JMIR Dermatology

Chronic Facial Abscess Mimicking Cervicofacial Actinomyces From Dermal Filler Migration: Case Report

2026-02-03T16:30:09-05:00

Dermal fillers are commonly used for facial augmentation, but delayed complications such as granulomatous inflammation and filler migration can clinically resemble infectious processes. We present the case of a 56-year-old woman with a chronic, draining abscess on the right cheek that persisted for three years and was initially suspected to represent cervicofacial actinomycosis. Tissue cultures were negative, and histopathologic analysis following excisional biopsy revealed polymethyl methacrylate (PMMA) microspheres and hyaluronic acid surrounded by granulomatous inflammation and reactive lymphoid aggregates, consistent with a foreign body reaction to dermal filler. The patient experienced complete resolution after surgical excision. This case underscores the diagnostic challenges posed by delayed filler complications and highlights the importance of considering prior cosmetic procedures in patients with chronic facial abscesses.

Differences in Electronic Consultation Conversion Rates Between Advanced Practice Providers and Board-Certified Dermatologists

2026-01-30T16:00:14-05:00

Not required Not required Not required Not required Not required

Assessment of Quality and Utility of Patient-Taken Smartphone Photographs of Atopic Dermatitis: Clinical Survey Study

2026-01-27T17:00:13-05:00

Background: Atopic dermatitis (AD) has a relapsing and remitting nature and scheduled clinic visits only provide a snapshot of the skin condition at the moment. Objective: To investigate the quality of patient taken smartphone photographs of AD skin lesions and characterize patients using smartphone photographs as a tool to assist the physician to show disease activity in between consultations. Methods: Patients from two university outpatient clinics specialized in AD were surveyed. A questionnaire regarding digital readiness was completed and a previously taken skin lesion photograph on the patients’ own smartphone was evaluated. Results: Between February and September 2024 one hundred questionnaires were completed, around 60% from the capital region and 40% from the urban area, including 62 men and 38 women. The mean age of the recruited patients was 33.9 years (SD 19.9). About 78% of the patients used computer, laptop or tablets often or always, 86% corresponded with the healthcare system using technology e.g. via e-mail to the general practitioner or contact with hospitals via apps. More than 50% (n=52) strongly agreed or agreed to the statement that they would prefer a remote online visit with e.g. upload of skin lesion photographs over a routine physical in office visit. Almost 3 out of 4 patients had a photograph of their AD skin lesion on their smartphone, the majority (54%) with the sole intention of presenting it to a physician. The photographs were of good quality in 85% of the cases, and the majority (86%) of the smartphone photographs were assessed to be useful for diagnostic and clinical evaluation. Receiving topical monotherapy was significantly associated with increased risk of having captured a skin lesion smartphone photograph. Conclusions: Patients with AD followed in an outpatient clinic often capture a good quality photograph of their skin lesion prior to consultation with the intention of presenting it to the physician.

Association of Skin Cancer With Clinical Depression and Poor Mental Health Days: Cross-Sectional Analysis

2026-01-22T16:15:08-05:00

Background: Mental health is becoming increasingly recognized as an important part of overall health, especially for patients with cancer. However, the relationship between non-melanoma skin cancer and mental health has not been widely studied. Objective: The objective of this study was to examine the association between non-melanoma skin cancer diagnosis and two key mental health outcomes: clinical depression and the number of poor mental health days. Methods: This study utilized the 2023 Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative survey of adults in the United States, which included 312,317 participants. Non-melanoma skin cancer diagnosis, depression, and self-reported mental health days were analyzed. Logistic regression was used to evaluate the association between non-melanoma skin cancer and depression, while Poisson regression was used to model the number of poor mental health days, adjusting for age, sex, race and ethnicity, education, BMI, and income, and major comorbid conditions (other cancers, heart disease, lung disease, and kidney disease). Results: Individuals with non-melanoma skin cancer reported a lower overall rate of depression (19.19%) compared to those without non-melanoma skin cancer (21.50%, p<0.001) but reported more poor mental health days on average (4.54 vs 3.20 days, p<0.001). After adjustment, non-melanoma skin cancer diagnosis was not significantly associated with depression (aOR 1.01, 95% CI 0.98–1.05 and was associated with a slightly lower number of poor mental health days (aRR 0.94, 95% CI 0.91–0.97). Conclusions: Adults with non-melanoma skin cancer experienced meaningful mental health burden, and unadjusted analyses suggested greater day-to-day distress than among adults without non-melanoma skin cancer. However, these differences were reduced and no longer significant for depression after adjusting for sociodemographic factors and comorbid chronic illnesses. These findings support the need for mental health screenings and support services in dermatologic and oncologic care.

