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In This Issue of JAMA Dermatology
October 2019


JAMA Dermatol. 2019;155(10):1099. doi:10.1001/jamadermatol.2018.3538


The Global Leprosy Strategy aims to avert leprosy disability. de Paula and colleagues performed a systematic review and meta-analysis to identify clinical factors associated with physical disability in patients with leprosy. Results confirmed the association between physical disabilities and male sex, multibacillary leprosy, leprosy reactions, and lepromatous presentation. These findings can guide interventions for early identification of individuals at high risk of developing physical disabilities. Ramam provides an Editorial.

Editorial and Related Article

There is limited understanding of the perceptions of black patients about their dermatologic care and factors affecting satisfaction. Gorbatenko-Roth and colleagues performed a cross-sectional study using surveys and focus groups to assess black patients’ perceptions of the care they received in and outside a skin of color clinic. Results showed that care satisfaction seemed to be related to dermatologists’ interpersonal style and knowledge in care of black skin and hair. Taylor provides an Editorial.


Author Audio Interview

Few randomized clinical trials (RCTs) have been conducted on palmoplantar pustulosis (PPP). Evidence seems to indicate the involvement of interleukin 23 in the pathogenesis of the condition. Terui and colleagues performed a phase 3 RCT to determine the safety and efficacy of guselkumab in Japanese patients with PPP. Results show that targeting interleukin 23 with guselkumab may be an effective and safe treatment option for a recalcitrant disease such as PPP.

No causal link between isotretinoin, which is used to treat acne, and psychiatric adverse events (AEs) has been established, but widespread media reports of depression and suicidality with use of the drug have prompted concerns among patients and clinicians. Singer and colleagues conducted a retrospective study to assess reports of psychiatric AEs associated with isotretinoin use that were submitted to the US Food and Drug Administration. Results suggest that the suicide rate of patients using isotretinoin may be lower than that of the general US population, but patients taking the drug appear to be vulnerable to psychiatric concerns.

Few studies have evaluated the literature on the number-needed-to-biopsy (NNB) metrics to account for differences in clinician type and melanoma prevalence by geographic area. Nelson and colleagues performed a systematic review and meta-analysis to synthesize worldwide data for NNB for the diagnosis of melanoma. Results showed that existing NNB for cutaneous melanoma varied widely worldwide, lacking standardization in the metric and its reporting, and according to clinician characteristics; therefore, the NNB of US clinicians may warrant further study.

Continuing Medical Education