IMPORTANCESkin cancer is the most common malignancy occurring after organ transplantation. Although previous research has reported an increased risk of skin cancer in solid organ transplant recipients (OTRs), no study has estimated the posttransplant population-based incidence in the United States. OBJECTIVE To determine the incidence and evaluate the risk factors for posttransplant skin cancer, including squamous cell carcinoma (SCC), melanoma (MM), and Merkel cell carcinoma (MCC) in a cohort of US OTRs receiving a primary organ transplant in 2003 or 2008. DESIGN, SETTING, AND PARTICIPANTS This multicenter retrospective cohort study examined 10 649 adult recipients of a primary transplant performed at 26 centers across the United States in the Transplant Skin Cancer Network during 1 of 2 calendar years (either 2003 or 2008) identified through the Organ Procurement and Transplantation Network (OPTN) database. Recipients of all organs except intestine were included, and the follow-up periods were 5 and 10 years.MAIN OUTCOMES AND MEASURES Incident skin cancer was determined through detailed medical record review. Data on predictors were obtained from the OPTN database. The incidence rates for posttransplant skin cancer overall and for SCC, MM, and MCC were calculated per 100 000 person-years. Potential risk factors for posttransplant skin cancer were tested using multivariate Cox regression analysis to yield adjusted hazard ratios (HR).RESULTS Overall, 10 649 organ transplant recipients (mean [SD] age, 51 [12] years; 3873 women [36%] and 6776 men [64%]) contributed 59 923 years of follow-up. The incidence rates for posttransplant skin cancer was 1437 per 100 000 person-years. Specific subtype rates for SCC, MM, and MCC were 812, 75, and 2 per 100 000 person-years, respectively. Statistically significant risk factors for posttransplant skin cancer included pretransplant skin cancer (

Increased ethnic diversity of physicians is associated with increased access to health care for underserved communities, better anticipation of patient needs, and acceleration of medical research. 1 Similarly, sex concordance between physicians and patients can improve communication and patient satisfaction. 2 Although sex and ethnic diversity of US physicians have both increased over the past several decades, not all clinical specialties have been impacted equally. To better characterize the dermatology field's evolution during this time period, we analyzed sex and ethnicity trends among dermatology residents and compared them with other specialties and medical school graduates over multiple decades. Methods | Thirty-six years of self-reported ethnicity and 19 years of self-reported sex composition data of American College of Graduate Medical Education (ACGME)-registered dermatology, internal medicine, emergency medicine, obstetrics/ gynecology, ophthalmology, general surgery, and orthopedic surgery residents were obtained from the National Graduate Medical Education Census. 3 Similar ethnic and sex composition data of graduating medical school classes were obtained from the Association of American Medical Colleges (AAMC) Data Book. 4 Ethnic groups were defined as white, Asian, African American, Hispanic, or other. Respondents could choose more than 1 category. The categories for sex were male or female. Changes in sex and ethnic compositions were analyzed across the periods for which data were available. Institutional review board approval was waived by the Beth Israel Deaconess Medical Center, because only publicly accessible data was used. Using Stata 14 statistical software (StataCorp), specialtyspecific logistic regression models were constructed to evaluate the proportion of residents across ethnicity and sex groups over time. Demographic differences over time between specialties were evaluated with the likelihood ratio test. To assess recent differences between specialties in sex and ethnic compositions, data from 2011 to 2013 were averaged and binomial proportions were compared using a 2-sample z test. All 2-sided P values <.05 were considered statistically significant.

Over the years, a number of studies have demonstrated an increase in gender and ethnic diversity among US physicians. Despite substantial progress in eliminating gender and racial inequities in the field of medicine, women and ethnic minorities are still underrepresented among medical faculty at academic institutions. This study aims to describe the trends in gender and ethnic diversity among Physical Medicine and Rehabilitation (PM&R) faculty through statistical analysis of data describing gender and ethnicity of full-time academic faculty gathered from the Association of American Medical Colleges Faculty Roster from 1994 to 2014. Proportions representing the percentages of females and ethnic minorities of a given faculty position in medical schools were compared across each of the other faculty ranks. Results showed that the average yearly percent increases in the proportion of female PM&R faculty in associate professor (0.68%) and full professor (0.54%) positions were greater than those in instructor (0.30%) and assistant professor (0.35%) positions. In contrast, the average yearly percent increase in the proportion of non-Caucasian PM&R faculty in full professor positions (0.19%) was less than those in instructor (0.84%), assistant (0.93%), and associate professor (0.89%) positions. Overall, trends among faculty exhibit a steady increase in gender and ethnic diversity, although promotion disparity continues to exist among specific academic positions for some groups. This study provides a current perspective on recent changes in diversity among faculty in PM&R and may prove useful when defining strategies to improve workforce diversity.

Diversity in the medical field has shown to be a beneficial factor in many aspects including research productivity and patient care. Understanding how the field of hand surgery has changed with regard to the diversity of its trainees may aid in providing more equitable and effective health care.

Pachydermodactyly (PDD) is a rare, benign condition characterized by swelling and thickening of the periarticular skin, most commonly at the proximal interphalangeal joints. Diagnosis is routinely made through correlation of clinical, histopathologic, and radiographic findings. Here, we report a case of PDD in a 25-year-old male, with emphasis on the clinical and histopathologic differential diagnosis and potential diagnostic pitfalls.

REFERENCES1. Dogan S, Atakan N. Multiple lentigines confined to psoriatic plaques induced by biologic agents in psoriasis therapy: a case and review of the literature. Cutan Ocul Toxicol. 2015;34: 262-264. 2. Gutierrez-Gonzalez E, Batalla A, de la Mano D. Multiple lentigines in areas of resolving psoriatic plaques after ustekinumab therapy.

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Rituximab, a chimeric monoclonal antibody against the CD20 B-cell antigen, is used to treat B-cell malignancies, rheumatoid arthritis, and autoimmune blistering diseases. Adverse events seen with rituximab include infusion reactions, infections, and late or early-onset neutropenia. Specifically, neutropenia is classified as grade III, an absolute neutrophil count (ANC) of 0.5-1.5 x 10 9 /L, or grade IV, an ANC less than 0.5 x 10 9 /L. In this case, we present a bullous pemphigoid (BP) patient with grade IV rituximabinduced neutropenia and safe re-treatment after two years.