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In This Issue of JAMA Dermatology
August 2016


JAMA Dermatol. 2016;152(8):861. doi:10.1001/jamadermatol.2015.3275


Medical research relies on continuous funding support. Although there are many funding sources, National Institutes of Health (NIH) awards remain the benchmark. In this retrospective study of NIH grants awarded to departments of dermatology, Cheng et al demonstrate a downward trend in NIH funding for female and MD-only dermatology investigators. Further research is needed to clarify the nature of these funding disparities, but this growing inequality of opportunity for women and MD physician-scientists in dermatology research suggests the importance of departmental support and junior faculty mentorship for women and MD investigators.


Many primary and secondary prevention interventions for skin cancer are best targeted to individuals classified as being at increased risk of melanoma. Most published risk-prevention models have limited reporting of methods and results, and few have been externally validated. In this Australian population-based case-control-family study, Vuong et al report a new melanoma risk-prediction model that includes self-assessed variables: hair color, nevus density, first-degree family history of melanoma, previous nonmelanoma skin cancer, and tanning bed use. This model demonstrated good discrimination and calibration and performed satisfactorily on external validation.


Continuing Medical Education

Anti-p200 pemphigoid is a rare subepidermal autoimmune bullous disease characterized by autoantibodies directed against a 200-kDa protein in the lower lamina lucida of the basement membrane zone. Anti-p200 pemphigoid is likely often misdiagnosed as bullous pemphigoid or epidermolysis bullosa acquisita because of the low availability of diagnostic assays and expertise. In this retrospective study, Meijer et al describe the use of direct and indirect immunofluorescence microscopy analyses to identify patients. Predominance of blisters on hands and feet may be a clinical clue to the diagnosis of anti-p200 pemphigoid, and these additional techniques may offer valuable tools to facilitate diagnoses.

Access to dermatologists is often limited for Medicaid enrollees. Teledermatology may improve access by bringing dermatologists to underserved communities and decreasing patient’s travel time, but the effects have rarely been assessed. In this analysis of claims data from a large California Medicaid managed care plan, Uscher-Pines et al demonstrate that primary care practices engaged in a teledermatology had a 64% increase in the fraction of patients visiting with a dermatologist. These data suggest that teledermatology offers promise for other Medicaid programs that struggle with meeting the specialty care needs of enrollees.

Physicians and patients quickly develop an opinion about each other during their initial encounter, and part of this perception is based on physician attire. In this cross-sectional, anonymous survey study of patients’ attitudes about dermatologist attire, Fox et al demonstrate that professional attire (white coat) was preferred in all clinic settings. Respondents who received a picture of a black physician were significantly more likely to exclusively prefer professional attire, while nonwhite and unemployed respondents were significantly less likely to prefer professional attire.