Female representation in academic dermatology leadership
Today’s report also covers research into pregnancy outcomes in patients with chronic urticaria, payment differences between female and male dermatologists and more (1,331 words, 6.5 minutes)
The Women in Dermatology e-newsletter is presented with support from Galderma Canada
Good morning and welcome to this edition of the Women in Dermatology e-newsletter from Chronicle Companies. We’re pleased to have you join us. This biweekly bulletin will update you on new findings regarding dermatologic issues that affect women and the female dermatologists who care for them. We welcome your feedback and opinions, so let us know if you have any comments, observations or suggestions. You can email them to us at health@chronicle.org.
A study published in 2018 found that women outnumber men in dermatology training programs. Women have been the majority of dermatology trainees and the dermatology workforce since the mid-‘90s. However, despite representing most trainees, a gender gap persists in dermatology faculty and leadership positions.
A recent study published in the International Journal of Women’s Dermatology (Oct. 2022; 8(3):e045) examined the gaps in academic dermatology leadership to assess if any improvements in gender diversity were made from 2016 to 2021. To evaluate the representation of women in leadership positions, the researchers conducted a cross-sectional observational study of dermatology departments accredited by the Accreditation Council for Graduate Medical Education (ACGME) in August 2021. They identified 142 accredited dermatology residency programs, 58 dermatopathology fellowships, and 74 micrographic surgery and dermatologic oncology fellowships.
The study showed that women constitute 53.5% of dermatology residency program directors, 62.6% of associate program directors, and 58.3% of assistant program directors. Regarding fellowship program leadership, women represent 41.4% of dermatopathology program directors, 26% of micrographic surgery program directors and 76.3% of pediatric dermatology program directors. Noticeably, women are underrepresented as program chairs, accounting for 39% of chairs.
According to the authors, previous research shows that in 2016 women made up 48% of program directors, 23% of chairs, 26% of dermatologic surgery program directors, 34% of dermatopathology program directors, and 64% of pediatric dermatology program directors. The authors report that these results show that female leadership has increased in most positions since 2016. However, they add that women remain underrepresented, especially in dermatopathology leadership and dermatologic surgery fellowships.
Finally, the authors add the data from 2012 to 2014 demonstrates that diversity in academic dermatology faculty decreases noticeably with rising faculty rank. The current study supports those results, showing a majority of women in assistant and associate program director positions, with a minority of women as program chairs.
Bottom line
Women’s representation in academic dermatology leadership has increased in the last few years. However, there is a persistent disparity within dermatologic pathology, surgery, and Chair positions. Further research is needed to determine the leading causes of this disparity to recommend a solution.
Treatment patterns and outcomes in patients with chronic urticaria during pregnancy
An article published in the Journal of the European Academy of Dermatology and Venereology analyzed the treatment patterns of chronic urticaria (CU) patients before, during and after pregnancy, as well as pregnancy outcomes. The authors did not find a significant link between adverse pregnancy outcomes and CU treatments. They did find that most CU patients continue their treatments during pregnancy, especially second-generation antihistamines, which appear to be safe during pregnancy.
The researchers summarized the results of the PREG-CU study, an international, multicentre study conducted by the Urticaria Centers of Reference and Excellence (UCARE) network. For this study, CU patients who became pregnant completed a 47-item-questionnaire. The results showed that 60% of patients continued to use urticaria medication during pregnancy, including standard-dose second-generation H1-antihistamines, first-generation H1-antihistamines, high-dose second-generation H1-antihistamines, and omalizumab. Emergency referrals for CU and twin pregnancies were risk factors for premature birth.
Differences in practice patterns and payment for female and male dermatologists in Canada
A study published in the Journal of Cutaneous Medicine and Surgery compared dermatologists to other medical and surgical specialty groups in Ontario to identify a potential sex pay gap in dermatology. The researchers found that the pay gap between female and male dermatologists was small and that this small sex pay gap may be due to differences in practice patterns. In contrast, the sex pay gap was significant for other specialty groups.
The authors used population-based data to analyze physician billing and clinical activity from 1992 to 2018 in Ontario. A total of 22,389 physicians were included in the study, including 381 dermatologists. They also used multilevel regression models to assess differences in payments between women and men over time.
The impact of genital lichen sclerosus and lichen planus on quality of life
A study published in the International Journal of Women’s Dermatology reviewed the existing literature on the impact of genital lichen planus (LP) and lichen sclerosus (LS) on quality of life. The researchers found that women were more often symptomatic and more likely to report worse quality of life impact than men.
For this study, the authors performed a literature review using PubMed. They screened articles published between 1994 and 2020. The results showed that both women and men experience a reduced quality of life related to LP and LS, but they face the symptomatology very differently. According to the study, male patients are more likely to be asymptomatic than women, while female patients are more likely to report a higher incidence of depression and anxiety. The researchers note that photodynamic therapy can improve depressive symptoms that affect quality of life.
A clinical study of venereal and non-venereal genital dermatoses in women
A study published in the European Journal of Molecular & Clinical Medicine compared the prevalence of venereal genital dermatoses to the prevalence of non-venereal genital dermatoses in women. The researchers found that non-venereal vulvar dermatoses are more common than those caused by sexually transmitted diseases.
For this study, the authors examined data from 102 sexually active female patients from the Department of Dermatology, Venereology and Leprosy at the Santosh Medical College & Hospital in Delhi, India. All patients were adults and had vulvar dermatoses. Of the patients, 71 presented non-venereal dermatoses, while 31 presented venereal dermatoses. The most common non-venereal condition was lichen sclerosus et atrophicus (LESA), and the most common venereal infection was syphilis.
VIDEO: Clinical considerations for the management of psoriasis in women
Dr. Jenny Eileen Murase, a San Francisco-based dermatologist, discusses the clinical considerations for managing psoriasis in women, especially during pregnancy. Dr. Murase highlights the potential of immunosuppression of the fetus in patients treated with biological therapies.
Treating twenty-nail dystrophy with fractional carbon dioxide laser and topical therapy
A case study published in the International Medical Case Reports Journal reported a 27-year-old woman who presented with rough, ridged, spotted, thick nails with ragged cuticles. The patient noted that she had been experiencing nail damage on all her fingers and toes and intense itching for approximately 20 years. A fungal culture examination was negative, but a histopathological examination revealed nail lichen planus (LP). The woman was diagnosed with twenty-nail dystrophy (TND) caused by LP.
The physicians prescribed tacrolimus, urea, and salicylic acid topical therapy. She also received 10 mg of oral desloratadine once daily. Additionally, they treated her with a fractional carbon dioxide (CO2) laser. The laser procedures were well tolerated, and the patient’s nails improved after two sessions.
The woman did not report any pain during the procedure and had no adverse effects. While she showed further improvement at the five-week follow-up, additional sessions and a longer follow-up are necessary to determine the treatment’s long-term effects. However, the authors conclude that a combination of laser therapy with topical or oral medication could effectively treat TND.
“I have always enjoyed beauty in all forms, be it in a person, art, or landscape, and this was one of the main reasons that I chose aesthetic dermatology. It feels natural for me; I do not need to think much as the work I do comes to me naturally. Of course, practice only makes us better and I am always thinking of how to innovate and better myself, and I am happy to share this with my colleagues and the aesthetic dermatology community.”
— Dr. Chytra V. Anand, a Bangalore, India-based dermatologist, in an interview with the European Medical Journal (EMJ).
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