irinections D Fall 2016 ­ResidencyOfficial Publication of the Residents/Fellows Committee, American Academy of Keeping financially afloat during residency By Dean Monti

Resident lives are saturated with books, charts, and a considerable amount of study- ing. With boards and the rest of their careers looming ahead, there is obviously a lot of associated stress. One area of education that’s generally not covered in residency pro- grams, however, is debt. Directions recently reached out to residents about this topic, and received plenty of feedback regarding their concerns, fears, advice, and more. One resident we talked to, Jeffrey Kushner, DO — a PGY-3 at Saint Joseph Mercy Health System in Ann Arbor, Michigan — has been augmenting his studies with a strong inter- est in investment and personal finance. He has researched and read extensively on a variety of financial topics that dermatology residents face early in their careers, and has discovered some universal principals that all don’t realize that they’re lacking the skills 2016 discussed the staggering additional dermatology residents should be aware of. or knowledge to handle their debt until it expense of simply applying to dermatology He has subsequently lectured and given pre- becomes a reality. residency! sentations to his fellow residents on finance For most of us, having a growing moun- Fortunately, not everything is doom and and investment topics. He has no conflict of tain of debt is an anxiety-provoking issue, gloom. We as dermatologists are still well- interest — which is often a concern for those but it can lead some to take an “out of sight, compensated compared to our colleagues seeking advice. He just hopes to provide out of mind” approach. This is undoubt- in other specialties, so the ability to over- helpful, unbiased information as a fellow peer edly a surefire way to create an even big- come debt and carve out a strong financial to any resident with limited knowledge about ger problem from an already unfortunate future is certainly possible. debt and personal finance. situation. For those who try to tackle it For this issue of Directions — after solicit- head on, some of the most common fears ing feedback from residents — we encapsu- See FINANCIALLY AFLOAT on p. 3 include: Will I ever be able to pay the debt lated some of the most prevalent concerns off? Where and how do I start? How will and included them here, with responses from this affect my decisions about where to Dr. Kushner. practice, when to start a family, and when Insidethis issue to ultimately retire? DIR: Residents indicated to us that Today, the increasing debt is a pervasive issue through- 1 Keeping financially afloat in residency tuition and looming threat of decreasing out residency. reimbursements are clouding our financial Dr. Kushner: Debt is a highly com- future, and it’s only going to get worse. 4-5 Boards’ Fodders: Neonatal Ichthyosis & plicated issue. It affects many different Compounding the problem even further is Neonatal Infectious Dermatoses aspects of resident life both personally and our “late” capacity to earn money in life. professionally. The majority of , We usually don’t start making a significant Race for the Case however, do not receive the proper train- salary until our early- to mid-thirties, put- 6 ing on how to manage debt in a timely and ting us “behind the eight ball” compared effective manner. Since it is hardly ever dis- to our friends in engineering or business. 8 Message from the Chair cussed in dermatology training, residents Furthermore, a recent JAAD article from April “Embracing Change is the Key to Skincare Success”

The past decade has seen unprecedented changes in professional skincare. Increasing demand. Better results. And distribution that left the control of the . That’s why I founded ZO®. We have advanced skincare protocols based on my philosophy of skin health. And our zero-tolerance of product diversion keeps physicians in control. Over 7,000 physicians have already made the change. Experience the ZO® Difference.

