The "Sephora Kids" trend, where children, especially tweens and teens, are increasingly using makeup and skincare products marketed by beauty retailers, presents notable dermatological challenges. Although these products can facilitate self-expression and teach self-care, their safety and efficacy for young users are largely unverified. This review examines 4 key ingredients commonly found in these products,retinol, exfoliating acids (AHA and BHA), and vitamin C, to assess their implications for pediatric skincare. Current literature and FDA-approved guidelines indicate that these ingredients have not been thoroughly tested in children. Consequently, using these products without medical supervision can pose risks such as skin redness, irritation, heightened sun sensitivity, dermatitis, and other potential adverse effects. This review underscores the importance of cautious use and highlights the need for further research to ensure the safety of these ingredients in young populations. By informing healthcare providers and consumers of these risks, we aim to promote safer skincare practices among children.

Analyses of women dermatology literature authorship from 2018 to 2022 reveal a slight increase in total female authors, female first authors, and female senior authors with no substantial immediate impact of COVID-19 on current trends, encouraging future examination of long-term effects and ongoing promotion of systemic initiatives to support gender equity.

This research letter assesses male skin care content on social media in order to bring to light the lack of content regarding skin cancer prevention posted on Instagram for male audiences.

This research letter assesses male skin care content on social media in order to bring to light the lack of content regarding skin cancer prevention posted on Instagram for male audiences.

BackgroundHenoch-Schönlein purpura (HSP), a leukocytoclastic small vessel vasculitis, exhibits both cutaneous and systemic manifestations. While predominantly observed in childhood, it may manifest in adults with more pronounced systemic involvement. Furthermore, HSP is a global phenomenon showcasing epidemiological and systemic variances. ObjectiveThis study aims to scrutinize extracutaneous manifestations in adults with HSP, discerning distinctions according to geographical regions on a worldwide scale. MethodsA comprehensive search encompassing PubMed, Embase, Cochrane Library, and Web of Science was executed, covering papers published from January 1, 1970, to December 1, 2019. Keywords used included “Henoch-Schönlein purpura,” “henoch schonlein purpura+adult,” “IgA vasculitis+adult,” “HSP+adult,” and “IgAV.” A total of 995 publications were identified, from which 42 studies encompassing 4064 patients were selected, with a predominant focus on cases reported in Asia, Europe, and the Americas. ResultsAmong adults afflicted with HSP, European patients exhibited a higher propensity for male predominance (P<.001), gastrointestinal involvement (P<.001), and musculoskeletal complications (P<.001). Conversely, patients from the Americas were least likely to experience genitourinary involvement (P<.001). ConclusionsHSP demonstrates a variance in distribution and extracutaneous manifestations within distinct geographical boundaries. In the adult population, European patients exhibited a higher prevalence of male gender and gastrointestinal and musculoskeletal involvement. Asian patients were more predisposed to genitourinary involvement when compared to their American counterparts. The establishment of prospective studies using standardized reporting measures is imperative to validate the relationships unveiled in this investigation.

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor with metastatic potential. EHE can have single- or multiorgan involvement, with presentations ranging from asymptomatic disease to pain and systemic symptoms. The extremely heterogeneous clinical presentation and disease progression complicates EHE diagnosis and management. We present the case of a 24-year-old woman with two periauricular erythematous papules, leading to the discovery of metastatic EHE through routine biopsy, despite a noncontributory medical history. Histology revealed the dermal proliferation of epithelioid cells and vacuoles containing red blood cells. Immunohistochemistry markers consistent with EHE solidified the diagnosis. Although extremely rare, prompt diagnosis of EHE is essential for informed decision-making and favorable outcomes. Key clinical and histopathological findings are highlighted to aid dermatologists in diagnosing and managing this uncommon condition.

Monkeypox has infected over 18,000 individuals in the United States since the first reported case on May 17, 2022.1 Monkeypox is a variola poxvirus that is related to smallpox, but monkeypox symptoms (fever, painful vesicular or pustular rash, and lymphadenopathy) are milder and fatalities are rare.

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.