Patient Satisfaction, Side Effects, and Other Reactions Reported by Adult Men Prescribed Compounded Topical Finasteride via a National Telehealth Platform: Retrospective Analysis of Real-World Data

2026-01-22T16:00:14-05:00

Background: Topical minoxidil and oral finasteride are approved by the FDA for the treatment of male androgenetic alopecia (AGA). Concerns about adverse events related to the use of oral finasteride have led to some apprehension about the treatment. Topical finasteride, though not FDA-approved, has demonstrated efficacy and safety in a limited number of clinical trials and may be a promising alternative, such that compounding pharmacies and telehealth companies in the United States now offer access to topical finasteride for patients with AGA. Objective: The current real world, retrospective study is to our knowledge the largest to date on patient satisfaction and tolerability associated with novel combinations of topical finasteride and topical minoxidil for the treatment of male AGA. Methods: We conducted a retrospective analysis of patient data collected during routine clinical follow-up via the platform between April 1, 2021 and April 30, 2025 to assess the frequency of side effects and other possible medication reactions associated with the use of compounded, topical finasteride and minoxidil available via the Hims & Hers platform. Data were gathered from two sources: 1) a follow-up check-in sent to patients approximately 130 days following the initiation of treatment; 2) unprompted communications sent via in-app or web-based messaging from patients to their care team. Patient satisfaction with treatment, frequency of any side effect, frequency of specific side effects, need for a higher level of care, and treatment discontinuation due to a side effect were extracted from the data sources. Results: 638,629 male patients with AGA received a prescription for a compounded, topical finasteride and minoxidil product between April 1, 2021 and April 30, 2025. Of 151,352 (23.7%) who completed a follow-up check-in, 121,615 (80.4%) reported being satisfied with treatment and 4,034 (2.7%) reported experiencing a side effect. Of all 638,629 patients, 230 (0.04%) sent their care team a message (outside of check-ins) indicating a side effect or other possible medication reaction. No patients reported seeking a higher level of care or discontinuing treatment due to such an occurrence. Conclusions: Patients prescribed novel formulations of compounded, topical finasteride and minoxidil for the treatment of AGA via a national telehealth platform reported satisfaction with treatment and tolerated it well. Limitations of the study include a reliance on retrospective data and lack of control group that preclude causal inference. Future research should include RCTs to assess the efficacy, safety, and tolerability of topical finasteride.

Patient Perceptions of Climate Change Impacts on Atopic Dermatitis: Cross-Sectional Survey Study

2026-01-20T15:00:13-05:00

This cross-sectional survey study (63.5% response rate) characterized how patients with atopic dermatitis (AD) perceive and experience the effects of climate change on their AD. Most participants reported that environmental factors such as heat and air pollution worsened their AD and expressed a desire for climate-health education, yet few had discussed these concerns with their dermatologist. These findings reveal a gap in patient-centered dermatologic care and support the development of tools to integrate environmental health into atopic dermatitis management.

Leveraging AI Large Language Models for Writing Clinical Trial Proposals in Dermatology: Instrument Validation Study

2026-01-12T15:15:06-05:00

Background: Large language models (LLMs) are becoming increasingly popular in clinical trial design but have been underutilized in research proposal development. Objective: This study compares the performance of commonly used open access LLMs versus human proposal composition and review. Methods: Ten LLMs were prompted to write a research proposal. Six physicians and each of the LLMs assessed 11 blinded proposals for capabilities and limitations in accuracy and comprehensiveness. Results: Chat GPT o1 was rated the most accurate and LLaMA 3.1 the least accurate by human scorers. LLM scorers rated Chat GPT o1 and Deepseek R1 the most accurate. Chat GPT o1 was the most comprehensive and LLaMA 3.1 the least comprehensive by human and LLM scorers. LLMs performed poorly on scoring proposals, and on average rated proposals 1.9 points higher than humans for both accuracy and comprehensiveness. Conclusions: Paid versions of ChatGPT remain the highest quality and most versatile option of available LLMs. These tools cannot replace expert input but serve as powerful assistants, streamlining the development process and enhancing productivity.