DR. ZEIN OBAGI Dermatologist and ZO Medical Director

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ZO Skin Health, Inc. and Dr. Obagi have no business relationship with Obagi Medical Products, and Obagi Medical products does not sell or endorse using ZO products. FINANCIALLY AFLOAT from p. 1 DIR: Some residents said Dr. Kushner: Consider refi- that their financial situa- nancing your loans. Many of DIR: Many residents we talk- tion directly impacted their my peers believe that the 6.8 per- ed to expressed surprise and career direction. cent Stafford Loan received during concern when they realized medical school is our only option, their finances didn’t match Dr. Kushner: Keep in mind and we are obligated to keep that their lifestyle. your future finances. This rate. Some of you will be getting “Embracing Change is the remains a dilemma for many resi- loan forgiveness through a govern- Dr. Kushner: Live like a resi- dents. While financial considerations ment program which is excellent, dent. This is easier for some than did not dictate the field I ended up but for the majority of dermatology Jeffrey Kushner, DO, Key to Skincare Success” others, but it’s probably the most choosing, it encouraged me to learn residents, this isn’t the case, and is a PGY-3 at Saint important factor: Do not live above as much as I could about debt, you should refinance your loans! Joseph Mercy Health System in Ann Arbor, your means. Once out of residency investing, and finance in general Your offers will depend upon your Michigan. and making significant money for to make myself better prepared to salary to debt ratio, and whether you The past decade has seen unprecedented changes in the first time, gradually grow into handle the monetary aspect of medi- want a fixed or variable option. A professional skincare. Increasing demand. Better results. your attending salary. Or better yet, cal practice. The good news is that if common misconception is that refi- And distribution that left the control of the physician. never fully grow into your attending you live like a resident, you can take nancing your loans can only occur salary! If you have the discipline any job in any location and be suc- as an attending. This is a fallacy. That’s why I founded ZO®. We have advanced skincare to do this after residency gradua- cessful. A strong savings rate is the For instance, Darien Rowayton Bank offers refinancing rates to residents. protocols based on my philosophy of skin health. And tion, you can easily wipe out all of most important take-away point of your debt within five years, regard- They have even established a busi- our zero-tolerance of product diversion keeps physicians this article. However, achieving your less of how much you have. An financial goals is definitely impacted ness relationship with the AAD (for in control. arbitrary but good goal is to save by your salary and earning potential. those who missed their booth in at least 20 percent of your gross Private practice tends to pay more Washington D.C.). I have personally utilized them and subsequently cut Over 7,000 physicians have already made the change. income for savings, debt reduc- than academia; rural pays more than ® my interest rate in half. And more Experience the ZO Difference. tion, etc. For the majority of resi- urban. Your emphasis should always companies are joining the mix every dents, debt is inevitable. The thing be based on happiness, but if you day. I’d encourage you to apply with to avoid, if you can, is debt on top got a late start to your medical multiple lenders and choose the of debt. If debt is a concern, hold career or have higher than average best rate. Again, only apply if you will off whenever possible on burden- debt, you may want to consider the not get loan forgiveness. ing yourself with purchases and more lucrative position… at least lifestyle changes that will put you initially. DIR: Residents feel intimidat- DR. ZEIN OBAGI any deeper in debt. Many residents ed by debt because they lack want to have academic careers, or DIR: Another common dilem- Dermatologist and the expertise that they’re so to give back to their communities ma for residents is figur- ZO Medical Director used to exhibiting in their with volunteer work, but student ing out whether to refinance professional lives. debt makes some of those ambi- or stay in government pro- tions unrealistic. grams. See FINANCIALLY AFLOAT on p. 7

Financial information for medical students Do you have a story to tell about Many residents we spoke to cited The White Coat Investor (whitecoatinvestor.com), a site created and managed by James residency or a spe- cific item of inter- Dahle, MD, who is a financial writer and a practicing emergency physician just a few years out of residency, as a key source of DR. ZEIN OBAGI RESPONDS TO CHANGE est? Study tips, financial information for medical students. Directions asked Dr. Dahle about resident debt. work life balance, Created the Science Conceived the Ended relationship Founded ZO Skin Developed new Now Exclusively unique images, ® of Skin Health original Obagi with OMP Health, Inc. medical products Recommends ZO What is the average debt for dermatology residents? iconoclastic views? Nu-Derm® and protocols I’ve never seen it broken down by specialty, but the most reliable stats are published each year from We’re now accept- the AAMC. It’s basically a compilation of the exit survey every medical student takes when leaving med ing submissions 1981 1988 2006 2007 2012 school. The average debt of those who have debt is $183k for MDs, and closer to $225k for DOs. for 2017! Email [email protected] to submit your story zoskinhealth.com | 888.893.1375 In terms of finances, what are the most common fears and concerns? or get more info. The biggest fear is whether they’ll ever be able to pay off the debt. Interestingly, those who should be the most worried are usually the least worried. I’m always surprised that a large percentage of those over $450k in debt are going into poorly paying specialties.

