Psoriasis is a chronic inflammatory skin condition with many associated co-morbidities, making timely diagnosis key in patient care. This study investigates racial, ethnic, gender, and insurance disparities in the time to diagnosis of psoriasis in adolescent patients. It is hypothesized that health disparities will lead to increased time to diagnosis in patients of color and those with no insurance or public insurance as compared to private insurance. Retrospective chart review of consecutive patients (n=83) diagnosed with psoriasis between 2012 and 2022 was conducted. The study found a considerable delay in time to diagnosis for pediatric patients, averaging 371.5 days. Females exhibited longer times to diagnosis than males. This prolonged period can lead to increased physical discomfort and a greater risk of developing complications. While no statistically significant differences were found based on race or ethnicity, patients with no insurance experienced significantly longer times to diagnosis compared to their insured counterparts. Patients with a previous misdiagnosis (i.e., eczema, fungal infection, atopic dermatitis) had significantly longer times to diagnosis as well. The fact that race and ethnicity did not significantly influence time to diagnosis suggests strides in reducing health disparities within medical institutions. However, the fact that social determinants of health significantly influenced time to diagnosis suggests that low socioeconomic status correlates to delayed diagnoses and poorer health outcomes, highlighting the need for more equitable access to timely medical care for uninsured populations. Overall, this study contributes valuable insights into health disparities affecting time to diagnosis of psoriasis in adolescent patients.

Background. Little is known about the impact of low- to moderate-penetrance genetic testing for skin cancer, which is a promising approach to skin cancer prevention. Methods. To address this deficit, we conducted an analysis comparing changes in skin cancer-related behaviors, distress, and beliefs measured at a baseline and twice after the receipt of skin cancer precision prevention materials containing MC1R risk feedback (higher or average risk) among 568 non-Hispanic White (NHW) and 463 Hispanic participants. Results. Regression analyses identified decreased average weekend hours in the sun (β = −0.25; 95% CI, −0.46–[−0.04]) and increased average skin cancer worry (β = 0.09; 95% CI, 0.01–0.18) among higher-risk NHW participants at the first but not second follow-up. On average, higher-risk NHW and Hispanic participants reported a persistent increased risk of developing skin cancer compared with similar others (β = 0.49; 95% CI, 0.33, 0.65; β = 0.42; 95% CI, 0.17, 0.67, respectively). Conclusions.MC1R genetic testing resulted in durable elevated skin cancer risk perceptions and shorter-term behavior changes among higher-risk individuals. Although higher-risk participants reported slight heightened worry at the first follow-up, the overall levels of skin cancer-related distress were low. The lack of sustained behavioral changes highlights the need for intervention reinforcement in precision prevention approaches to reduce cancer risk.

Neuropathic pain presenting as dermatologic symptoms can occur when damaged or dysfunctional nerves manifest with symptoms that resemble skin-related conditions. We present a case of a 62-year-old male who presented with burning pain and redness in the perineum and gluteal cleft. Initially, the patient was treated for dermatologic symptoms, resulting in the resolution of erythema. However, the pain persisted, prompting a neurologic workup. Despite the improvement of skin symptoms, the patient's pain persisted, prompting a neurological workup. Diagnostic imaging revealed significant degenerative changes in the lumbar spine, supporting a neuropathic etiology. This case highlights the importance of considering neurologic disorders in dermatologic practice, especially when cutaneous symptoms persist despite appropriate dermatological treatments.

This study aims to quantify the relationship between economic disadvantage and access to dermatological care in Florida in order to advocate for tailored healthcare policies. Identifying underserved geographic communities can guide policymakers in implementing strategies to enhance accessibility to care in these areas. Using data from the Centers for Medicare & Medicaid Services (CMS) and the US Census, this study analyzed dermatologist density across 920 Florida zip codes. Economic disadvantage was assessed using the distressed community index (DCI), a metric that stratifies zip codes into 5 levels of economic well-being. Statistical analyses, including the Kruskal-Wallis test, were conducted to assess disparities. Findings revealed significant differences in the number of providers by DCI quintile (p<.001) and urban/rural designation (p<.001). Lower deprivation areas were more likely to have providers, with 33.2% of the least deprived quintile having at least one provider compared to 11.8% in the most deprived quintile. Urban areas were more likely to have at least one provider (p<.001), with 36.6% of urban zip codes having providers versus 1.1% of rural ones. Zip codes with at least one provider had significantly higher total population (p<.001). These findings highlight the need for targeted interventions to address geographic disparities in the provision of dermatologic care, particularly in economically disadvantaged and rural areas of Florida. Considering the state’s high sun exposure rates and associated skin cancer risks, ensuring accessible dermatology services across all zip codes, regardless of socioeconomic status, is imperative for public health.