The impact of strong female leadership in dermatology
Today’s report also covers research into psoriasis and adverse pregnancy outcomes, systemic immunosuppressive treatment of vulvovaginal lichen planus, and more (1580 words, 7 minutes)
The Women in Dermatology e-newsletter is supported by an unrestricted grant from Galderma Canada.
Good morning and welcome to the Women in Dermatology e-newsletter from Chronicle Companies. We are pleased to have you join us. This bulletin will update you on new findings regarding dermatologic issues that affect women and the female dermatologists who care for them every two weeks. 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.
On April 29-30, 2022, the third biennial Women in Dermatology Leadership Conference, organized by the Canadian Dermatology Association took place in downtown Toronto. This was the CDA’s first in-person event since the beginning of the pandemic. The interactive meeting featured presentations from experts who covered themes ranging from how to manage work/life balance to avoid burnout to how to have an impact on patient communication and develop skills for leadership growth and mentorship.
Some of the overall learning objectives of this year’s conference included:
Recognizing how to develop and strengthen leadership competencies in oneself and others
Identifying how to establish successful mentorship relationships either as a mentor or mentee
Applying strategies for communicating and using leadership styles effectively
Gaining perspectives and advice on improving dermatology leadership in Canada
The morning began with a welcoming message from Dr. Ashley Sutherland, chair of the event and a dermatologist who was part of the organizing committee that included Drs. Sheila Au, Julia Carroll and Kerri Purdy. While this was an in-person event, Dr. Sutherland joined virtually from Dartmouth, N.S.
After Dr. Sutherland’s introduction, Dr. Mamta Gautam, a psychiatrist practicing in Ottawa, took to the podium for the first session of the day. Her presentation “Better: Self-awareness as the Key to Being a Resilient and Effective Leader” offered insights into effective leadership as well as her career journey.
After a brief networking break, Dr. Deborah Saltman, an Australian physician based in Philadelphia, led off the second session. She described communication styles and leadership for healthcare practitioners in her presentation “Seven Principles for Effective Leadership in Healthcare Environments.”
After a lunch break, the third session was a discussion panel moderated by Dr. Mamta Gautam. During the “Leadership Journey: A discussion with early, mid and late-career dermatologists” panel, Drs. Noelle Wong (Vancouver), Kerri Purdy (Halifax) and Catherine McCuaig (Montreal) shared their experiences as dermatologists who are in three different stages of their leadership journeys. They also described how to achieve a good work/life balance, dealing with complex patients and how dermatologists at the start of their careers can use their youth to their advantage.
Throughout the entire discussion, attendees were able to ask questions and provide insights about their career journeys.
The fourth and last session, “Leveraging Mentoring for Gender Equity” by author and professor W. Brad Johnson, Ph.D., provided insights into how men can contribute to gender equality and provide effective mentorship for women at the early stages of their careers.
Key Takeaways
At the end of the conference, Linda Jones, the Canadian Dermatology Association CEO, shared some key points that summarized the event. These key takeaways are meant to help women in dermatology looking to further advance their career, and also engage in effective leadership and mentorship.
Be open to technology. It is not going away.
Speak up and work on confidence because you are already confident.
Consider your opportunities for leadership positions, both formal and informal.
Be aware of your communication style and those with whom you are talking.
Mentorship brings many benefits for the mentor and the mentee.
Be open to the possibilities that are in front of you, it is okay not to know what’s coming next.
Step up, take a chance, reach out, and then do it again with courage, openness and support from your network.
Identifying predictors of systemic immunosuppressive treatment of vulvovaginal lichen planus
A study published in the Australasian Journal of Dermatology analyzed existing data to identify the clinical features that characterize women with vulvovaginal lichen planus (VLP) at risk of severe, resistant disease that will eventually require systemic treatment.
The researchers found that younger, non-white women with VLP who also present with vulvar pruritus may be at the highest risk of severe disease requiring systemic immunosuppressive treatment. They also suggest that these patients would benefit most from earlier initiation of systemic therapy.
For this study, the authors reviewed the charts of 122 adult women with VLP who were followed prospectively for 15 years by the same doctor in private dermatological practice in Australia between Jan. 1, 2004, and Oct. 1, 2021. The researchers also used univariable and multivariable binary logistical regression analyses to identify clinical variables that differentiated women who needed systemic VLP therapy from those who just needed topical corticosteroids.