Many medical students today get stuck trying to figure out whether to refinance or stay in government programs, and, if so, which one to choose. It’s a surprisingly complicated decision. The ZO® Difference Better Results | More Referrals | Patient Loyalty | Enhanced Revenue irinections www.aad.org/DIR Fall 2016 • p. 3 Desidency ZO Skin Health, Inc. and Dr. Obagi have no business relationship with Obagi Medical Products, and Obagi Medical products does not sell or endorse using ZO products. ­R boards’ fodder Neonatal Ichthyosis by Alyx Rosen, MD and Kate Oberlin, MD

Gene Additional Prognosis/ Disease Clinical Presentation Defect Manifestations Outcome Premature delivery; Survival rate Harlequin Thick membrane with deep cracks AR respiratory distress; ~50%; oral ichthyosis and fissures forming plate-like ABCA12 ear deformities; retinoids may help scales, ectropion, eclabium fluid imbalance prolong survival Congenital AR Generalized erythema and fine Heat intolerance; ichthyosiform TGM-1 No improvement scale; collodion membrane at birth; scarring alopecia; erythroderma (CIE) ALOX12B with age involves flexures; nail dystrophy rare ectropion ALOXE3

AR Thick, brown scale involving Lamellar ichthyosis Heat intolerance; No improvement TGM-1 flexural areas and trunk; eclabium, hypernatremia with age ABCA12 ectropion

Evolves into Epidermolytic Widespread blistering and Failure to thrive; AD verrucous hyperkeratosis erythema at birth; involves flexures, hypernatremia; K1/K10 hyperkeratotic (EHK); Bullous CIE palmoplantar keratoderma recurrent infections plaques

Ichthyosis vulgaris AD Generalized fine, adherent scale Atopic diathesis; Improves with age Filaggrin sparing flexures keratosis pilaris

XLR Corneal opacities; Brown “dirty” X-linked ichthyosis Generalized fine scale and Steroid cryptorchidism; scales sparing desquamation at birth sulfatase prolonged labor flexures

Trichorrhexis invaginata, ichthyosis Failure to thrive; Pruritus; Netherton AR linearis circumflexa, atopic infections; elevated IgE; eczematous syndrome SPINK5 dermatitis food plaques

AR Accumulation of Refsum Skin resembles ichthyosis vulgaris Retinitis pigmentosa; PEX7 phytanic acid; disease with mild scaling cerebellar ataxia PHYH deafness

Mental Sjögren-Larsson AR Generalized erythema and scale at Parafoveal glistening retardation, syndrome FALDH birth, then dark scales on trunk white dots on retina seizures and spastic paralysis Kate Oberlin, MD, Conradi- Severe ichthyosiform erythroderma Chondrodysplasia Follicular PGY-3, University of XLD Hünermann-Happle and scale following lines of punctata; cataracts; atrophoderma Miami, department EBP gene of dermatology & syndrome Blaschko deafness; alopecia and scarring cutaneous AD Keratitis, ichthyosis, deafness, Photophobia; Increased risk of KID syndrome GJB2 keratoderma leukonychia cutaneous SCC

AR Photosensitivity, ichthyosis, Photosensitivity Trichothiodystrophy Sulfur deficiency in hair; ERCC2 brittle hair “tiger tail”, intellectual decreases with (PIBIDS) diffuse alopecia ERCC3 impairment, decreased fertility, short age

Congenital hemidysplasia with Erythema XLR Ipsilateral organ aplasia; CHILD syndrome ichthyosiform erythroderma, limb fades into NSDHL stippled epiphyses defects hyperkeratosis

DDx “Collodion Baby”: Lamellar Ichthyosis, Congenital Ichthyosiform Erythroderma (CIE), Netherton syndrome, Harlequin Ich- Alyx Rosen, MD, thyosis, Self-healing collodion baby (SHCB), Trichothiodystrophy (PIBIDS), Sjögren-Larsson syndrome, Infantile Gaucher disease, PGY-4, University of Neutral lipid storage disease with ichthyosis, Hay-Wells syndrome, Conradi-Hünermann-Happle syndrome Miami, department References: of dermatology & 1. Bolognia, Jean, Joseph Jorizzo, and Julie Schaffer. “Chapter 57.”Dermatology. 3rd ed. Philadelphia: Elsevier Saunders, 2012. cutaneous surgery 837-870. Print. 2. Cohen, Bernard. “Chapter 2.” Pediatric Dermatology. 4th ed. Philadelphia: Elsevier Saunders, 2013. 25-39. Print. 3. Schachner, Lawrence, Ronald Hansen. “Chapter 8.” Pediatric Dermatology. 4th ed. Philadelphia: Elsevier Mosby, 2011. 567-643. Print. irinections D­Residency p. 4 • Fall 2016 boards’ fodder Neonatal Infectious Dermatoses by Alyx Rosen, MD, and Kate Oberlin, MD

