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In This Issue of JAMA Dermatology
February 2016

Highlights

JAMA Dermatol. 2016;152(2):125. doi:10.1001/jamadermatol.2015.3233
Research

Online consumer review websites are designed to facilitate instantaneous and public communication among patients, providing elaborate and timely data for dermatologists to garner insight into their patients’ experiences. Using the search functions on Yelp and ZocDoc, Smith and Lipoff qualitatively analyzed patient-generated reviews, revealing consistent physician-specific and practice-specific themes across both platforms. These consumer ratings websites offer dermatologists rapid, low-cost, and efficient means to review data and derive actionable insights on subjective patient perspectives that may guide improvements in care. Patients noted relying on review websites to select dermatology practices.

Editorial

As insurance formularies become increasingly restrictive and more patients are covered with high-deductible plans, many patients are forced to pay high retail prices to obtain their medications. In this survey of 4 national chain pharmacies, Rosenberg and Rosenberg report that prices of surveyed brand-name dermatologic drugs rapidly increased between 2009 and 2015. Most price increases occurred after 2011. The cost of selected generic dermatologic drugs increased a mean of 290% during the study period. Percentage increases for many medications greatly outpaced inflation, national health expenditure growth, and increases in reimbursements for physician services.

Viewpoint

Immune dysfunction and therapy-related immunosuppression can inhibit cancer-related immune surveillance in patients with rheumatoid arthritis and inflammatory bowel disease. For patients with a history of nonmelanoma skin cancer (NMSC), data are limited on the effects of drug-induced immunosuppression on the risk of additional NMSC. In this retrospective cohort study, Scott et al demonstrate that methotrexate use is associated with an increased risk of a second NMSC. Use of anti–tumor necrosis factor agents with methotrexate for rheumatoid arthritis may increase the risk of a second NMSC.

Melanoma is a treatable cancer and has a high survival rate if detected in its early stages. Patients can be trained in skin self-examination (SSE), and melanomas detected during SSE are more likely to have favorable outcomes. In-person training of patients with partners results in significantly more SSEs. In this randomized clinical trial, Hultgren et al demonstrate that training of patients and partners in early-detection SSE benefited some more than others. Pairs with low relationship quality may have received the greatest benefits because they were given an activity to perform together.

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