Background: During the 2019 Coronavirus (COVID-19) pandemic, the Division of Dermatology, University of Ottawa, adapted pre-existing local healthcare infrastructures to provide increased provider-to-provider teledermatology services as well as integrated teledermatology into the dermatology residency training program. Objectives: (1) To assess the differences in utilization of provider-to-provider teledermatology services before and during the COVID-19 pandemic; and (2) to assess dermatology resident and faculty experiences with the integration of teledermatology into dermatology residency training at the University of Ottawa. Methods: We conducted a cross-sectional analysis comparing provider-to-provider teledermatology consults submitted to dermatologists from April 2019 to October 2019 pre-pandemic with the same period during the pandemic in 2020. Two different questionnaires were also disseminated to the dermatology residents and faculty at our institution inquiring about their perspectives on teledermatology, education, and practice. Results: The number of dermatologists completing consults, the number of providers submitting a case to Dermatology, and the number of consults initiated all increased during the pandemic period. Ninety-one percent of residents agreed that eConsults and teledermatology enhanced their residency education, enabled continuation of training during the pandemic, and that eConsult-based training should be incorporated into the curriculum. Ninety-six percent of staff incorporated a virtual dermatology practice model, and one-third used teledermatology with residents during the pandemic. Most staff felt there was value in providing virtual visits in some capacity during the pandemic. Conclusions: Our study confirms that the use of teledermatology services continues to increase accessibility during the pandemic. Teledermatology enhances the education and training of residents and will be incorporated into dermatology residency programs.
19 November 2021 in Journal of Cutaneous Medicine and Surgery
Background: Since its legalization in Canada, cannabis use has expanded to include commercially available topical formations. Several scientifically unsupported claims regarding the therapeutic efficacy of topical cannabis are also being made. Developing an understanding of the consumer uses of topical cannabis is important for clinicians to provide appropriate counseling and inform potential areas of therapeutic development. We are examining the prevalence, purpose of use, and sources of information regarding topical cannabis in the Canadian population, with a focus on dermatologic uses. Method: A cross-sectional, anonymous electronic, voluntary survey was developed to assess the use of topical cannabis amongst adults in Canada. Results: Cannabis was used topically at least once by 24.3% of respondents who started the survey. The commonest form of topical cannabis were creams (26.2%). The most common dermatologic conditions being treated with topical cannabis included atopic dermatitis (25%), acne (19%), and anti-aging (16%); for non-dermatologic conditions, common uses were for joint stiffness or tendonitis (30%) and headaches and migraines (27%). Topical cannabis was reported to be most effective for joint stiffness and tendonitis, general muscular soreness, headaches, eczema, pruritus, acne, and psoriasis. Most respondents obtained and received information about topical cannabis from dispensaries. Conclusion: Canadians use topical cannabis for a broad range of systemic and dermatologic purposes, most of which have limited evidence. Future clinical studies are required to elucidate the therapeutic efficacy and safety of topical cannabis. Dermatologists should screen their patients for topical cannabis use and be aware of the limited evidence of therapeutic potential.
The rapidly increasing skin cancer rates in Canada are alarming, with current data estimating that 1/3 of Canadians will be affected in their lifetime. Thus, deeper understanding of high-risk sun exposure behaviors is needed to help counter this trend. Only limited action has been taken by federal/provincial governments to reduce skin cancer incidence. A cross-sectional survey study was conducted in Manitoba, with frequency counts, means, and percentages used to encapsulate responses. Age- and gender-adjusted odds ratios were calculated using logistic regression analyses. Our study identified worrying inadequacies in sun protective behaviors and attitudes, with the threat of such high-risk behaviors amplified by a lack of skin cancer awareness. Alarming elements were noted in participants’ sun exposure history (>65% reported a history of sunburns, >50% previously used a tanning bed, and >75% recently tanned for pleasure), beliefs and attitudes (>50% believe that they look better/healthier with a tan, and >40% believe that having a base tan is protective against further sun damage), and sun protection efforts (sun protective clothing was used <60% of the time, sunscreen was used by <50%, and there was a lack of knowledge about sunscreen characteristics in ~30% of respondents), in addition to significant differences being established between demographic subgroups (based on gender, age, skin phototype, income, and education attained). This study provides worrisome insight onto the grim landscape of sun protective behaviors and attitudes in Manitoba, which will inevitably translate into higher skin cancer rates and should serve as a call to action to promote targeted public health messaging in this jurisdiction and beyond.
Background: Skin cancer prevention relies on effective sun safety practices. Previous studies have shown that LGBTQ+ individuals exhibit lower sunscreen use and higher tanning bed usage compared to their non-LGBTQ+ counterparts. This study is the first to assess skin cancer risk factors, sun-protective behaviors, and skin cancer concerns among LGBTQ+ individuals across Canada. Methods: A national survey study was conducted between July 2020 and March 2024 and included LGBTQ+ respondents aged ≥ 16 years who had completed the survey. Responses were summarized using frequency counts/percentages for categorical variables and means/standard deviations for continuous variables. Logistic regression models were used to calculate age- and gender-adjusted odds ratios for subgroup analyses. Results: Of the 700 LGBTQ+ participants included (59.3% women; median age 38 years), the majority had a Fitzpatrick skin phototype (FSP) I–III (76.4%). Concerningly, 60% reported >10 lifetime sunburns, 58% reported ≥1 blistering sunburn, 34% had used a tanning bed ≥1 time in their lifetime, and 69% reported having a tan in the last 12 months. Sunscreen was worn regularly by only half of the respondents, and half of the participants agreed or strongly agreed with “I look better and/or healthier with a tan”. Additional comparisons are presented based on gender, FSP, education, and income. Conclusion: The findings of this study highlight the need for public health campaigns tailored to the LGBTQ+ community, emphasizing culturally sensitive sun safety education, particularly for LGBTQ+ men, individuals with FSP IV–VI, and those with lower education levels, to help reduce future skin cancer risk.
12 October 2022 in Journal of Cutaneous Medicine and Surgery
Background: Dermatology for diverse skin types is a globally growing area of medicine, but the inclusion of skin of color dermatology has not yet been formally included across all Canadian undergraduate medical education curricula. There is also a paucity of representation of diverse skin types in most medical textbooks, research, and clinical trials. Objectives: The main objective was to develop a concise, Skin of Colour Dermatoses Self-Learning Module (SOCSLM) that could be implemented at an undergraduate medical education level. The secondary objective was to analyze participant responses to improve and add to learning module content. Methods: From March to May 2022, second-year medical students at the University of Ottawa completed pre- and post-SOCSLM questionnaires which were available in French and English through their online student learning portals. The pre-test consisted of five multiple choice questions relating to images of dermatoses seen in diverse skin types. The post-test repeated the same five questions, rearranged, with an additional five new ones, and responses were analyzed. Results: Twenty-five participants completed the surveys, and twenty responses were included. Percent correct answers increased between pre- and post-test, 51% vs 87%. In the post-test, questions repeated from the pre-test had a mean score of 95% while the new post-test questions had a mean score of 80%. Interest in dermatology did not have an impact on correct response rates. Conclusions: Skin of color dermatology self-learning modules may be an effective way to integrate skin of color dermatology into undergraduate medical curricula.