Design and Validation of a Handheld Optical Polarization Imager for Preoperative Delineation of Basal Cell Carcinoma.

Background: Accurate removal of basal cell carcinoma (BCC) is challenging due to the subtle contrast between cancerous and normal skin. A method aiding with preoperative delineation of BCC margins would be valuable. The aim of this study was to implement and clinically validate a novel handheld optical polarization imaging (OPI) device for rapid, noninvasive, in vivo assessment of skin cancer margins.

COVID-19: Perspectives From Frontline Critical Care Nurses in New York.

New York City quickly became the epicenter of coronavirus disease-2019 (COVID-19) in early March of 2020. While hospitals were aware of the potential of COVID-19, the volume of critically ill patients that flooded the hospitals in the New York City area was clearly not anticipated. Hospital staff worked quickly to create COVID-19-free areas, but were overcome with the volume of COVID-positive critically ill patients.

Approaches to Perineural, Lymphovascular, and Single-Cell Disease.

Background: Mohs micrographic surgeons should be adept in identifying and managing perineural invasion (PNI), lymphovascular invasion (LVI), and single-cell spread (SCS), features denoting high-risk behavior of basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC) and microcystic adnexal carcinoma (MAC).

Objective: The purpose of this article is to review the literature and guidelines regarding the diagnosis of PNI, LVI, and SCS in BCC, cSCC, and MAC and examine the role of advanced diagnostic studies, adjuvant therapy, and reconstructive techniques of these high-risk tumors.

Materials And Methods: We performed a literature search including the following terms: PNI, LVI, SCS, BCC, cSCC, keratinocyte carcinoma, MAC, sentinel lymph node biopsy, radiation, chemotherapy, and staging.

Health Technology Agency insights: informing modification of a qualitative benefit risk framework for Health Technology Reassessment of prescription medications.

Objectives: This study's intent was to determine if a qualitative benefit risk framework could be used or modified to further enable Health Technology Reassessment (HTR) of prescription medicine recommendations. The purpose of this research was to understand Canadian Health Technology Agency assessors past experiences and insights to inform any modifications to the Universal Methodology for Benefit-Risk Assessment (UMBRA) qualitative framework. The UMBRA framework consists of an eight-step process, used during the assessment phase, to aid in decision making and dissemination.

Patient satisfaction and physician productivity in shared medical appointments for vitiligo.

Background: The shared medical appointment (SMA) allows patients with a similar diagnosis to be simultaneously cared for and educated by 1 provider, which has had success in dermatology and other fields of specialty. The SMA provides a potential solution to improve patient access to dermatologists.

Objective: The purpose of this study was to implement the SMA for patients with vitiligo and compare it to traditional appointments with regard to patient satisfaction, time to appointment, number of new patients seen per month, and generated revenue.

DRUG DISINVESTMENT FRAMEWORKS: COMPONENTS, CHALLENGES, AND SOLUTIONS.

Objectives: Value assessments of marketed drug technologies have been developed through disinvestment frameworks. Components of these frameworks are varied and implementation challenges are prevalent. The objective of this systematic literature review was to describe disinvestment framework process components for drugs and to report on framework components, challenges, and solutions.

Avoiding Medical Errors in Cutaneous Site Identification: A Best Practices Review.

Background: Although the field of dermatology has a relatively low incidence of medical errors, dermatologic surgery is a major area where medical errors occur.

Objective: The purpose of this article is to catalog the many cutaneous site identification techniques used by practitioners and determine which techniques are most evidence based.

Materials And Methods: A comprehensive literature review of cutaneous surgical site identification techniques and medical errors in dermatology.

Dermatologic surgery on the chest wall in patients with a cardiac surgery history: a review of material that may be encountered intraoperatively, including potential complications and suggestions for proceeding safely.

Background: Thoracic surgical procedures and the use of cardiac devices such as pacemakers are becoming increasingly prevalent in the population. As such, dermatologists may have a greater likelihood of encountering previously implanted or abandoned surgical material in the course of dermatologic surgery on the chest wall. A basic understanding of the wire types and the tunneling paths utilized in such procedures is important in accurately anticipating the presence of these wires to effectively manage any chance encounters.

A Retrospective Study of Nail Squamous Cell Carcinoma at 2 Institutions.

Background: Squamous cell carcinoma (SCC) of the nail is infrequently reported in the medical literature and its causes are poorly understood. Studies have shown strong associations with immunosuppression, tobacco use, toxin/radiation exposure, and trauma. Common treatments include Mohs surgery and digital amputation.

Single-Cell Squamous Carcinoma: An Underreported High-Risk Variant.

Background: There is increasing interest in establishing diagnostic and treatment guidelines for high-risk squamous cell carcinoma (SCC). Single-cell SCC has been recognized as a high-risk subtype but continues to be a less commonly reported and more poorly understood variant.

Objective: To present the current literature on single-cell SCC.

To scoop or not to scoop: the diagnostic and therapeutic utility of the scoop-shave biopsy for pigmented lesions.

Background: Concern over transection of melanomas has inhibited many practitioners from using the scoop-shave for removal of pigmented lesions.

Objective: To assess the safety and efficacy of the scoop-shave for pigmented lesions.

Materials And Methods: The practitioner's clinical diagnosis, intent (sample or completely remove), and removal technique (excision, punch, shave biopsy, or scoop-shave) were recorded.

Dermatologic surgery and cosmetic procedures during pregnancy and the post-partum period.

Dermatologic surgery is changed in the pregnant and postpartum patient. The physiologic changes associated with pregnancy require attention to the timing of surgery as well as the positioning and technique to maximize the outcome for the patient. The surgeon must also remember the risks to the fetus or nursing newborn in planning any surgical procedure.

Ethical mentorship: the dilemma of success or failure.

Mentorship has enhanced many careers, and it can be important in both job satisfaction and enjoyment; however, mentorships are complex human relationships and, as such, can be successful or can fail to be successful. This contribution explores some of the factors that facilitate both the success or failure of ethical mentorship relationships in medicine.

Prospective evaluation of dermatologic surgery complications including patients on multiple antiplatelet and anticoagulant medications.

Background: Few prospective studies have evaluated the safety of dermatologic surgery.

Objective: We sought to determine rates of bleeding, infection, flap and graft necrosis, and dehiscence in outpatient dermatologic surgery, and to examine their relationship to type of repair, anatomic location of repair, antibiotic use, antiplatelet use, or anticoagulant use.

Methods: Patients presenting to University of Massachusetts Medical School Dermatology Clinic for surgery during a 15-month period were prospectively entered.