Extracutaneous Double the Disease Clinical Presentation Work-Up Treatment Manifestations Boards’ Fodders Macules or papules on palms Maternal and online! IUGR, HSM, osteo- High dose penicillin G and soles, trunk, extremities; neonate serology; Syphilis chondritis, “snuffles” or to prevent late com- also erosions, bullae and pete- darkfield examina- In addition to this rhinitis plications chiae; mucous patches tion issue’s Boards’ Fodder, you can Gram stain or Diffuse red eruption with satellite Topical nystatin, download two new Oral thrush, paronych- KOH reveals Candidiasis red papules and pustules on the ciclopirox, imidazoles, Boards’ Fodder ia, systemic infection pseudohyphae or folds and scrotum PO/IV if septic budding yeast online exclusives from www.aad. Serologic testing Varies depending on timing of Chorioretinitis, hydro- Pyrimethamine with org/Directions. for antigen, PCR, Toxoplasmosis infection; non-specific, diffuse cephalus, deafness, Sulfadiazine and leu- or antibody (IgG, The latest online macules or papules, ecchymosis preterm birth, IUGR covorin IgM) Boards’ Fodders are Sound-alikes Cataracts, congenital Viral cultures of in Dermatology by “Blueberry muffin” macules due heart disease, deaf- pharynx, CSF, Neuroimaging; sup- Rubella to extramedullary hematopoiesis ness, HSM, micro- urine, conjunctiva, portive care Jeffrey Kushner, cephaly rubella antibody DO, and Kristen Whitney, DO; Generalized petechiae or pur- IUGR, deafness, HSM, plus Tropical Viral culture, PCR, Ganciclovir, valganci- CMV pura within 48 hours of birth, thrombocytopenia, Dermatology: antibody testing clovir, foscarnet “blueberry muffin” macules chorioretinitis Bacterial and Viral Infections by Vesicles and papules with rare Mineral oil prep Kristen Whitney, Pruritus, irritability, poor Scabies burrows on the palms, soles, demonstrating Permethrin cream DO. To view, down- feeding trunk and genitalia mite or eggs load, or print every Boards’ Fodder ever published, Thrush, widespread seborrheic Bacterial and viral Serology testing, Zidovudine; anti- HIV check out the dermatitis infections PCR retroviral archives at www.aad.org/ boardsfodder. Grouped vesicles on red base; Ocular and CNS Viral cultures, HSV Intravenous acyclovir diffuse erosions involvement, sepsis PCR, Tzanck prep

Cicatricial dermatomal lesions Ocular and CNS Antibody testing, Varicella-zoster immu- Varicella with hypoplasia (congenital); abnormalities PCR, Tzanck prep noglobulin; acyclovir generalized papules (neonatal)

Gram stain with Pustules, vesicles or bullae on Rarely complicated by Dicloxacillin or Impetigo Gram-positive an erythematous base in folds sepsis, osteomyelitis cephalexin for a neonatorum cocci in clusters and groin; second week of life and pneumonia 10-day course and neutrophils Staphylococcal Scarlatiniform eruption with Histology (frozen) β-lactamase-resistant Scalded Skin erythroderma in intertrigi- Irritability, fever, skin with granular layer antibiotics; decoloni- Syndrome nous sites; periorificial crust, tenderness, rhinorrhea cleavage; bacterial zation (SSSS) +Nikolsky sign, spares mucosa cultures

Abbreviations: HSM=hepatosplenomegaly; CMV=Cytomegalovirus; HSV=Herpes simplex virus; HIV=Human immunodefi- ciency virus; CNS=Central nervous system; IUGR=intrauterine growth restriction

DDx of “Blueberry muffin baby”: CMV, varicella, zoster, rubella, toxoplasmosis, langerhans cell histiocytosis, syphilis, leukemia cutis, neuroblastoma, parvovirus, hemolytic anemia, twin-twin transfusion, myelodysplasia, rhabdomyosarcoma, neonatal lupus

