American Academy Of Dermatology Research Articles

Young-GRAPPA 2023: The Future Is Bright.

Two years after its inception, Young Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (Y-GRAPPA) has established itself as a productive network for junior investigators and clinicians. The group's achievements in the last year include updating the educational GRAPPA slide library, the "Bring a Derm" campaign to expand the GRAPPA community to include more dermatologists, and the publication of multiple "Do Not Miss" newsletters covering the highlights on PsDs from the major international conferences (American Academy of Dermatology [AAD] Annual Meeting, European Alliance of Associations for Rheumatology [EULAR] Congress, European Academy of Dermatology and Venereology [EADV] Congress, and American College of Rheumatology [ACR] Convergence).

Assessing the response quality and readability of chatbots in cardiovascular health, oncology, and psoriasis: A comparative study

BackgroundChatbots using the Large Language Model (LLM) generate human responses to questions from all categories. Due to staff shortages in healthcare systems, patients waiting for an appointment increasingly use chatbots to get information about their condition. Given the number of chatbots currently available, assessing the responses they generate is essential. MethodsFive chatbots with free access were selected (Gemini, Microsoft Copilot, PiAI, ChatGPT, ChatSpot) and blinded using letters (A, B, C, D, E). Each chatbot was asked questions about cardiology, oncology, and psoriasis. Responses were compared to guidelines from the European Society of Cardiology, American Academy of Dermatology and American Society of Clinical Oncology. All answers were assessed using readability scales (Flesch Reading Scale, Gunning Fog Scale Level, Flesch-Kincaid Grade Level and Dale-Chall Score). Using a 3-point Likert scale, two independent medical professionals assessed the compliance of the responses with the guidelines. ResultsA total of 45 questions were asked of all chatbots. Chatbot C gave the shortest answers, 7.0 (6.0 – 8.0), and Chatbot A the longest 17.5 (13.0 – 24.5). The Flesch Reading Ease Scale ranged from 16.3 (12.2 – 21.9) (Chatbot D) to 39.8 (29.0 – 50.4) (Chatbot A). Flesch-Kincaid Grade Level ranged from 12.5 (10.6 – 14.6) (Chatbot A) to 15.9 (15.1 – 17.1) (Chatbot D). Gunning Fog Scale Level ranged from 15.77 (Chatbot A) to 19.73 (Chatbot D). Dale-Chall Score ranged from 10.3 (9.3 – 11.3) (Chatbot A) to 11.9 (11.5 – 12.4) (Chatbot D). ConclusionThis study indicates that chatbots vary in length, quality, and readability. They answer each question in their own way, based on the data they have pulled from the web. Reliability of the responses generated by chatbots is high. This suggests that people who want information from a chatbot need to be careful and verify the answers they receive, particularly when they ask about medical and health aspects.

Disparities in the initial presentation of melanoma across two socioeconomically diverse New York City neighborhoods.