Actemra (tocilizumab) received emergency use authorization for the treatment of coronavirus disease 2019 (COVID-19) in June 2021. Literature has linked numerous cutaneous adverse effects to tocilizumab. In this current survey, investigators reviewed and compared these adverse effects to the common cutaneous manifestations of COVID-19. While similarities in patient presentation exist, important distinctions are made to aid dermatologists in their clinical diagnosis. &nbsp;J Drugs Dermatol. 2023;22(12):e42-e43.&nbsp; &nbsp;&nbsp; doi:10.36849/JDD.6532e.

To the Editor: We commend Siller et al1Siller A. Daneshjou R. Lipoff J.B. Increasing the visibility of dermatologic research contributions by women and underrepresented minorities.J Am Acad Dermatol. 2020; 83: e375-e376Google Scholar for their illuminating study on women and minority representation in dermatology research. Their study suggests further bibliometric analysis of female authorship in academic dermatology. In an effort to further illuminate the patterns of gender representation in dermatologic publications, we have completed this analysis to address the gap in dermatologic literature and provide a concerted effort for diverse representation in dermatologic academia. Clarivate Analytics' Web of Science was used to isolate the names of all first and last authors of published works in the Journal of Investigative Dermatology, the Journal of the American Academy of Dermatology, and the Journal of the American Medical Association Dermatology from 2009 to 2019.2Web of Science platform - Web of Science group.https://clarivate.com/webofsciencegroup/solutions/webofscience-platform/Google Scholar These 3 US-based journals were selected as they hold the highest h-index of influence over the past 10 years. Gender API (www.gender-api.com), a large online database linking known gender-name relationships, was used to predict binary gender (female vs male) for each name. Results were reported as percent female first or last author (senior authorship) for all publications in the journal by year. Statistical analysis was performed using 1-way analysis of variance and covariate regression, with significance set at P value of <.05. The results demonstrated that the percentage of female first authorship was consistent with that of their male counterparts for the past 10 years (Fig 1). However, the percentage of female senior authorship remained substantially lower than that of their male counterparts (Fig 2). The average percentages of female first authors from 2009 to 2019 were 50.91% (Journal of Investigative Dermatology), 49.73% (Journal of the American Academy of Dermatology), and 52.55% (Journal of the American Medical Association Dermatology), with no significant differences between the journals. In contrast, the average percentages of female last authors were 38.55% (Journal of Investigative Dermatology), 38.55% (Journal of the American Academy of Dermatology), and 37.45% (Journal of the American Medical Association Dermatology), with no significant differences between the journals. Linear regression models, including the year and journal as covariates, corroborated these findings.Fig 2Female last authors as percentage of total in the Journal of the American Academy of Dermatology, Journal of Investigative Dermatology, and Journal of the American Medical Association Dermatology by year. JAAD, Journal of the American Academy of Dermatology; JAMA Derm, Journal of the American Medical Association Dermatology; JID, Journal of Investigative Dermatology.View Large Image Figure ViewerDownload Hi-res image Download (PPT) The higher percentage of female first authorship to male counterparts suggests consistent representation of females as lead authors in dermatology; however, senior authors are often those that are further and more advanced in their academic medical careers.3Bendels M.H.K. Dietz M.C. Brüggmann D. Oremek G.M. Schöffel N. Groneberg D.A. Gender disparities in high-quality dermatology research: a descriptive bibliometric study on scientific authorships.BMJ Open. 2018; 8: e020089Google Scholar Lester et al4Lester J. Wintroub B. Linos E. Disparities in academic dermatology.JAMA Dermatol. 2016; 152: 878-879Google Scholar have highlighted that associate and full dermatology professorships in university hospitals are disproportionately held by male physicians. The discrepancy between the percentage of female first authorship and senior authorship can be attributed to this unequal gender representation in university professorships; however, the closing gap in first authorship inequality suggests that time may also alter the disjunctional proportions of female senior authorship.4Lester J. Wintroub B. Linos E. Disparities in academic dermatology.JAMA Dermatol. 2016; 152: 878-879Google Scholar The limitations of this study include restricting the search to the top 3 peer reviewed journals in the dermatologic literature. Although rated as the most influential journals, they do not encompass all the literature. Secondly, our determination of gender was based on the Gender API algorithm of gender identity and not on personal author gender identification. In an effort to more fully represent the community in which the dermatologists serve, additional studies are required to reduce inequalities in dermatologic research, including those directed at increasing the percentages of female dermatologists in academics contributing to the current literature. It is paramount that the conversation surrounding gender disparities in dermatologic research continues. 'Dr Dellavalle is the podcast editor for JID and a social media editor or JAAD.

