U.S. teledermatology programs have increased in number and annual consultation volume. Academia is the most prevalent practice setting, and self-pay is the dominant accepted payment method. Innovative platforms and the provision of direct-to-patient care are changing the practice of teledermatology.

Psoriasis and psoriatic arthritis are associated with a significantly increased risk of cardiovascular risk factors and major adverse cardiovascular events (MACE). Active research is ongoing to elucidate this relationship between psoriatic diseases and cardiovascular comorbidities, as well as their shared pathogenic mechanisms. This review focuses on (1) the epidemiologic association between psoriasis and cardiovascular risk factors, (2) the epidemiologic association between psoriasis and MACE, (3) the epidemiologic association between psoriatic arthritis, cardiovascular risk factors, and MACE, and (4) proposed mechanisms for the contribution of psoriatic diseases to cardiovascular diseases. The proposed mechanisms for shared pathogenesis between psoriatic diseases and cardiovascular diseases are inflammation, insulin resistance, dyslipidemia, angiogenesis, oxidative stress, and endothelial dysfunction. There is complex interplay and overlap among these mechanisms and their contributions to shared pathogenesis. Future translational research is necessary to elucidate the link between psoriatic diseases and cardiovascular diseases. Such findings may be applied clinically to improve the lives of psoriasis patients.

Background: Many dermatologists have experienced significant changes to their practices due to the COVID-19 pandemic. Objective: It is vital to recognize how the pandemic has affected dermatology practices and identify methods to maximize clinical efficiency while maintaining patient safety. Methods: Private practice dermatologists in metropolitan areas were interviewed regarding various issues, including patient volume, types of visits or procedures being performed, screening for COVID-19, and operational modifications. Results: On average, there was a 65.2% decrease in patient volume during the initial surge of the COVID-19 outbreak, which was improved to a 15.5% decrease in July 2020. Despite this reduction in patient volume, the proportion of acute dermatologic issues, biopsies performed, and skin cancer concerns were all increased compared to pre-COVID. All of the dermatologists reported notable changes in regards to scheduling, staff, operations, and workplaces. Limitations: Interview participants were limited to metropolitan dermatologists mainly within the California region. Conclusion: Improving patient communication, implementing protocols to facilitate social distancing, and utilizing teledermatology were reported to be essential to optimizing efficiency and safety. As the COVID-19 pandemic continues to evolve, it is important that dermatologists identify specific ways to practice efficiently and effectively, while mitigating the spread of the virus.

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Kaposi sarcoma is a malignant vascular tumor consisting of multiple clinical subtypes and varying histopathologic patterns. We report a case of a 53-year-old African-American male with HIV/AIDS who presented multiple times with skin nodules, pain, and edema in his lower extremities, secondary to recurrent Kaposi sarcoma. The patient was treated with two courses of liposomal doxorubicin with improvement, but his symptoms recurred a third time. A biopsy specimen of one of the nodules showed prominent neoplastic cells of epithelioid morphology, some with clear-cell change, appearing to form rudimentary vessels in the superficial dermis. Further inspection of the deeper dermis revealed more classic findings of Kaposi sarcoma, including admixed spindle cells, poorly defined vessels, scattered apoptotic bodies, entrapped collagen bundles, and extravasated erythrocytes. Both the epithelioid and classic portions of the neoplasm stained positive for CD31 and human herpesvirus 8, supporting a diagnosis of Kaposi sarcoma. Prior to this case, the epithelioid variant of Kaposi sarcoma has been reported only twice in the literature. Recognizing this rare histopathologic variant of Kaposi sarcoma among its other histopathologic patterns may assist in accurate and expedient diagnosis of this well-recognized disease.

Leishmaniasis is a parasitic infection classified into Old World and New World species of sandfly vectors, classically Phlebotomus and Lutzomyia, respectively. 1 Old World leishmaniasis, seen in the Eastern hemisphere, typically manifests as cutaneous and visceral disease. New World leishmaniasis, arising in Latin and South America, results in cutaneous, mucocutaneous, and visceral disease. The incidence of

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