1593 Background: Disparities in stage at diagnosis among melanoma patients are often seen between urban and rural communities, with patients in rural areas being diagnosed with more advanced tumors. Factors contributing to the disparities include decreased access to dermatologists in rural areas, and lower socioeconomic status (SES). We investigated urban disparities in melanoma T stage at diagnosis among patients residing in 2 New York City (NYC) neighborhoods of differing SES and receiving care within the NYU Langone Health System. The neighborhoods were: Upper East Side (UES) and Brighton Beach/Coney Island (BB/CI). Methods: We conducted a retrospective chart review (NYU IRB 23-01020) of melanoma patients (N=243) diagnosed from 2018-2022 using ICD-10-CM codes: C43 (malignant melanoma of skin); D03 (melanoma in situ); and Z85.820 (personal history of malignant melanoma of skin). For community-level data we used the American Academy of Dermatology’s “Find a Dermatologist” search function to locate member-dermatologists; New York State Cancer Registry data (2016-2020) to determine annual melanoma incidence; and the United States Census Bureau Public Use Microdata Areas to determine the proportion of Non-Hispanic Whites (NHW), income levels, and educational attainment. The distribution of T stages was compared using a chi-square test. A two-sample test was used to assess equality of proportions. Results: In UES, the annual melanoma incidence was 30.2/100,000 (95% CI: 27.4-33.2); NHW comprised 74.6% of the population; the median household income was $135,820; 78% attained education higher than high school; and there are 190 dermatologists within a 0.5-mile radius. In BB/CI the annual melanoma incidence was 14/100,000 (95% CI: 11.6-16.9); NHW comprised 55.1% of the population; the median household income was $43,118; 46% attained education higher than high school; and there is 1 dermatologist within a 0.5-mile radius. There are 15 dermatologists within a 3.0-mile radius. 155 and 88 patients met inclusion criteria in UES and BB/CI respectively. The distribution of T stages (i.e. Tis to T4) was significantly different between UES and BB/CI with higher proportions of advanced stage tumors in BB/CI (p=0.0002). Specifically, the proportion of (T2+T3+T4) tumors/total melanomas was 35/155 (23%) in UES; and 41/88(47%) in BB/CI (p<0.0001). For reference, the proportion of T2+T3+T4 melanomas in the United States is 30%. Conclusions: We identified substantial disparities in the initial presentation of melanoma in 2 NYC neighborhoods, with proportionately more advanced stage tumors in the community of low educational attainment, less access to dermatologic services, and lesser household income. Neighborhood-based approaches to uncover melanoma disparities can identify areas for community outreach and engagement efforts to improve melanoma awareness and access to dermatologic care.

The American Academy of Dermatology's "Good Skin Knowledge" program enhances children and adolescents' confidence regarding dermatologic knowledge.

The American Academy of Dermatology (AAD) has resources meant to be used by children. Herein, we discuss the Good Skin Knowledge (GSK) curriculum, which was created to educate youth aged 8-13 about common dermatologic conditions to promote healthy skin habits, build self-confidence, and encourage careers in science and medicine. To assess participants' confidence regarding understanding and retention of GSK materials, the authors developed a pre- and post-training survey consisting of 10 questions. Results of our survey demonstrate a significant improvement in participants confidence regarding knowledge of skin function and care with at least two thirds of youth surveyed indicating understanding across all areas, with the largest gains centered around knowledge of the three skin layers, knowing what a dermatologist does, and appreciating the causes of acne.

Review of the 2024 American Academy of Dermatology (AAD) Annual Meeting

Review of the 2024 American Academy of Dermatology (AAD) Annual Meeting

Comparative Analysis of US Guidelines for the Management of Cutaneous Squamous Cell and Basal Cell Carcinoma.

This study presents a comparative analysis of recently published guidelines to manage cutaneous squamous cell carcinoma (cSCC) and cutaneous basal cell carcinoma (cBCC) within the United States (US). A PubMed database search was performed for the time period between June 1, 2016, and December 1, 2022. A comprehensive comparison was performed in the following clinical interest areas: staging and risk stratification, management of primary tumor and regional nodes with curative intent, and palliative treatment. Guidelines from 3 organizations were analyzed: the American Academy of Dermatology (AAD), the National Comprehensive Cancer Network (NCCN), and the American Society for Radiation Oncology (ASTRO). The guidelines used different methodologies to grade evidence, making comparison difficult. There was agreement that surgery is the preferred treatment for curative cBCC and cSCC. For patients ineligible for surgery, there was a consensus to recommend definitive radiation. AAD and NCCN recommended consideration of other topical modalities in selected low-risk cBCC. Postoperative radiation therapy (PORT) was uniformly recommended in patients with positive margins that could not be cleared with surgery and in patients with nerve invasion. The definition and extent of nerve invasion varied. All guidelines recommended surgery as the primary treatment in patients with lymph node metastases in a curative setting. The criteria used for PORT varied; NCCN and ASTRO used lymph node size, number of nodes, and extracapsular extension for recommending PORT. Both NCCN and ASTRO recommend consideration of systemic treatment along with PORT in patients with extracapsular extension. Conclusion: US guidelines provide contemporary and complementary information on the management of cBCC and cSCC. There are opportunities for research, particularly in the areas of staging, indications for adjuvant treatment in curative settings, extent of nerve invasion and prognosis, and the role of systemic treatments in curative and palliative settings.

Drugs for acne.

Acne is common among adolescents and adults. Guidelines for treatment of acne were last published by the American Academy of Dermatology in 2016.

Practices, Efficacy, and Reported Side Effects Associated with Isotretinoin Treatment in Palestine.

Isotretinoin is a commonly prescribed medication for the treatment of acne. It is associated with serious side effects that require monitoring and adherence by patients and healthcare providers. No studies have been conducted in Palestine to explore isotretinoin prescribing and utilization. This study aims to evaluate the current clinical practices, adherence to clinical guidelines, efficacy, and reported side effects associated with Isotretinoin treatment in Palestine. A descriptive cross-sectional online questionnaire-based study using social media platforms (eg, Facebook and Telegram) was conducted among Birzeit University students in April 2023. This study included participants aged ≥ 18 years with a history of isotretinoin treatment; subjects with incomplete data were excluded. Statistical significance was set at P < 0.05. SPSS version 27 was used for data analysis. A total of 548 participants were included in the study, the majority of most of whom were female (96%). The most predominant side effects were cracked, dry lips and xeroderma (96.2%). Moreover, 12% of participants had depression. Most respondents were educated about medication side effects and only 39.1% were counseled about blood donation. Of the 59 sexually active women, only 4 (6.8%) were asked for a recent pregnancy test. A total of 60.2% of dermatologists adhered to the American Academy of Dermatology (AAD) guidelines, and 48.7% ordered the required laboratory tests before initiating isotretinoin treatment. Only 1.7% of pharmacists followed the FDA-suggested protocols for dispensing isotretinoin to childbearing females. Adherence to isotretinoin safety prescribing protocols to provide patient education, monitoring, and ordering of laboratories to ensure patient safety can be improved by adapting policies and protocols in pharmacy and medical practice in Palestine to monitor and enforce adherence when prescribing, dispensing, or taking high-risk medications.

Evidence-Based Performance Measures for Reconstruction after Skin Cancer Resection: A Multidisciplinary Performance Measure Set.

The American Society of Plastic Surgeons commissioned the multidisciplinary Performance Measure Development Work Group on Reconstruction after Skin Cancer Resection to identify and draft quality measures for the care of patients undergoing skin cancer reconstruction. Included stakeholders were the American Academy of Otolaryngology-Head and Neck Surgery, the American Academy of Facial Plastic and Reconstructive Surgery, the American Academy of Dermatology, the American Society of Dermatologic Surgery, the American College of Mohs Surgery, the American Society for Mohs Surgery, and a patient representative. Two outcome measures and five process measures were identified. The outcome measures included the following: (1) patient satisfaction with information provided by their surgeon before their facial procedure, and (2) postprocedural urgent care or emergency room use. The process measures focus on antibiotic stewardship, anticoagulation continuation and/or coordination of care, opioid avoidance, and verification of clear margins. All measures in this report were approved by the American Society of Plastic Surgeons Quality and Performance Measures Work Group and Executive Committee, and the stakeholder societies. The work group recommends the use of these measures for quality initiatives, Continuing Medical Education, Continuous Certification, Qualified Clinical Data Registry reporting, and national quality reporting programs.

CUTANEOUS SQUAMOUS CELL CARCINOMA AT NATIONAL HOSPITAL OF DERMATOLOGY AND VENEREOLOGY: A FOLLOW-UP RETROSPECTIVE STUDY

Objectives: This study assessed the postoperative follow-up attendance of patients with cutaneous squamous cell carcinoma (cSCC) who underwent management at the National Hospital of Dermatology and Venereology, following the protocol based on the American Academy of Dermatology (AAD) guidelines of care for the management of cutaneous squamous cell carcinoma in 2018 and the classification of low and high-risk cSCC according to the National Comprehensive Cancer Network (NCCN). Materials and Methods: A retrospective study involving 60 cSCC patients was conducted. The monitoring included recurrent cancerous lesions, new cancerous lesions (cSCC, BCC, melanoma, and other types), detection of metastatic lesions (lymph node and distant metastases), late complication monitoring (bad scarring), and mortality monitoring. Results: Depending on their stage and risk factors, cSCC patients underwent tumor removal by wide local excision (61.7%) or Mohs surgery (38.3%). Regional lymph node screening for metastasis included clinical examination, ultrasound, cytology, or sentinel lymph node biopsy (SLNB). Distant metastases in cSCC were infrequent, accounting for 1.7%, mainly presenting as lymph node metastases (6.7%). Patients were re-examined at least 5 years after treatment, revealing 4 of 56 patients with lymph node metastasis, 1 with bone metastasis, and 4 in the high-risk group who succumbed in the subsequent period. Conclusion: The management of cSCC, following the AAD guidelines and risk classification by NCCN, is effective, with treatment modifications as needed and strict monitoring being imperative. Received 19 June 2023Revised 18 September 2023Accepted 25 November 2023

OpenAI's GPT-4 performs to a high degree on board-style dermatology questions.

Artificial intelligence tools such as OpenAI's GPT-4 have shown promise in medical education, but their potential in dermatology remains unexplored. To assess GPT-4's performance on dermatology board-style questions and determine its value as a supplementary educational tool for trainees and educators. This cross-sectional study evaluated GPT-4's performance on 250 random dermatology board-style questions sampled from the American Academy of Dermatology's Board Prep Plus resource. Questions were divided into five subspecialties and various difficulty levels. GPT-4 responses were compared to the correct answers and evaluated by two physicians. GPT-4 achieved an overall accuracy of 75% on the 250 questions, with no significant variation based on subspecialty or question difficulty. The most common errors were factual and misunderstanding inaccuracies. Responses scored high in clarity, accuracy, and relevance but frequently lacked depth and completeness. GPT-4 performed to a high degree and demonstrated promising performance as an educational adjunct in dermatology. Improvements in response depth and completeness are needed before its use as an unsupervised learning tool is established.

Assessment of Wound Care Products at Major Retailers in Accordance with the American Academy of Dermatology’s Recommendations

Background: Proper wound care is important for improving healing outcomes and minimizing long-term effects of scar formation. Selection of appropriate care may be challenging for individuals due to overabundance of product selection, and conflicting evidence on common wound care products, which may pose a risk for delayed wound healing. &#x0D; Objective: We aimed to assess whether wound care products sold by major retailers, specifically Walmart, Walgreens, and Target, align with the recommendations on patient support information websites provided by the American Academy of Dermatology.&#x0D; Methods: A unique search inquiry was established for each major retailer, and analysis of their first aid wound care sections was performed.&#x0D; Results: 393 Walgreens, 334 Walmart, and 285 Target products were included. 0% of wound cleansing products available were recommended by the academy. Petroleum-based products were represented in 61% in Walgreens, 76.2% in Walmart, and 78.4% in Target products assessed. In total, 61.6% of products in Walgreens, 57% in Walmart, and 52.7% in Target were consistent with AAD recommendations for providing appropriate wound coverage.&#x0D; Conclusion: Many products sold in retailers are not recommended in managing acute minor wounds; appropriate counseling from the AAD may provide insight to optimizing wound care and scar minimization.

American Academy of Dermatology's shade structure grants

American Academy of Dermatology's shade structure grants

Sunscreen Label Marketing Towards Pediatric Populations: Guidance for Navigating Sunscreen Choice.

Sunscreen marketing to specific demographics is largely unregulated.Marketing specifically targeting pediatric populations has the potential to drive consumer behavior.The American Academy of Pediatrics (AAP) and American Academy of Dermatology (AAD) provide recommendations for sunscreen use in children over the age of six months.This study sought to determine if sunscreen products marketed toward pediatric populations align with healthcare guidelines. Sunscreens available in major retail outlets in the Philadelphia area were cataloged and reviewed for marketing targeting specific demographics such as "baby", "babies", "children", "kids", "sports", and "active".The products were reviewed for sun protection factor (SPF), broad-spectrum ultraviolet (UV) protection, water resistance, active UV filters, and application method. Results:Of 410 sunscreens cataloged, 27 were marketed towards "baby" or "babies", 44 towards "children" or "kids", and 71 towards "sports" or "active".All of the sunscreen products reviewed targeting the pediatric population offered water resistance for up to 80 minutes and broad-spectrum UV coverage.Sunscreens targeting "baby" or "babies" aligned most closely with AAP guidelines for sunscreen use in pediatric populations, with 92.6% offering an SPF between 15 to 50 and no products including oxybenzone as a UV filter.However, sunscreens targeting "children", "kids", "sports", and "active" bore a close resemblance to the overall sunscreen profile for all demographicsbut with a higher percentage of products containing oxybenzone.Oxybenzone was found in 11.4% of "children" and "kids" products and 16.9% of "sports" and "active" sunscreen products, compared to 7.6% of all sunscreen products available, and was also found in most sunscreen products with an SPF of 70 or higher. Sunscreen products marketed towards "baby" and "babies" tend to align closely with guidelines for sunscreen use in the pediatric population for children over six months of age; however, those with brand marketing towards "children", "kids", "sports", and "active" do not.Limiting recommendations for a sunscreen product with an SPF of 30 to 50 targeting this demographic, however, sufficiently meets guidelines set forth by the AAP and AAD.

Recommendations for Cost-Conscious Treatment of Basal Cell Carcinoma.

Basal cell carcinoma (BCC) affects 3.3 million Americans annually. Treatment modalities for BCC include many surgical and nonsurgical options. The cost of BCC treatment can pose a substantial burden to patients and the healthcare system. Cost can be an important consideration in BCC treatment planning. We present an approach to the management of BCC when cost reduction is a priority. A PubMed literature search identified studies on effectiveness of current BCC therapies. Treatment prices were obtained from the Medicare National Fee Schedule, GoodRx, and pharmaceutical companies. The American Academy of Dermatology's (AAD) guidelines for treating BCC were used to develop recommendations for cost-reductive treatment. The cost of treating a primary superficial BCC < 0.5cm arising on Area M (cheeks, forehead, scalp, neck, jawline, pretibial surface) was $143 with curettage and electrodesiccation (C&E), $143 with cryosurgery, $210 with standard excision and simple reconstruction (SE), $1221 with Mohs Micrographic Surgery (MMS) and simple reconstruction, $472 with imiquimod, $186 with 5-fluorouracil (5-FU), and $354-$371 for photodynamic therapy (PDT). The cost of treating a primary nodular BCC 1.1-2cm arising on Area L (trunk and extremities, excluding pretibial surface, hands, feet, nail units and ankles) was $183 with C&E, $183 with cryosurgery, $251 with SE and simple reconstruction, $1163-1351 with MMS and simple reconstruction, $472 with imiquimod, $186 with 5-FU, and $354-$371 for photodynamic therapy (PDT). The cost of treating a giant BCC (BCC > 10cm with aggressive behavior) was $465-3311 with radiation, $139,560 with vismodegib, $144,452 with sonidegib, ~ $44.5 with cisplatin (medication cost only), and at least $184,836 with cemiplimab-rwlc. For a primary superficial BCC < 0.5cm arising on Area M, the cost-conscious algorithm prioritizes C&E or cryosurgery. For a primary nodular BCC 1.1-2cm arising on Area L, the cost-conscious algorithm prioritizes C&E, cryosurgery, or 5-FU. For a giant BCC, the cost-conscious algorithm identifies superficial radiation therapy as first line.

Oral Tetracycline-Class Drugs in Dermatology: Impact of Food Intake on Absorption and Efficacy.

Tetracycline-class drugs are frequently used in dermatology for their anti-inflammatory properties to treat skin diseases such as acne, rosacea, and hidradenitis suppurativa (HS). The American Academy of Dermatology (AAD) clinical guidelines do not offer guidance regarding the co-administration of food with tetracycline-class drugs. The objectives of this study were to review the available evidence regarding whether taking tetracycline-class drugs with food decreases systemic absorption and is associated with an impact on clinical efficacy. A literature search was conducted using the PubMed database between February to May 2023 using the keywords "tetracycline-class drugs", "pharmacokinetics", "absorption", and "dermatology". Inclusion criteria included articles written in English and relevant to the absorption and efficacy of tetracycline-class drugs. This search yielded 131 articles written between 1977 to 2022, of which 29 met the criteria for review. United States Food and Drug Administration (FDA)-approved prescribing information for oral formulations of tetracycline, doxycycline, minocycline, and sarecycline were reviewed. Systemic absorption of tetracycline decreased when co-administered with food. Systemic absorption of oral doxycycline and minocycline was variable with food co-administration. The impact on bioavailability varied with the drug formulation and dosage. The absorption of oral sarecycline decreased when administered with food. Sarecycline is the only oral antibiotic where population pharmacokinetic studies demonstrated limited or no impact of food intake on clinical efficacy. There are no available data for other tetracycline-class drugs in dermatology. If patients find it more tolerable to take doxycycline, minocycline, and sarecycline with food to avoid gastrointestinal distress, this may merit consideration to encourage patient adherence. Since the impact of food intake on absorption varied with the dosage form of doxycycline and minocycline, consulting the appropriate package insert may give clinicians additional insight into differences in the various formulations.

DS06 Does the content of patient information leaflets reflect real-life practice? A comparison of four patient information leaflets in Mohs micrographic surgery

Abstract In our experience, patients referred for Mohs micrographic surgery (MMS) often have unrealistic expectations, anticipating defects that are small in size and depth, and incorrectly describe the procedure as removal of skin cancer by ‘taking away thin slices’ or ‘skimming the skin layer by layer’. This observation prompted us to critically appraise four widely accessed online patient information leaflets (PILs) on MMS produced by the British Association of Dermatologists, the American Academy of Dermatology, Dermnetnz.org and the European Society of Micrographic Surgery. Our aim was to evaluate the wording used and propose evidence-based changes to help manage patients’ expectations. We focused on two core themes: (i) excision of tumour by MMS, including the number of stages, and (ii) cosmetic benefit of MMS over standard excision (SE). All of these PILs state the need for ‘stages’ to achieve margin clearance, with an initial margin of excision as low as 1 mm per stage mentioned in one PIL. The leaflets suggest cosmetic benefit and tissue preservation of MMS over SE, and one leaflet ranked this higher than other advantages offered by MMS. We feel that these points are overstated and better addressed with evidence-based facts. Studies have shown that 60% of cases of MMS are cleared in one stage; &amp;gt; 90% of tumours are cleared within two stages, and the number of patients needing three or more stages is only 6% (Macfarlane L, Waters A, Evans A et al. Seven years’ experience of Mohs micrographic surgery in a UK centre, and development of a UK minimum dataset and audit standards. Clin Exp Derm 2013; 38:262–9). In our experience, a surgical margin of 1 mm is not feasible in MMS. There is no direct evidence that MMS improves cosmesis compared with SE (Brown AC, Brindley L, Hunt WTN et al. A review of the evidence for Mohs micrographic surgery. Part 2: basal cell carcinoma. Clin Exp Dermatol 2022; 47:1794–804). Cosmetic and functional outcomes are usually only relevant in high-risk sites (e.g. the central face H zone) and in certain high-risk tumours where wide local excision would be the alternative treatment. In conclusion, we propose that PILs in MMS should avoid using misleading language like ‘thin’ and ‘small’ when describing the procedure. Patient information leaflets should clarify that the vast majority of tumours are cleared after two stages rather than requiring multiple stages. Tissue sparing should not be highlighted as the main advantage of MMS, and patients should not be pledged small wounds and better cosmetic outcomes.