Objectives: The purpose of this non interventional study was to define changes in anxiety, depression, and sleep quality of medical students in their first two years of medical school while considering potential risk factors of self-reported chronic disease, sleep quantity, year of medical school and exercise habits. Since this study was ongoing during the COVID-19 pandemic, its effect was also evaluated. Participants: /METHODS: A cohort of 197 medical students was evaluated longitudinally using survey methods to quantify changes from pre-medical school and summer break to each semester in medical school throughout years one and two. This study was performed from July 2019 through June 2021. Data was analyzed using Generalized Linear Mixed Models (GLMMs) on the numeric responses of General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Sleep Quality (SQ-3) and Pittsburg Sleep Quality Index (PSQI). Additional assessments evaluated exercise habits, chronic disease, and impact of COVID-19 Pandemic. The COVID-19 Pandemic was evaluated directly in the model (pre- and post-COVID-19 period variable), and through additional questions on their perceived effect. Results: Depression, anxiety, and sleep habits displayed a cyclical change that was associated with the academic/seasonal cycle. The COVID-19 pandemic was never found significant. Medical students who had a chronic disease diagnosis and fewer hours of sleep had increased severity. Exercise did not play a role. Conclusion: Based on our sample, the main driver for depression, anxiety, and poor sleep quality appears to be the academic/seasonal cycle, while the COVID-19 pandemic did not have an impact on mental health. (c) 2022 Elsevier B.V. All rights reserved.

