Faculty Bibliography

The field of contact dermatitis is constantly evolving. Trends in irritant and allergic contact dermatitis are shaped by the introduction of new chemicals, revival of older allergens, industrial practices, and consumer behaviors. This article discusses the most noteworthy trends within the field, organized by allergen category, with particular attention to newer and/or controversial allergens.

Atopic dermatitis (AD) and allergic contact dermatitis (ACD) are common T-cell-mediated inflammatory skin conditions that can share clinical presentations. The variable expression of ACD among patients with AD represents the shades of gray of the multifaceted relationship between the 2 disorders, where increased allergen permeation in compromised epidermal barriers augments antigen presentation and sensitization, with subsequent immune dysregulation. Further studies are needed to define the relationship and immunologic intersection points of these 2 conditions.

BACKGROUND:Medical photography enhances patient care, medical education, and research. Despite medical photography's widespread use, little is known about how dermatologists choose to implement photography in routine clinical practice, and how they approach issues of image storage, image security, and patient consent. OBJECTIVE:To characterize dermatologists' medical photography habits and opinions. METHODS:A 32-item anonymous, multiple-choice SurveyMonkey questionnaire about medical photography practices was emailed to program directors of the 117 United States (US) dermatology residency programs between May and August 2015, with a request to forward to faculty and affiliated dermatologists. Only board-certified dermatologists practicing in the US were eligible. The Institutional Review Board exempted our study from full review. RESULTS:Our survey included 153 board-certified dermatologists, primarily representing the northeast (43.1%) and identifying as academic dermatologists (75.5%). Medical photography is prevalent: 61.8% report everyday use and 21.7% photograph every patient. Those reporting rare use (3.3%) were, on average, 20 years older. Dermatologists most commonly use photography to mark biopsy sites (87.5%), track disease (82.9%), and for education/teaching (72.4%). Nearly half (46%) use smartphone cameras. Emailing and texting photographs with patients or colleagues are common (69.1%). Most dermatologists (75.7%) always request patient consent for photographs. Only 23.7% adhere to a photography protocol and 73.9% desire more training opportunities. CONCLUSION/CONCLUSIONS:Dermatologists value medical photography. While patterns of image acquisition, storage, and consent are noted, a variety of methods and preferences exist. Clearer photography guidelines and increased educational resources are likely to improve image quality, exchangeability, and confidentiality.

In adult obesity, low-grade systemic inflammation is considered an important step in the pathogenesis of insulin resistance (IR). The association between obesity and inflammation is less well established in adolescents. Here, we ascertain the importance of inflammation in IR among obese adolescents by utilizing either random forest (RF) classification or mediation analysis approaches. The inflammation balance score, composed of eight pro- and anti-inflammatory makers, as well as most of the individual inflammatory markers differed significantly between lean and overweight/obese. In contrast, adiponectin was the only individual marker selected as a predictor of IR by RF, and the balance score only revealed a medium-to-low importance score. Neither adiponectin nor the inflammation balance score was found to mediate the relationship between obesity and IR. These findings do not support the premise that low-grade systemic inflammation is a key for the expression of IR in the human. Prospective longitudinal studies should confirm these findings.