradigm that LPP/FFA is a disease of postmenopausal women. 3 Doche I. Nico M.M.S. Gerlero P. et al. Clinical features and sex hormone profile in male patients with frontal fibrosing alopecia: a multicenter retrospective study with 33 patients. J Am Acad Dermatol. 2021; 86: 1176-1178https://doi.org/10.1016/j.jaad.2021.04.076 Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar ,4 Lobato-Berezo A. Iglesias-Sancho M. Rodríguez-Lomba E. et al. Frontal fibrosing alopecia in men: a multicenter study of 39 patients. J Am Acad Dermatol. 2021; 86: 481-484https://doi.org/10.1016/j.jaad.2021.09.033 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar This multicenter descriptive study is the first to characterize LPP/FFA among men in the United States.

Since the initial coverage of the monkeypox virus, there has been debate among physicians over how to responsibly communicate public health information without harming historically marginalized communities. On November 28, 2022, the World Health Organization (WHO) announced its plan to rename monkeypox "mpox" following growing concern regarding the stigmatizing nature of the disease's original name. We believe providers, and especially dermatologists, have an opportunity to further shape conversations about the virus to mitigate the same stigmas that were perpetuated by media coverage surrounding the HIV epidemic and contributed to the rise of anti-LGBTQ and HIV+ violence. Specifically, dermatologists have an opportunity to engage in conversations about the psychosocial impact of visible skin disease, advocating for healthcare equity by using both inclusive imagery and non-discriminatory language.J Drugs Dermatol. 2023;22(12):1235-1236. doi:10.36849/JDD.7482.

Introduction The purpose of this study is to systematically review data pertaining to breast cancer and radiation-induced skin reactions in patients with skin of color (SOC), as well as data pertaining to objective measurements of skin pigmentation in the assessment of radiation dermatitis (RD). Methods and materials We conducted a systematic review utilizing MEDLINE electronic databases to identify published studies until August 2022. Key inclusion criteria included studies that described RD in breast cancer with data pertaining to skin of color and/or characterization of pigmentation changes after radiation. Results We identified 17 prospective cohort studies, 7 cross-sectional studies, 5 retrospective studies and 4 randomized controlled trials. Prospective cohort and retrospective series demonstrate worse RD in African American (AA) patients using subjective physician-graded scales. There is more limited data in patients representing other non-White racial subgroups with SOC. 2 studies utilize patient reported outcomes and 15 studies utilize objective methods to characterize pigmentation change after radiation. There are no prospective and randomized studies that objectively describe pigmentation changes with radiotherapy in SOC. Conclusions AA patients appear to have worse RD outcomes, though this is not uniformly observed across all studies. There are no studies that describe objective measures of RD and include baseline skin pigmentation as a variable, limiting the ability to draw uniform conclusions on the rate and impact of RD in SOC. We highlight the importance of objectively characterizing SOC and pigmentation changes before, during and after radiotherapy to understand the incidence and severity of RD in SOC.

Purpose: Acute radiation dermatitis (ARD) is common after radiation therapy for breast cancer, with data indicating that ARD may disproportionately affect Black or African American (AA) patients. We evaluated the effect of skin of color (SOC) on physician -reported ARD in patients treated with radiation therapy. Methods and Materials: We identified patients treated with whole breast or chest wall +/- regional nodal irradiation or high tangents using 50 Gy in 25 fractions from 2015 to 2018. Baseline skin pigmentation was assessed using the Fitzpatrick scale (I = light/pale white to VI = black/very dark brown) with SOC defined as Fitzpatrick scale IV to VI. We evaluated associations among SOC, physician-reported ARD, late hyperpigmentation, and use of oral and topical treatments for RD using multivariable models. Results: A total of 325 patients met eligibility, of which 40% had SOC (n = 129). On multivariable analysis, Black/AA race and chest wall irradiation had a lower odds of physician-reported grade 2 or 3 ARD (odds ratio [OR], 0.110; 95% confidence interval [CI], 0.030-0.397; P =.001; OR, 0.377; 95% CI, 0.161-0.883; P =.025), whereas skin bolus (OR, 8.029; 95% CI, 3.655-17.635; P = 0) and planning target volume D0.03cc (OR, 1.001; 95% CI, 1.000-1.001; P =.028) were associated with increased odds. On multivariable analysis, SOC (OR, 3.658; 95% CI, 1.236-10.830; P =.019) and skin bolus (OR, 26.786; 95% CI, 4.235-169.432; P = 0) were associated with increased odds of physician-reported late grade 2 or 3 hyperpigmentation. There was less frequent use of topical steroids to treat ARD and more frequent use of oral analgesics in SOC versus non-SOC patients (43% vs 63%, P <.001; 50% vs 38%, P =.05, respectively). Conclusions: Black/AA patients exhibited lower odds of physician -reported ARD. However, we found higher odds of late hyperpigmentation in SOC patients, independent of self-reported race. These findings suggest that ARD may be underdiagnosed in SOC when using the physician -rated scale despite this late evidence of radiation-induced skin toxicity. (c) 2023 Elsevier Inc. All rights reserved.

