Faculty Bibliography

Mucous membrane pemphigoid (MMP) is an autoimmune blistering disorder that can involve the esophagus, potentially leading to complications such as stricture or stenosis. Diagnosis of MMP is challenging owing to overlapping clinical features with other subepithelial blistering diseases and limitations of current diagnostic techniques. Although direct immunofluorescence (DIF) remains the gold standard, it requires fresh tissue samples, which are not always available, particularly in cases without active mucosal or cutaneous lesions. Complement fragment 4d (C4d) immunohistochemistry (IHC) on formalin-fixed tissue has demonstrated diagnostic utility in bullous pemphigoid but has been less explored in MMP. This case highlights that C4d IHC may serve as a useful ancillary test to support MMP diagnosis, especially for mucosal or esophageal biopsies received in formalin, offering a potential diagnostic pathway when fresh biopsy samples are unavailable.

INTRODUCTION/UNASSIGNED:Pseudofolliculitis barbae (PFB) is a chronic inflammatory condition of hair follicles characterized by inflamed papules and pustules, with increased risk in individuals with curly or coarse hair. While psychiatric comorbidities in acne are well studied, limited research exists on PFB's psychological impact. METHODS/UNASSIGNED:dataset, which includes EHR data from US adults since 2018. RESULTS/UNASSIGNED:= 0.15). DISCUSSION/UNASSIGNED:Our study demonstrated a significant association between PFB and mood disorders like depression or anxiety. Future studies should examine PFB severity and treatment efficacy on psychological outcomes.

BACKGROUND:Janus kinase (JAK) inhibitors represent promising therapies for dermatologic conditions, including psoriasis, hidradenitis suppurativa (HS), atopic dermatitis (AD), systemic lupus erythematosus (SLE), and vitiligo. There are little data available evaluating the composition of research cohorts for this emerging treatment modality. Adequate racial representation in clinical trials is essential. OBJECTIVE:To characterize the study populations of clinical trials for Janus kinase inhibitors for dermatologic indications. METHODS:Clinical trials were identified from January 2000 to March 2025 through PubMed using the following keywords: "Janus kinase inhibitor," "JAK inhibitor," "alopecia areata," "atopic dermatitis," "hidradenitis suppurativa," "systemic lupus erythematosus," "systemic sclerosis," "psoriasis," and "vitiligo." Additional trials were retrieved from ClinicalTrials.gov using the search term "JAK inhibitor." Each trial was reviewed for demographic data, including race and ethnicity. Additional variables collected included Fitzpatrick skin type and quality-of-life measures. The distribution of race among trial participants was compared to the current US population and the condition-specific prevalence data where available. RESULTS:Of 399 identified studies, 207 clinical trials were included in our analysis, including 57,112 study participants were analyzed. Among studies reporting race (57.5%), representation was predominantly White (75.1%), followed by Asian (13.2%), Black (6.6%), American Indian/Alaska Native (0.48%), Native Hawaiian (0.11%), and multiple races (0.43%). Underrepresentation was pronounced among Black participants in psoriasis (1.3%), SLE (1.0%), and vitiligo trials (5.1%), although higher in HS (27.9%). Representation in these trials significantly differed from the racial distribution of US patients with vitiligo (P=0.012) and AD (P=0.00088). White patients were overrepresented in vitiligo and AD trials (Pearson residual=1.06, 2.71), while Black patients were underrepresented in these trials (Pearson residual=-2.66, -2.14). Additionally, a minority of studies (28.98%) reported on QoL metrics, which are essential tools for measuring disease burden and impact on patients. CONCLUSION AND RELEVANCE/CONCLUSIONS:Reporting on racial data, Fitzpatrick skin type, and quality of life measures is lacking in clinical trials for Janus kinase inhibitors. These factors play a key role in addressing comorbidities and mitigating disease burden. These findings highlight a need for improved recruitment strategies targeting underrepresented populations in dermatologic clinical research. &nbsp.