References: 1. Bolognia, Jean, Joseph Jorizzo, and Julie Schaffer. “Chapters 80-81.” Dermatology. 3rd ed. Philadelphia: Elsevier Saunders, 2012. Page 1321-1366. Print. 2. Cohen, Bernard. “Chapter 2.” Pediatric Dermatology. 4th ed. Philadelphia: Elsevier Saunders, 2013. 25-39. Print. 3. Schachner, Lawrence, Ronald Hansen. “Chapter 6.” Pediatric Dermatology. 4th ed. Philadelphia: Elsevier Mosby, 2011. 299- 373. Print. irinections www.aad.org/DIR Fall 2016 • p. 5 D­Residency RFTC Race for the Case: Fall 2016 Winner Profile: By Alina Goldenberg, MD, MAS Lauren Seline A 32-year-old African American male presented to the ER with gen- eralized fatigue, and over the previ- ous three months had a 25-pound weight loss along with headaches Alina Goldenberg, MD, and a rash on his back. The rash MAS, is a resident was previously diagnosed as shin- physician, department gles with unclear treatment and of dermatology at worsening progression. The physi- University of California, cal exam revealed five non-tender, San Diego. grouped and coalescing angular ulcers with central hemorrhagic and necrotic crust, and surround- ing localized mottled hyperpig- mentation. Size of the largest ulcer was 5cm x 5cm. His past medical history is non-contributory, and his social history is remarkable for prior 5. What does this condition have in incarceration. His occupation is in common with syphilis, sarcoid- construction, and he temporarily osis, TB, pulmonary embolus? resides in Arizona. Respond online with the cor- 1. What is the diagnosis and 3 rect answers at www.aad.org/ Lauren Seline, MD differentials? RaceForTheCase for the 2. Historical snippet: who first opportunity to win a Starbucks gift Lauren Seline, MD, is a described the lesions? card! If you win, we will also publish second year resident at 3. What previously off-market skin your mug (face), and if you have an test can be used for diagnosis? interesting story to tell residents, we the Medical College of 4. What are the risk factors for this might share it (see our current win- Wisconsin in Milwaukee. patient? ner profile to the right). Good luck! D­R She attended St. Olaf College in Northfield, Minnesota for under- Answers to Summer 2016 Race for the Case grad — majoring in biol- Summer 2016 RFTC was submit- ogy and chemistry before ted by Aman Sandhu, MD — a attending medical school resident physician at Loma Linda at the Medical College of University, dermatology. A 70-year-old Caucasian man Wisconsin. Lauren also with a history of melanoma present- completed her intern year at ed for his scheduled skin monitor- Aurora St. Luke’s Hospital ing evaluation. On physical exam, in Milwaukee. Her hobbies he was noted to have a diffused include traveling, biking, gray-blue discoloration of his skin and nails. He has been otherwise running, cross country ski- healthy and does not take medica- ing, cooking/baking, and tions, with the exception of a natural spending time with her fam- immune-boosting supplement. in the basement membrane and ily and friends. In addition, 1. Which over-the-counter supple- around eccrine glands. her husband, Darren, and ment is the patient likely taking? 4. What type of microscopy can she recently celebrated their Silver salts, consistent with a further support diagnosis? Silver diagnosis of argyria. second wedding anniversa- granules can be highlighted by 2. Which topical medication can ry! They love visiting nation- dark field microscopy. also cause this finding? Silver al parks together and have sulfadiazine (if on extensive sur- 5. What other heavy metal can been to Zion, Yellowstone, faces). cause a similar presentation if and Bryce Canyon since 3. What is the classic histopatho- administered parenterally? logic finding? Silver granules Gold, chyriasis. starting residency, and have D­R plans to visit many more! D­R irinections D­Residency p. 6 • Fall 2016 FINANCIALLY AFLOAT from p. 3 money than you do, so it absolutely makes sense to put in the time to Plan ahead An enhanced standard letter understand how financial decisions for boards of recommenda- Dr. Kushner: Learn about should be made. costs! finance! A great illusion that tion (SLOR) for While this article is not nearly dermatology was financial advisors would have you Aaron Secrest, MD, who recently enough space to fully review every developed to finished residency and is now a believe is that finance and investing aspect of debt, I highly suggest improve the resi- clinical instructor at the University are complicated. Thus, their busi- going to the website for “White Coat dency application of Utah, said: “My number one ness thrives when you trust them Investor” by visiting www.white process and better piece of advice is to plan for the to make all your financial decisions. coatinvestor.com (see page meet the needs of boards exam. It is $2,500, plus the dermatology The truth of the matter is that basic 3). It is the single best financial blog/ at least $500 for the flight/hotel community. A link finance is not challenging…it’s cer- website that I’ve found so far regard- to Tampa. I tell residents to plan to a PDF of the tainly easier than learning geno- ing all matters of personal finance, on $3,000 due in winter/spring of new SLOR can be derms or random Boards Fodder! including updated information on their third year. If you save $100/ accessed at www. The tough part is getting started. student loans and refinancing. month from the start of residen- aad.org/members/ Try and read at least one financial residents-fellows, Some final words of advice: do cy, you will have enough to cover book a year (or sections of books under the “for your own research, discuss every- everything when it is due. It is that are meaningful to you) or fol- thing with your significant other, medical students” ~$150/month if you wait until tab. low a specific financial blog that and get several opinions from your the beginning of second year to will get you going on the right track. peers before making any final deci- start saving for it.” Nobody cares more about your sions. D­R

