Faculty Bibliography

BACKGROUND:HPV is a prevalent sexually transmitted infection (STI) associated with malignancies and condyloma acuminata (CA), with significant healthcare costs. Despite vaccine availability, vaccination rates remain low, highlighting the need for effective interventions to increase uptake. OBJECTIVE:To improve HPV vaccination rates among eligible individuals at a safety-net dermatology STI clinic. METHODS:A multiphase quality improvement program aimed to improve HPV education and vaccination rates was implemented in a dermatology STI clinic. The cohort included 175 patients with CA between August 2019 and December 2022. HPV vaccine education and immunization rates were measured. RESULTS:While counseling/education rates were high, vaccination initiation rates remained low before the onset of in-office HPV vaccine. In-office HPV vaccine administration demonstrated a 175% increase in vaccine initiation (p < 0.01). LIMITATIONS/CONCLUSIONS:This study had a relatively small sample size and was conducted in an urban, safety-net hospital; results may not be generalizable to smaller or rural practices. CONCLUSION/CONCLUSIONS:This quality improvement initiative successfully increased HPV vaccination rates at a safety-net dermatology STI clinic, demonstrating that in-office, same day vaccination for HPV was critical for the success. Our study highlights an effective approach toward improving vaccination rates for HPV and is a model for vaccine delivery.

The surging rates of STIs necessitate medical practitioners in the appropriate specialties to focus on rapid recognition, treatment and prevention of these conditions. Through both pre- and post-exposure prophylaxis with doxycycline, dermatologists can provide up-to-date treatment in the field of venereology. Herein, we review the results of clinical trials in the available literature that investigate doxycycline prophylaxis in the prevention of bacterial STIs. A search was performed using the PubMED and Scopus databases which yielded six clinical trials for our review. Based on the results of these clinical trials, doxycycline prophylaxis offers significant reductions in bacterial STIs, specifically in men who have sex with men (MSM). Additional research is needed in other high-risk groups, including females. Moreover, additional research is needed to determine the effects of doxycycline prophylaxis on tetracycline resistance in STI-causing bacteria. As the utilization of doxycycline prophylaxis for STIs becomes more common, it is important that dermatologists become familiar with the data surrounding this prevention regimen and patient populations who may seek to know more about it. More research is needed to determine benefits in other subpopulations, antimicrobial resistance and cost effectiveness.

Penoscrotal skin diseases encompass an array of pathologies that present with unique clinical features. A patient-tailored approach to management is necessary. This article, part of a continuing medical education series, is dedicated to offering insights for managing penoscrotal dermatoses. The first article will provide an overview of normal variations, benign lesions, and malignant growths. We will then highlight up-to-date diagnostic and treatment protocols. In the second article, we will discuss inflammatory and infectious conditions, reviewing common diseases such as syphilis, human papilloma virus, and psoriasis, as well as rarer, difficult to treat diseases such as lichen sclerosus, lichen planus, and genital dyesthesias. Considering 70% of patients with genital skin diseases report that physicians lack awareness of these conditions,¹ this CME series will help practitioners identify penoscrotal diseases, expand differential diagnoses, and discuss appropriate and emerging therapies.