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In a year with the global coronavirus disease 2019 (COVID-19) pandemic, worldwide protests against structural racism, and international economic hardship, the opportunity to provide an annual review of the journal is a welcomed pause for reflection. JAMA Dermatology, with fully remote operations, had continuous publication throughout the pandemic and continued to thrive in 2020. Manuscript submissions rose by 21% in the past year (Table)1-7; the journal received 3559 article submissions in 2020, almost 300% higher than the number of submissions in 2017. Approximately 44% (1567 of 3559 submissions) were research articles. Notably, 10% of all submissions in the past year were related to COVID-19 as a disease process or its impact on dermatologists. A total of 8% of submissions overall and research articles were accepted, continuing a trend of reduced acceptance rates in recent years. In the face of many workflow changes caused by the pandemic, the journal continued its goal of reducing the time to publication, shortening the median time of acceptance to publication from 75 to 65 days while offering timely editorial decisions, including maintaining its median time to first decision without peer review of 4 days and time to first decision with peer review of 41 days. The editorial leadership team continued to strive to find ways to improve the authors’ experience to ensure authors the fastest and best publication of their work. The journal’s impact factor remained high at 7.74. I sincerely thank the many authors and peer reviewers8 who contributed to JAMA Dermatology in 2020. The journal increased its digital reach, with more than 4.8 million article views and downloads in the past year, and expanded the number of social media followers by 10% to more than 56 000 on Twitter, Facebook, and Instagram.
JAMA Dermatology published a number of important practice-changing clinical trials in 2020, including 2 of the 3 top-cited articles.3,6,7 In addition, 3 articles were among the top-scoring dermatology publications by Altmetric score (a measure of news and social media coverage) in 2020,1,4,5 including 2 articles on the mucocutaneous manifestations of COVID-19. In “Enanthem in Patients With COVID-19 and Skin Rash,” Jimenez-Cauhe et al1 report the presence of enanthems in a series of 21 patients infected with severe acute respiratory syndrome coronavirus 2 presenting with rash, one of the only publications to date to highlight mucosal signs of the infection. Droesch et al4 report a striking eruption of retiform purpura and acral fixed livedo racemosa in “Livedoid and Purpuric Skin Eruptions Associated With Coagulopathy in Severe COVID-19,” a potential cutaneous manifestation of systemic hypercoagulability in critically ill patients with COVID-19. A third article that achieved a high Altmetric score highlights the ongoing investigation into the association between diet and acne in adults,5 presenting the potential acnegenic role of Western diet, namely animal products and fat-rich and sugar-rich foods, in the NutriNet-Santé prospective cohort study. Not surprisingly, the top articles in terms of views were related to COVID-19.1-3 Other publications deserve attention covering a broad span of key topics for discussion and practice change among dermatologists. The safety and efficacy of a novel topical antiandrogen (clascoterone cream, 1%) for the treatment of acne9 is one of the first innovations in acne therapeutics in decades. A network meta-analysis on systemic immunomodulatory treatments for atopic dermatitis10 is an important first for the journal in what will likely be the future development of evidence for the specialty and will inform shared decision-making in the treatment of patients. Three articles11-13 addressed ongoing efforts to educate patients about the harms of indoor tanning. Pagoto and Geller12 thoughtfully discuss a cluster-randomized clinical trial reported by Brinker et al11 in which a face-aging mobile phone application is used as part of a skin cancer prevention behavioral intervention for middle-school students. The critical importance of this work is illuminated by the economic analysis by Gordon et al13 that models the potential health and economic impact of eliminating indoor tanning in Europe and North America, of which only one-third of the benefit would be achieved by prohibiting indoor tanning only by minors.
It is a journal priority to feature important research that informs the clinical practice of dermatologists. JAMA Dermatology also welcomed critical self-reflections on current events of this extraordinary year. The COVID-19 pandemic highlighted the reliance on the rapid dissemination of clinical information over social media, long before formal publications were available, including of the emerging concept of “COVID toes.”14 While the core patterns of mucocutaneous manifestations associated with COVID-19 continue to be reported worldwide through many platforms, journals and the peer review process must play an essential role to shape the rigorous science describing their prevalence, underlying pathophysiology, and significance.15 The pandemic also impacted the practice of dermatology, posing equal threat to the clinical operations and financial solvency for private practice and academic clinics alike16 and significant disruption of training programs. These disruptions included the redeployment of dermatologists across the country as well as opportunities to reconsider paradigm shifts in the clinical learning environment to a virtual space and the need to remediate for critical lost time for procedural learning. There were also important opportunities for dermatologists in the past year. Innovative methods of seeing patients using teledermatology in both the outpatient and inpatient settings were rapidly implemented shortly after the start of the pandemic, stemming in part due to regulatory changes by the US Centers for Medicare and Medicaid Services that predate the pandemic. As suggested for COVID-19–related skin disease research, it is now important that a quality improvement process is applied to these practice changes to determine the quality of this telehealth care, including to ensure that dermatology is reaching those patients who need us the most, and also to find the path forward for sustaining efficient, effective teledermatology as part of an integrated dermatology care model.
Last but not least, protests against structural racism were witnessed across the globe, with a call to action to take down institutionalized racism that has been present for more than 400 years in the US and even longer outside of the country. The importance of reflecting on its manifestations within dermatology as a specialty was indicated by a surge of submissions—mostly Viewpoints—on the topic. Several perspective pieces have already been published, including the important voices of dermatology trainees17 and a call to reconsider some of the highest awards in our specialty18 in 2020 and a vision for local and national antiracism efforts to improve diversity in dermatology19 in 2021. These and future manuscripts will hopefully prompt long-overdue discussions among dermatologists and identify avenues for future improvement.
I wish to close this year’s annual review by acknowledging this year of unparalleled demands—both personal and professional—that forced dermatologists to create space for stress, loss, grief, and gratitude alike. I personally extend gratitude to the entire editorial team, all of the authors and peer reviewers8 who contributed their time and expertise, and our readers for their collective support of the journal and its educational mission. The global upheaval in 2020 also presents an opportunity to pause and reflect on how dermatologists can move ahead into 2021 with intention and hope to safely care for patients, continue to learn, innovate, and thrive as a specialty.
Corresponding Author: Kanade Shinkai, MD, PhD, Department of Dermatology, University of California, San Francisco, 1701 Divisadero St, 3rd Floor, San Francisco, CA 94115 (firstname.lastname@example.org).
Published Online: March 24, 2021. doi:10.1001/jamadermatol.2021.0275
Conflict of Interest Disclosures: None reported.
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Shinkai K. JAMA Dermatology—The Year in Review, 2020. JAMA Dermatol. 2021;157(5):507–509. doi:10.1001/jamadermatol.2021.0275
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