An article published in the Journal of the American Academy of Dermatology studied the association between psoriasis and adverse pregnancy outcomes (APOs) and how this connection changes according to psoriasis severity. The researchers found a significant association between ectopic pregnancy (EP) and psoriasis.
For this nationwide register-based case-control study, the authors collected patient data from 1973 to 2017 in Denmark. In the cases included in the study, patients experienced APOs such as spontaneous abortion, EP, intrauterine fetal death, and stillbirth. Singleton live births were controls. According to the authors, EP was the only APO that was found to be statistically associated with psoriasis. Additionally, women with moderate-to-severe psoriasis had a higher odds ratio for EP and the total risk of EP was 2.48% higher for them compared with women without psoriasis.
Objective and automatic grading system of facial signs from selfie pictures of South African women
A recent article published in the journal Skin Research and Technology evaluated the ability of an automatic detection system to appropriately assess the severity of 15 facial signs and their changes related to age and sun-exposure habits based on smartphone selfie pictures of South African women. The researchers found that South African women have specific aging and sun-exposure facial signs compared to European or East Asian women. They also conclude that the results confirm sunavoidance and photo-protective measures to avoid long-term skin damage.
For this study, 306 South African women between 20 and 69 years of age were recruited. The women were separated into two groups according to their sun-exposures habits: sun-phobic (SP) and non-sun-phobic (NSP). Age changes on 15 facial signs were then measured by an artificial intelligence-based automatic grading system previously validated by dermatologists.
The researchers found that the scores for sagging and wrinkles/texture revealed substantial changes with age. They also found that the pigmentation cluster scores did not vary significantly with age, but the size of the pores on the cheek skin enlarged at a low pace. Finally, NSP women had considerably more wrinkles/texture and sagging at 60 years of age compared to SP women.
Primary cutaneous adenoid cystic carcinoma of the scalp
A case report, immunohistochemistry and review of the literature published in the journal Skin Health and Disease presented the case of a 70-year-old Thai woman with primary cutaneous adenoid cystic carcinoma (PCACC). The authors also described the diagnosis and treatment of some other Southeast Asian cases to understand this case better. They found that PCACC tends to be more common in women over 60 years of age and is often located on the head or neck.
According to the case report, the patient presented with a slow-growing, painless, solid to a cystic, skin-coloured tumour on her scalp. The lesion was surgically excised and histopathological exams confirmed the diagnosis of PCACC. The patient remained disease-free for 16 months after surgery and diagnosis. The authors concluded that this case highlights the importance of a meticulous inspection for PCACC diagnosis after initial surgery and pathological assessment of the lesion for proper diagnosis and treatment. It is also essential to keep in mind PCACC’s locally aggressive nature and tendency to recur due to perineural invasion.
Dr. Vivian Oputa, a medical practitioner and a specialist in aesthetic medicine, surgery and dermatology, talks about the disadvantages of skin bleaching and the side effects of this practice.
Urticarial vasculitis in a young woman with Graves hyperthyroidism
A case report published in the Canadian Medical Association Journal presented the case of a 29-year-old woman who showed up to the emergency department with dyspnea, palpitations, and a pruritic and painful rash that had developed over the previous five days. She experienced a mild fever, and both her heart and respiratory rates were above normal. A diffusely enlarged thyroid gland was observed when the patient swallowed, and she also had erythematous–violaceous plaques on her face, trunk and extremities. A skin biopsy from an abdominal lesion showed perivascular infiltrates with multiple neutrophils, nuclear dust, scattered eosinophils and erythrocyte extravasations, indicating leukocytoclastic vasculitis. The patient was then diagnosed with hypocomplementemic urticarial vasculitis associated with Graves hyperthyroidism. The patient’s skin lesions resolved after two weeks of treatment with methylprednisolone (40 mg/d), propylthiouracil (200 mg/d) and propranolol (30 mg/d). She had no recurrence of urticarial vasculitis in the three months after treatment.
“I think a tip for a great career is to remember: good enough is enough. I'm a perfectionist. I learned through time that it's a bad thing. You need to be comfortable with good enough. If you have drawbacks, that's okay. You're still running. It's a marathon; it's not a sprint.”
— Dr.Roni Dodiuk-Gad, an Israel-based dermatologist in an interview with CTech, an Israeli technology news site.
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