In This Issue March 2017 Volume 153, Number 3 JAMA Pages 245-364

Research Opinion Dermatitis Treatment in FLG and TSLP Genotypes 275 Viewpoint Atopic dermatitis (AD) is a common infl ammatory skin disorder among children. Thera- 259 Rethinking How We Select Dermatology Applicants—Turning peutic options include topical steroids and topical calcineurin inhibitors (TCIs). Loss of the Tide function (LOF) mutations in the FLG gene and genetic variants of the interleukin 7–like A Chen and K ShinKai cytokine thymic stromal lymphopoietin (TSLP) each demonstrate an association with AD 261 The Role of Rifampin in Leprosy: severity and persistence. In this cohort study, Chang et al demonstrate that children with Leprosy Through a New Lens 2 FLG LOF alleles were less likely to experience skin clearance and use steroids, while TSLP HB Allen and SL Moschella rs1898671 homozygotes were less likely to report TCI use. The number of LOF alleles or Editor's Note single-nucleotide polymorphisms were more important than the absolute presence of 262 Samuel L. Moschella, MD— An Exceptional Leader these variants. JK Robinson Editorial 269 Continuing jamanetworkcme.com HUMANITIES Notable Notes Staged Excision of Head and Neck Melanoma 282 262 A Study in Trypanosomiasis— Melanoma arising in chronically photodamaged skin, especially on the head and neck, is Carlos Chagas and His Unique Approach often characterized by poorly defi ned clinical margins and unpredictable occult exten- R Gupta and Coauthors sion. Excision with standard margins may be inadequate among these patients and is 303 Early Reports of “Sycosis” N Papavramidou and A Karpouzis associated with a higher risk of local recurrence. In this cohort study, Moyer et al dem- 308 John Tyndall’s Eff ect onstrate that staged excision with comprehensive permanent section margin control of on Dermatology these melanomas had low local recurrence rates, and patient satisfaction with reconstruc- PM Richey and SA Norton tive outcomes was high. 314 Harvey Cushing, MD— A Neurosurgeon’s Contributions Editorial 267 to Cutaneous J Kashkoush and Coauthors Photodynamic With Laser for SCC 289 318 Much More Than Movie Magic— Squamous cell carcinoma (SCC) is potentially metastatic and life threatening. Surgical ex- Dermatologic Applications of Medical cision remains the standard treatment, but microinvasive SCC is limited to the papillary Moulage dermis and may be diff erentiated from invasive SCC. Photodynamic therapy (PDT) with A Rabionet and N Patel 328 Hematoxylin in History— methyl aminolevulinate (MAL) is an innovative treatment that has been approved for ac- The Heritage of Histology tinic keratosis, basal cell carcinoma, and Bowen disease. In this randomized clinical trial, FR Ali and Coauthors Choi et al demonstrate that priming the treatment site with ablative fractional resurfacing prior to MAL-PDT was more effi cacious than conventional MAL-PDT for microinvasive SCC. 357 Correction

Skin Cancer in US Organ Transplant Recipients 296 The number of solid organ transplants performed in the United States is increasing, but the lifelong immunosuppression required to preserve graft function places organ trans- plant recipients (OTRs) at risk for skin cancer. Although this increased risk has been pre- viously reported, incidence data across a wide transplant population are lacking. In this population-based cohort study, Garrett et al demonstrate that the incidence rate for post- transplant skin cancer overall was 1437 per 100 000 person-years. Elevated risk was im- parted by increasing age, white race, male sex, and thoracic . Departments 252 Staff Listing Beach Umbrella vs High-SPF Sunscreen 304 275 CME Article Seeking shade is widely practiced to avoid direct sun exposure. People often assume that 359 Classifi ed Advertising their skin is fully protected as long as they are under the shade of an umbrella. Beach um- 361 Journal Advertiser Index brellas may have high UV protection factor ratings but do not protect skin from UV rays 362 Contact Information with angles of approach diff used by atmospheric particles or refl ected from the ground. 363 CME Questions In this randomized clinical trial, Ou-Yang et al demonstrate that umbrella shade alone may Instructions for Authors not provide suffi cient sun protection during extended exposure to UV rays. Neither um- www.jamanetwork.com/journals brella nor SPF 100 sunscreen alone completely prevented sunburn, highlighting the im- /jamadermatology/pages portance of combining sunscreen practices to optimize UV protection. /instructions-for-authors

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