To the Editor: As many as 42% of Americans report utilizing social media to access health information.1 Despite this trend, a minority of dermatology-related social media posts are produced by board-certified dermatologists.2 During clinical encounters, dermatologists regularly rely on verbal instruction or educational text to convey complex information to patients.3 However, through the production of high-quality, publicly available online learning tools, dermatologists have the opportunity to improve continued access to and retention of health information.

Evidence-based literature regarding management of rare and severe dermatologic disease is limited. Canakinumab and anakinra, two therapeutics used for inhibiting IL-1 pathways, have seen increased utilization for treatment of refractory dermatoses. We sought to better characterize the breadth of dermatologic conditions for which these medications could be utilized.

To the Editor: We read with great interest the letter by Ranpariya and Lipoff1Ranpariya V.K. Lipoff J.B. Direct-to-consumer teledermatology platforms may have inherent conflicts of interest.J Am Acad Dermatol. 2021; 85: e259-e260https://doi.org/10.1016/j.jaad.2021.04.102Google Scholar discussing the ethical issues and financial conflicts of interest inherent to direct-to-consumer (DTC) teledermatology platforms. We would like to note that there are several other shortcomings of these platforms that limit their ability to provide the same level of safe and efficacious dermatologic care as a visit with an in-person provider would. In addition to the inherent financial conflicts of interest and profit-driven nature of these platforms, the promotion and selling of non–evidence-based therapies in DTC teledermatology platforms present yet another ethical concern. Hims and Hers markets biotin gummies to promote hair growth, despite the lack of peer-reviewed literature to support the recommendation, especially in patients with normal biotin levels (Table I).2Lipner S.R. Rethinking biotin therapy for hair, nail, and skin disorders.J Am Acad Dermatol. 2018; 78: 1236-1238https://doi.org/10.1016/j.jaad.2018.02.018Google Scholar The website also fails to notify consumers of a recent warning by the US Food and Drug Administration that biotin supplementation can significantly interfere with laboratory tests.2Lipner S.R. Rethinking biotin therapy for hair, nail, and skin disorders.J Am Acad Dermatol. 2018; 78: 1236-1238https://doi.org/10.1016/j.jaad.2018.02.018Google ScholarTable IList of non–evidence-based therapies promoted by direct-to-consumer platformsPlatformAdvertised product/ingredientClaimSourceHims and HersBiotin gummiesSupports healthy hairhttps://www.forhims.com/hair-care/vitaminshttps://www.forhers.com/hair-loss/vitaminsHersCollagen peptide powderHydrates skin, increases elasticity, shiny hair, strong nailshttps://www.forhers.com/well-being/collagen-peptides Open table in a new tab We must recognize that among DTC platforms, there is a lack of follow-up and individualized patient care that makes monitoring for medication side effects challenging. Finasteride, for example, carries a risk of depression for which routine medical visits are critical for screening for changes in mood.3Nguyen D.D. Marchese M. Cone E.B. et al.Investigation of suicidality and psychological adverse events in patients treated with finasteride.JAMA Dermatol. 2021; 157: 35-42https://doi.org/10.1001/jamadermatol.2020.3385Google Scholar Although platforms such as Hims collect intake information on medical comorbidities and depressive symptoms, there is limited opportunity for continuity of care, which is important for establishing therapeutic rapport should the patient's physical or mental health change throughout the treatment course. Furthermore, the lack of objective measures, such as trichoscopic analysis and scalp photographs, hinders the provider's ability to determine the efficacy, or lack thereof, of the prescribed therapies. Although not every dermatologist collects objective trichologic measurements at each patient visit, standardized scalp photography is commonly used in practice to monitor the response to therapy. Patients and providers are left to use subjective judgments to inform their therapeutic decision making. Finally, these platforms are limited by having to adhere to the therapies approved by the US Food and Drug Administration, although dermatologists in the clinical setting often prescribe off-label medications to optimize patients' results, with off-label prescribing rates reaching up to 73%.4Sugarman J.H. Fleischer Jr., A.B. Feldman S.R. Off-label prescribing in the treatment of dermatologic disease.J Am Acad Dermatol. 2002; 47: 217-223https://doi.org/10.1067/mjd.2002.120469Google Scholar Low-dose oral minoxidil, commonly used in the management of alopecia, is not approved by the US Food and Drug Administration for the management of hair loss and requires careful monitoring for hypotension, tachycardia, headache, and fluid retention.5Vañó-Galván S. Pirmez R. Hermosa-Gelbard A. et al.Safety of low-dose oral minoxidil for hair loss: a multicenter study of 1404 patients.J Am Acad Dermatol. 2021; 84: 1644-1651https://doi.org/10.1016/j.jaad.2021.02.054Google Scholar As low-dose oral minoxidil cannot be prescribed or effectively managed through DTC teledermatology platforms, patients who rely on these platforms are limited in their treatment options. We encourage dermatologists to be cognizant of these additional limitations associated with DTC teledermatology platforms and to appropriately counsel patients regarding their shortcomings and risks. None disclosed. Direct-to-consumer teledermatology's limitations may be addressed with greater in-person care synergyJournal of the American Academy of DermatologyVol. 86Issue 5PreviewTo the Editor: We thank Karim et al1 for their expanded discussion surrounding direct-to-consumer (DTC) teledermatology companies. Given the likely growing importance of DTC in dermatology, we must continue to review the limitations of DTC in relation to traditional in-person care. Full-Text PDF