Identifying Over- and Underfunded Diseases by Comparing National Institutes of Health Funding for Skin Disease Research With US Skin Disease Burden According to 2021 Global Burden of Disease Data: Cross-Sectional Analysis

2026-01-06T14:30:09-05:00

Background: Understanding the burden of various skin diseases can help guide funding allocation for skin disease research. In 2015, Hagstrom and colleagues conducted a cross-sectional study that found partial correlation between United States (US) skin disease burden according to the 2010 Global Burden of Disease (GBD) study and National Institutes of Health (NIH) funding from 2012-13. Objective: This study aims to re-investigate the relationship between US skin disease burden and NIH research funding allocation using the latest data from GBD 2021 and NIH funding data from fiscal years 2021-22. Methods: A cross-sectional analysis was conducted to compare the disability-adjusted life years for 15 skin conditions from GBD 2021 with NIH funding for these conditions from 2021-2022. Data was sourced from GBD Results and the NIH RePORT database Results: NIH funding for skin disease research and US skin disease burden according to GBD were partially correlated with several outliers. Malignant skin melanoma and pruritus were relatively overfunded, while psoriasis and urticaria were relatively underfunded. Conclusions: Disease burden is just one of the many important factors that must be considered when allocating resources including research funding to encourage research efforts that improve patient outcomes and positively impact public health.

Diagnostic Accuracy, Implementation Barriers, and Equity Implications of Teledermatology in Rural Skin Cancer: Scoping Review

2025-12-29T17:30:07-05:00

Background: Skin cancer is the most commonly diagnosed malignancy in the United States, with rural populations facing disproportionate delays in diagnosis due to geographic isolation, workforce shortages, and limited access to dermatologic care. These delays contribute to higher rates of late-stage diagnosis and poorer outcomes. Teledermatology has emerged as a promising solution to expand access to dermatologic evaluation and treatment in underserved settings. Objective: To evaluate the diagnostic performance, implementation challenges, and equity considerations of teledermatology in the context of rural skin cancer care, and to assess its potential to improve clinical outcomes in underserved populations. Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar to identify studies published between January 2015 and March 2025. Search terms included “teledermatology,” “skin cancer,” “rural health services,” “telemedicine,” “diagnostic accuracy,” and “health disparities.” Studies evaluating diagnostic metrics, time to diagnosis, patient satisfaction, and implementation barriers were included. Results: Nine key studies spanning various countries and healthcare settings were included. Diagnostic sensitivity ranged from 41.9% to 100%, and specificity from 46% to 90%, depending on modality and lesion type. Teledermatology consistently reduced time to diagnosis, in some cases by over 75%, and was associated with high patient satisfaction due to increased convenience and reduced travel. Key barriers included technological limitations, inconsistent imaging protocols, and reimbursement variability. Successful implementation was facilitated by standardized workflows, dermoscopy integration, and centralized platforms. Conclusions: Teledermatology is a viable and effective approach to addressing disparities in rural skin cancer care. It offers diagnostic accuracy comparable to face-to-face evaluations while reducing wait times and improving patient satisfaction. Overcoming technological and systemic barriers is critical to ensuring equitable, long-term integration of teledermatology in rural health systems.

Direct-to-Consumer Teledermatology for Male Androgenetic Alopecia: Narrative Review

2025-12-19T17:00:11-05:00

This narrative review examines the advantages and disadvantages of direct-to-consumer teledermatology for the treatment of male androgenetic alopecia, finding that this treatment modality improves access to care, ensures high adherence rates, and enhances patient satisfaction, while raising concerns about increased drug costs.