Assessment of the American Academy of Dermatology diagnostic criteria for pediatric atopic dermatitis and modification into a checkbox form: A cross-sectional study.

Diagnostic criteria for atopic dermatitis (AD) are limited in their performance and/or usability. The American Academy of Dermatology (AAD) consensus criteria include hierarchical categories of disease features to improve these metrics but have not been validated. Our objective was to create and validate a checkbox form of the AAD consensus criteria in the pediatric population. We performed a cross-sectional study of 100 pediatric patients with AD (n = 58) and diseases in the differential diagnosis of AD (n = 42). Having three or more "Essential," ≥2 "Important," ≥1 "Associated" features of the AAD criteria was optimal for the diagnosis of AD in children. This combination was 91.4% (95% CI, 84.2%-98.6%) sensitive and 95.2% (88.8%-100%) specific. The UK working party criteria and the Hanifin-Rajka criteria had sensitivities of 96.6% (95% CI 91.9%-100%) and 98.3% (95% CI 94.9%-100%) and specificities of 83.3% (95% CI 72.1%-94.6%) and 71.4% (95% CI 57.8%-85.1%), respectively. The AAD criteria had significantly greater specificity than the Hanifin-Rajka criteria (p = .002). This study represents an important step in validating the AAD consensus criteria and formulating a useable checkbox form for diagnosing AD in the pediatric population.

Community outreach in vulnerable populations: Skin cancer screening for firefighters.

e21587 Background: Firefighters have both an increased risk (21%) and 20-year younger median age (42) at diagnosis of melanoma compared to the general population. The World Health Organization classifies firefighters’ occupational exposures as "carcinogenic to humans," but there is limited knowledge regarding sun protection habits, skin cancer history, and community outreach in this at-risk population. Methods: Free, full-body skin examinations conducted by board-certified dermatologists using the American Academy of Dermatology’s SPOT Skin CancerTM screening form were offered to firefighters from 26 cities and towns in Massachusetts on two separate days in August 2021 and October 2022. Data from the screening form and subsequent skin biopsy results were obtained and reported. Results: Of 195 firefighters screened, 30 (15.4%) were referred for biopsy. All were white males, mean age was 44.7 years, 26.7% had prior tanning bed exposure, 80% had prior blistering sunburns, 20% used sunscreen regularly, 86.7% did not have a regular dermatologist, and 6.7% had a history of keratinocyte-based skin cancer. Nineteen (63.3%) had biopsies, most frequently on the back or face, which resulted in three nodular basal cell carcinomas and 11 dysplastic nevi (seven moderate-to-severe). Conclusions: Firefighters are an underrecognized vulnerable population for the development of skin cancer. Community outreach in the form of free skin cancer screenings is a successful model for increasing awareness and early diagnosis of skin cancer among this population. In addition to providing access to care, community screenings offer tailored educational opportunities that promote skin cancer prevention in this high-risk group.

Evaluation of skin of color publication trends over the past 2 decades in the Journal of the American Academy ofDermatology

Evaluation of skin of color publication trends over the past 2 decades in the Journal of the American Academy ofDermatology