Dermatomyositis (DM) is an inflammatory myositis that commonly presents with a characteristic skin eruption, which can occur even in the absence of muscle inflammation. Cutaneous manifestations tend to be more severe in a recently described DM-specific autoantibody subtype, transcription intermediary factor 1-γ (TIF1-γ) DM.1 As DM has the potential to cause significant pruritus, photosensitivity, and dyspigmentation, TIF1-γ-associated DM may be psychologically distressing to patients and have a negative effect on overall quality of life.

BACKGROUND:Social media platforms continue to grow in popularity and have become common sources of medical information and education for patients struggling with hair loss.OBJECTIVE:We sought to determine the characteristics of popular hair loss related content on Instagram and TikTok.METHODS:The top 9 most popular posts within 10 hair loss related hashtags on Instagram and TikTok were analyzed. Quantitative and qualitative analysis was used to evaluate posts from December 2020. The characteristic of the author, content category, and number of likes were analyzed for each post.RESULTS:Of 90 posts analyzed within Instagram, non-medical professional influencers created 66%, hair and wig companies created 29%, and medical professionals created 4%. Of 100 posts analyzed within TikTok, influencers created 38%, patients created 38%, hair and wig companies created 14%, and medical professionals created 10%. None of the top posts was created by board-certified dermatologists.LIMITATIONS:This study was limited by the extent of data that can be collected from Instagram and TikTok.CONCLUSIONS:A majority of the content promoted hair care products, services, or treatments not substantiated by evidence-based medicine. Instagram and TikTok provide new opportunities for dermatologists to educate the general population on alopecia while simultaneously correcting misinformation. J Drugs Dermatol. 2022;21(12):1316-1321. doi:10.36849/JDD.6707.

Sexually transmitted infections (STIs) often have skin manifestations, with patients presenting to dermatologists.• Pre-exposure prophylaxis (PrEP) uses antiretrovirals taken prophylactically to prevent transmission of and infection with HIV.Dermatologists are aware of PrEP, but several barriers prevent them from being prescribers.• Patients with a history of an STI should be considered for PrEP.

International Journal of DermatologyEarly View Correspondence A cross-sectional survey of dermatologists: assessing practice patterns in sexually transmitted infections Peter B. Chansky MD, Peter B. Chansky MD orcid.org/0000-0002-1444-7239 The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USASearch for more papers by this authorPayal Shah BS, Payal Shah BS The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USASearch for more papers by this authorDaniel Gutierrez MD, Daniel Gutierrez MD orcid.org/0000-0001-5539-6119 The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USASearch for more papers by this authorChristopher Kuhner BS, Christopher Kuhner BS The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USASearch for more papers by this authorJohn Zampella MD, Corresponding Author John Zampella MD john.zampella@nyulangone.org The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USASearch for more papers by this author Peter B. Chansky MD, Peter B. Chansky MD orcid.org/0000-0002-1444-7239 The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USASearch for more papers by this authorPayal Shah BS, Payal Shah BS The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USASearch for more papers by this authorDaniel Gutierrez MD, Daniel Gutierrez MD orcid.org/0000-0001-5539-6119 The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USASearch for more papers by this authorChristopher Kuhner BS, Christopher Kuhner BS The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USASearch for more papers by this authorJohn Zampella MD, Corresponding Author John Zampella MD john.zampella@nyulangone.org The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USASearch for more papers by this author First published: 07 April 2022 https://doi.org/10.1111/ijd.16196 Conflict of interest: None. Funding source: None. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation