RESUMEN
OBJECTIVE: Clinicians report low confidence assessing cutaneous lupus erythematosus (CLE) lesions, especially for patients who identify as Black, Indigenous, and People of Color (BIPOC) who are historically excluded from educational materials. To address this, we created an online, interactive module teaching an approach to assessing CLE across skin tones and measured its impact on medical knowledge and confidence. METHODS: Our team created a module with case-based methods to introduce an approach to CLE, common mimicking rashes, and tips for photographing cutaneous lesions in BIPOC. Graduate medical trainees from five academic institutions completed the module. Using surveys and pre-post testing, we assessed changes in medical knowledge and clinical confidence along with learner satisfaction, comparing responses using Wilcoxon-signed rank tests and chi square analysis. We assessed the module's representation of light, medium, and dark skin tones with chi square analysis. RESULTS: The module represented light, medium, and dark skin tones (χ2 = 4.788, P = 0.091) among 102 images (77.5%, n = 79) were novel images from authors' personal libraries. Ninety-four participants completed the postmodule test and evaluation survey. Analyses revealed significant improvement in medical knowledge identifying serologic studies associated with subacute CLE (χ2 = 14.035, P < 0.001) and describing how to photograph rashes (χ2 = 38.211, P < 0.001). Participants reported improved confidence across all learning objectives after module completion (P < 0.001). CONCLUSION: This module is the first to introduce an approach to assessing CLE across skin tones, effectively increasing medical knowledge and confidence among graduate medical trainees.
RESUMEN
Contact dermatitis caused by the sap of plants from the Anacardiaceae family, including poison ivy, oak, and sumac, is among the most common skin conditions in the United States. The author reports the case of a 50-year-old man who presented with numerous vesicles and flaccid bullae on erythematous bases on his right volar wrist; smaller areas of vesiculation on his trunk and legs, several of which displayed a linear configuration; and erythema and swelling on and around his penis. The patient was diagnosed with Toxicodendron contact dermatitis caused by exposure to poison ivy. The author describes symptoms, assessment methods, and differential diagnoses, as well as provides a brief review of pathologic and etiologic factors, epidemiology, and treatment approaches for cutaneous dermatitis caused by contact with poison ivy and related plants. The author also provides an brief history, recommended therapies, and notable physical characteristics of poison ivy, with the final takeaway point-Clinicians should educate their patients on how to identify, and, thus, avoid, contact with these highly irritating plants.
RESUMEN
At the beginning of the 21st century, the prevalence of Cimex species (bedbugs) infestation in human dwellings rose exponentially, particularly in the United States. Although there is no evidence that bedbugs transmit diseases to their hosts, they are difficult to eradicate, making them a source of psychological and physical distress and a socioeconomic burden to society. Here, the author describes the case of an eight-year-old boy who presented with widespread, multiple, itchy, red papules surrounded by round patches of erythematous, edematous skin, and was eventually diagnosed with cimicosis (bedbug infestation). Other family members living with the boy showed no clinical signs of bedbug infestation, and the bites on the boy were not in the typical three-row linear configuration associated with bedbug bites-which made this case compelling. Clinical diagnostic characteristics, symptom management, and suggestions on infestation eradication are provided. Biological and epidemiological characteristics of bedbug infestation are also described. Currently, evidence of simple, safe, and effective means of bedbug eradication is lacking.