To the Editor: We applaud Jayakumar and Samimi1Jayakumar K.L. Samimi S.S. Trends in US dermatology residency and fellowship programs and positions, 2006 to 2016.J Am Acad Dermatol. 2018; 78: 813-815https://doi.org/10.1016/j.jaad.2017.09.072Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar for highlighting the trends observed in the number of positions available in US dermatology residencies and fellowships from 2006 to 2016. Population-adjusted increases in the number of dermatology residency positions (14.4%) and micrographic surgery and dermatologic oncology fellowship positions (119.8%) were noted during this period, compared with a slight decrease in dermatopathology fellowship positions (−1.3%).1Jayakumar K.L. Samimi S.S. Trends in US dermatology residency and fellowship programs and positions, 2006 to 2016.J Am Acad Dermatol. 2018; 78: 813-815https://doi.org/10.1016/j.jaad.2017.09.072Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar Forecasted shortages within the dermatology workforce coupled with minimal reduction in the burden of skin disease in the United States indicate a continued need for dermatologists and dermatology subspecialists.2Porter M.L. Kimball A.B. Predictions, surprises, and the future of the dermatology workforce.JAMA Dermatol. 2018; 154: 1253-1255https://doi.org/10.1001/jamadermatol.2018.2925Crossref PubMed Scopus (2) Google Scholar,3Mounessa J. Braunberger T. Dunnick C.A. Dellavalle R.P. Minimal improvements in the global burden of skin disease from 1990 to 2013.J Am Acad Dermatol. 2017; 76: 148-149https://doi.org/10.1016/j.jaad.2016.08.006Abstract Full Text Full Text PDF Scopus (2) Google Scholar We aimed to provide a 5-year update on the work by Jayakumar and Samimi1Jayakumar K.L. Samimi S.S. Trends in US dermatology residency and fellowship programs and positions, 2006 to 2016.J Am Acad Dermatol. 2018; 78: 813-815https://doi.org/10.1016/j.jaad.2017.09.072Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar by performing a similar analysis of dermatology residency and fellowship positions over the years 2016 to 2021. For the academic years of 2016 to 2021, the number of graduate medical education, dermatology residency, and fellowship (dermatopathology and procedural dermatology) positions was determined based on an analysis of the Accreditation Council for Graduate Medical Education data resource book.4ACGME data resource book. Accreditation Council for Graduate Medical Research.https://acgme.org/about-us/publications-and-resources/graduate-medical-education-data-resource-book/Date accessed: October 10, 2021Google Scholar To adjust for population growth, population data were obtained from the US Census Bureau. Between the academic years of 2016 to 2017 and 2020 to 2021, the US population increased by 3.12%. Population-adjusted increases in the number of active dermatology resident physicians (10.8%) followed closely behind the increase in the total number of graduate medical education residents (11.88%) (Table I). The number of micrographic surgery and dermatologic oncology fellowship positions minimally increased by 0.48%. An overall loss of 2 dermatopathology fellowship positions over this 5-year period resulted in a population-adjusted reduction of −5.92% in the number of positions (Fig 1).Table INumber of active residents by specialty and subspecialty and academic year, from 2016-2017 to 2020-2021SpecialtyAcademic year5-year changePopulation-adjusted change from 2016 to 20212016-20172017-20182018-20192019-20202020-2021nnnnnn%%All GME programs129,720135,326140,391144,988149,20019,48015.00%11.88%Dermatology1424151715631594161218813.20%10.08%Dermatopathology7172676969−2−2.80%−5.92%Micrographic surgery and dermatologic oncology838382888633.60%0.48%GME, Graduate medical education. Open table in a new tab GME, Graduate medical education. The continued increase in the number of US physicians receiving dermatologic training may minimize previously identified and forecasted shortages within the dermatology workforce as well as reduce the overall burden of skin disease.2Porter M.L. Kimball A.B. Predictions, surprises, and the future of the dermatology workforce.JAMA Dermatol. 2018; 154: 1253-1255https://doi.org/10.1001/jamadermatol.2018.2925Crossref PubMed Scopus (2) Google Scholar,3Mounessa J. Braunberger T. Dunnick C.A. Dellavalle R.P. Minimal improvements in the global burden of skin disease from 1990 to 2013.J Am Acad Dermatol. 2017; 76: 148-149https://doi.org/10.1016/j.jaad.2016.08.006Abstract Full Text Full Text PDF Scopus (2) Google Scholar However, previous studies have demonstrated that increased dermatology residency positions provide minimal improvement in the lack of dermatologists available in rural communities and in nationally extensive patient wait times. These problems have persisted despite the increased production of newly trained dermatologists.2Porter M.L. Kimball A.B. Predictions, surprises, and the future of the dermatology workforce.JAMA Dermatol. 2018; 154: 1253-1255https://doi.org/10.1001/jamadermatol.2018.2925Crossref PubMed Scopus (2) Google Scholar Additional measures should be explored to ameliorate such obstacles. The plateauing of micrographic surgery and dermatologic oncology fellowship positions from 2016 to 2021 differs drastically from the growth observed in prior years, which might have increased the burden of nonmelanoma skin cancer in patients. The minimal growth over this time (0.48%) may be explained by the exponential growth between 2005 and 2016 (119.8%), leaving little room for growth in these past 5 years. Enhanced training and knowledge qualify dermatopathologists to diagnose and guide treatment for particularly difficult dermatologic diseases.5Gaudi S. Zarandona J.M. Raab S.S. English III, J.C. Jukic D.M. Discrepancies in dermatopathology diagnoses: the role of second review policies and dermatopathology fellowship training.J Am Acad Dermatol. 2013; 68: 119-128https://doi.org/10.1016/j.jaad.2012.06.034Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar Our analysis indicated a notable population-adjusted decrease in dermatopathology fellowships from 2016 to 2021. This downward trend was also observed to a lesser degree between the years of 2005 and 2016.1Jayakumar K.L. Samimi S.S. Trends in US dermatology residency and fellowship programs and positions, 2006 to 2016.J Am Acad Dermatol. 2018; 78: 813-815https://doi.org/10.1016/j.jaad.2017.09.072Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar These trends pose a risk to patients because the processing and reading loads of specimens increase as the workforce of fellowship-trained dermatopathologists decreases. Our study is limited by the exclusion of non-Accreditation Council for Graduate Medical Education fellowship positions, such as pediatric dermatology. Additional studies evaluating the trends and population-based needs within this subspecialty are warranted. Our study, alongside the findings of Jayakumar and Samimi,1Jayakumar K.L. Samimi S.S. Trends in US dermatology residency and fellowship programs and positions, 2006 to 2016.J Am Acad Dermatol. 2018; 78: 813-815https://doi.org/10.1016/j.jaad.2017.09.072Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar aids graduate medical education programs in further development of dermatology subspecialty fellowships to match the increasing population demand for dermatology subspecialists. Residency and fellowship programs will need to analyze resources to train more dermatologists in these subspecialties to prevent increased risk of dermatologic disease among patients. Dr Dellavalle is the editor-in-chief of the Journal of Medical Internet Research Dermatology, a joint coordinating editor for Cochrane Skin, a dermatology section editor for UpToDate, a social media editor for the Journal of the American Academy of Dermatology, and a podcast editor for the Journal of Investigative Dermatology. He is a coordinating editor representative on Cochrane Council.