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irinections www.aad.org/DIR Fall 2016 • p. 7 D­Residency Faranak Kanangar, MD Message fromtheChair dermpath rotationsandbecome Utilize your to answerthequestion. nize thephoto,youwillnotbeable visual field,andifyoudonotrecog- chromes enough.Dermatology is a tions. Icannotemphasizekoda- a resourceformorepracticeques- necessary,absolutely not was is but this purchased BoardVitals; I also from ourfaculty. For theboards, Review bySimaJain,andlectures Guide andComprehensive Board bank, Dermatology inReviewquestion the using directed studying, boards personally,boards, Ifocusedon to in-service examinations andthe Dermatology . Comingup Pediatric by Dr.and HurwitzClinical Rapini, Elston, include Othertextbooks books aspossible. and Andrewstext of theBolognia I focusedmainlyonreadingasmuch in yourfirstyear. Earlyoninresidency, sprint, anditisimportanttostartearly be anastutedermatologist. der ofyourcareer, youwillhaveto will comeandgobutfortheremain- learning dermatology. Theboards on doable. Itisimportanttofocus out residency,very test is then this studythrough- be. Ifyouconsistently need to not it reallydoes although quite anxiety-provoking formost, test is This than theboards! cuss message, whatbettertopictodis- certification exam.ForBoard this This pastweek, I sat forthe ABD This test is a marathon, not a This testisamarathon, newsletter.and theDirections in Residency Dermatology: IllustratedStudy Practical Dermatopathology Practical ZO SkinHealthInc.byZeinObagi,MD, Dermatopathology American Academy of Dermatology American Academy of Dermatology proudly supports the proudly supports by Dr. Dr. - next year. Happystudying! of youwhowillbetakingthistest examination, andbestoflucktoall one whojustcompletedtheboard every by congratulating conclude Residency through the AAD’s Directions in 60 BoardsFodder chartsoffered study,for the morethan including not worthit. career,your stage of this just is it and get to to worked veryhard have all obtaining boardcertification.You to sitfortheboardexaminationand the ABD,not beingable including from result inseriousrepercussions refuse. Use of these materials can your benefit,politely study aids,for residents, ifyouareofferedanysuch offer is: pieces ofadvicethatIwill important Dermatology.of the most One of Board the American of be inviolation may that questions and resources use study programs and residents lack ofavailableresources,some the exam, and with this associated stay tuned!Giventhehighanxiety residents, so questions for practice offer to platform a on rently working cur also to befunded.TheAADis continue will Review questionbank dents. HopefullytheDermatologyin tions availabletodermatologyresi- section ofthe exam. the scope for the dermatopathology familiarized andcomfortablewith On alighternote,I would like to There areplentyofgoodoptions ques- study of lack There isa do notthis.To thenew !

D ­R - - Senior Dir.,AADMembership AAD StaffLiaison: CindyKuhn, Director, CreativeandPublishing:LaraLowery Associate Director, Publishing:KatieDomanowski Senior GraphicDesigner:TheresaOloier Staff Editor:DaniellePiquette Managing Ed.,SpecialPublications: DeanMonti Xiaolong Zhou,MD Eric Wilkerson,MD Meredith Wagner, MD chair, Young PhysiciansCommittee Bethanee JeanSchlosser, MD,PhD, Khang Nguyen,MD Nicole Yar-Lute Lee,MD Nikita Lakdawala,MD Sarah BKoch, MD Dana LEllis,MD Macey Renault Delcambre,MD Kathleen M.Casamiquela,MD Shiver,Mallory MD,physicianreviewer 2018 Faranak Kamangar, MD,chair Residents /FellowsCommittee Fall 2016 American Academy of Dermatology Association P.O. Box 4014 Schaumburg, Illinois 60168-4014 D ­R ire esidency in ctio

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