The Patient-Oriented Eczema Measure (POEM) is a validated patient-reported outcome measure for atopic dermatitis (AD), though its use in routine pediatric dermatology practice remains underexplored. In this cross-sectional study of 297 pediatric patients with AD at a tertiary pediatric dermatology clinic, POEM scores were collected and compared with physician-rated investigator global assessment (IGA) and IGA × body surface area, as well as treatment selection. Older patients (> 12 years) had significantly higher mean POEM scores (17.5 vs. 10.4; p < 0.001) with no significant differences observed by race, ethnicity, or socioeconomic status; total POEM scores correlated strongly with IGA (r = 0.68) and moderately with IGA×BSA (r = 0.54), and higher severity scores were associated with more potent topical corticosteroids and systemic treatments (p < 0.001). POEM detected clinically relevant changes, aligned with physician-rated measures, and correlated with treatment intensity, underscoring its utility in both clinical practice and future predictive modeling applications.

INTRODUCTION/BACKGROUND:TikTok, a social media platform, is a tool for disseminating dermatological public health education. On TikTok, like other social media platforms, both board-certified dermatologists and non-medical providers ("influencers") provide dermatological advice, but how the quality of the advice compares between the two creator groups is unclear. OBJECTIVES/OBJECTIVE:This study sought to assess similarities and differences in the language used within content, user receptibility, and engagement and the utility of online education in understanding hair and scalp disorders. METHODS:A cross-sectional analysis of 97 TikTok videos from 2023 was performed to evaluate the content quality of videos made by dermatologists and influencers regarding three common hair and scalp disorders: seborrheic dermatitis, telogen effluvium, and traction alopecia. RESULTS:Dermatologists and influencers had similar user engagement, but 49% of dermatologists were more likely to recommend standard treatments compared to 27% of influencers; 46% of influencers were more likely to recommend alternative treatment options compared to 25% of dermatologists. An analysis of user comments to assess audience understanding indicated that the three disorders were often confused with at least 2-3 other similar hair and scalp conditions. CONCLUSIONS:This study highlights a need to clarify for patients the standard of care for common hair and scalp disorders. This study also identified a universal lack of messaging encouraging users to seek in-person medical attention for their dermatological concerns.

BACKGROUND/UNASSIGNED:Academic dermatologists manage a broad array of responsibilities, often extending beyond clinical duties to include education, research, mentorship, and administrative work. OBJECTIVE/UNASSIGNED:This study aimed to quantify the scope of paid and unpaid responsibilities among academic dermatologists in the United States and identify disparities based on gender, career stage, and geography. METHODS/UNASSIGNED:A cross-sectional survey of 63 board-certified academic dermatologists from 12 institutions collected data on demographics, workweek allocation, after-hours tasks, compensation, burnout, and resilience from January to May 2025. RESULTS/UNASSIGNED:Respondents reported spending 58.3% of their time on clinical care, 15.9% on administrative duties, 13.8% on education, and 11.9% on research. Nearly half received 11 to 50 daily patient messages via the clinical inbox, and over 80% took hospital call duties, with most receiving no extra compensation. Burnout affected 63.5% of respondents and was significantly more prevalent among women, early-career physicians, and those in the Mid-Atlantic and Northeast regions. Resilience scores were lower among women. Consulting opportunities, often associated with supplemental income and career advancement, were more common among male and senior physicians. Parental leave policies were inconsistently applied and poorly understood; nearly 20% of respondents had 8 or fewer weeks of paid parental leave. LIMITATIONS/UNASSIGNED:Study limitations include the relatively small sample size and overrepresentation of the Northeast region, potentially hindering generalizability. Additionally, no significant race-based differences were observed, which may be due to insufficient sample sizes within comparator groups. CONCLUSION/UNASSIGNED:These findings highlight the cumulative burden of undercompensated labor, inadequate institutional support, and gender disparities in workload and opportunity. Structural changes in compensation transparency, workload distribution, recognition of academic labor, and support for early-career and female physicians are essential to fostering sustainability and equity within academic dermatology.