UNSTRUCTURED Dermatology content is widespread on social media. Prior studies indicate dermatologists are underrepresented among those producing Skin of Color (SoC) content on social media. TikTok has emerged as a widely used social media platform. This study provides an analysis of SoC content and creator type on TikTok. Dermatologists were discovered to produce a small amount of SoC dermatologic content on TikTok. We suggest TikTok as an underutilized platform to promote educational SoC dermatology content.

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.

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.

Recent studies have reported a notable rise in social media use (i.e., TikTok) by dermatologists to educate users about dermatological conditions. Similarly, patients have reported utilizing social media to obtain dermatological information. Due to the nature of Tik-Tok, specifically, any user is permitted to create and post content with very few regulations that might ensure content accuracy. Thus, arises the likelihood that inaccurate medical information is propagated on social media, potentially misleading users in dermatological disease management. We have analyzed the top 10 posts from each of the 13 most searched hashtags on TikTok relating to either disease state or treatment options for lower extremity telangiectasias/spider veins. Information regarding content creator, post type, and user engagement was gathered for each post individually. Of the analyzed posts, 59.2% were published by medical providers while 40.8% were by influencers and businesses (i.e., med spas, equipment suppliers). 81.5% of total posts were classified as educational, 13.1% as advertisement, and 5.4% as promotional. The proportion of creators producing educational content who are not licensed or trained healthcare providers emphasizes the opportunity for inaccurate medical information to be spread via social media. This study highlights the need for dermatologists to engage with social media apps to correct unreliable information as well as prioritize correct patient education during clinical encounters regarding vein pathology treatment.

ABSTRACT BACKGROUND and OBJECTIVES This study aims to define changes in anxiety and depression among medical students while evaluating the association of sleep habits and other risk factors, including exercise habits and a diagnosis of chronic disease. The effect of the COVID-19 pandemic was also evaluated. DESIGN A cohort of first- and second-year medical students was evaluated longitudinally using survey methods to quantify changes from pre-medical school and summer break to each semester in medical school throughout years one and two. METHODS Data was analyzed using Generalized Linear Mixed Models (GLMMs) on the numeric responses of General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Pittsburg Sleep Quality Index. Additional assessments evaluated exercise habits, chronic disease, and impact of COVID-19 Pandemic. RESULTS Depression, anxiety, and sleep habits displayed a cyclical change that was associated with the academic cycle. The COVID-19 pandemic was never significant. Medical students who had a chronic disease diagnosis had increased severity. Exercise did not play a role. CONCLUSION The main driver for depression, anxiety, and poor sleep quality was the academic cycle, while the COVID-19 pandemic did not have an impact on mental health.