Short-term dermoscopic monitoring is an accepted approach to evaluating atypical melanocytic lesions. The presence of any clinically significant dermoscopic change over 2.5 to 4.5 months is deemed sufficient to warrant excision. In this prospective cohort study, Wu et al found that most patients were able to acquire baseline and follow-up images with an iPhone that were subsequently deemed evaluable by a teledermatologist. These data suggest that teledermoscopy is a feasible and effective method for short-term monitoring of clinically atypical nevi that can potentially enhance patient convenience, optimize physician scheduling, and promote efficiency.
Mobile smartphones are rapidly emerging as an effective means of communicating with many Americans. Using mobile applications (apps), they can access remote databases, track time and location, and integrate user input to provide tailored health information. In this randomized survey, Buller et al demonstrate that Solar Cell, a mobile app that provides sun protection advice to reduce the risk of skin cancer, promoted sun protection practices, especially through increased use of shade and wide-brimmed hats. Unfortunately, Solar Cell did not reduce sunburns.
Effective patient-physician communication is integral to providing quality health care and improves patient outcomes. Physicians may not notify patients of abnormal biopsy results because of the benign nature of the results, upcoming scheduled visits, or forgetfulness. Although patients in the past preferred to receive bad news in person, notification via telephone, email, or text messaging may be acceptable. In this patient survey, Choudhry et al demonstrate that patient preference has shifted from face-to-face visit to discussion over the telephone because of desire for rapid notification. An online patient portal option was the second most preferred method of delivery of results.
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a complex pathogenesis. The co-occurrence of AD with vitiligo or alopecia areata (AA) may indicate differing disease phenotype, prognosis, and/or response to therapy, but previous studies have demonstrated inconsistent associations between these diseases. In this meta-analysis, Mohan and Silverberg demonstrate that patients with either vitiligo (especially early onset) or AA (especially alopecia totalis or universalis variants) have significantly higher rates of AD than patients who do not have these disorders.
Continuing Medical Education
Herpes zoster, or shingles, is the consequence of reactivation of endogenous latent varicella zoster virus infection within the sensory ganglia. Shingles causes substantial morbidity, disability, and chronic pain in the form of postherpetic neuralgia. Known risk factors for shingles are age older than 50 years and immune suppression. The association between the use of biologic medications and shingles remains unclear. In this cohort study of patients with psoriasis, Shalom et al demonstrate that monotherapy with biologic medications or systemic treatment was not associated with increased shingles risk but that patients treated by a combination of methotrexate and a biologic medication were at increased risk.
Highlights. JAMA Dermatol. 2015;151(5):469. doi:10.1001/jamadermatol.2014.2916