Pagetoid Bowen disease is a subtype of Bowen disease that accounts for 5% of Bowen disease. It is extremely rare for Bowen disease to appear on the nipple-areola complex, with only seven cases described in the previous literature. Of those seven cases, only one was of the pagetoid subtype. We report two cases of pagetoid Bowen disease on this location, one of them being the first case of pagetoid Bowen disease affecting the nipple reported to date. On this location, it is crucial to perform a meticulous differential diagnosis to rule out Paget disease, because of its contrasting therapeutic and prognostic implications. In order to do this, clinical and histopathological aspects must be considered. From a clinical point of view, previous literature has stated that nipple involvement can be a clue that points to Paget disease. However, one of our cases shows that this is not always true. Regarding histopathological analysis, a complete excision of the tumor might be necessary to observe clear features of Bowen disease, such as full-thickness atypia of the epidermis and intercellular bridges. An immunohistochemical panel comprising carcinoembryonic antigen, gross cystic disease fluid protein, epithelial membrane antigen, p63, CK34betaE12, periodic acid-Schiff, estrogen receptor, and progesterone receptor can be decisive in complicated cases.

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Background Patients increasingly search for dermatological information on YouTube; however, the successful presence of dermatologists on this platform is limited. Audience retention is essential to ensure success, as the YouTube algorithm considers it to rank videos. To the best of our knowledge, this is the first study in dermatology that focuses on audience retention on YouTube. It is based on a real-life dermatologist-led channel. Objectives To determine factors that influence audience retention on a dermatologist-led YouTube channel and provide insights that can help dermatologists create engaging content that becomes successful. Methods This research studies 137 videos. First, multiple linear regression was performed to test whether the specific video characteristics significantly predicted audience retention. Second, moments of peak retention (spikes) were identified, and their content was analysed to determine what was particularly interesting for viewers. As the videos were educational, spikes were classified into conceptual or procedural knowledge. Results The average audience retention was 41.69%. Longer video length and increasing number of days from release had a negative and significant effect on audience retention, with the effect of video length (β = -.6979; p < .0001) being strong and that of days from release being weak (β = -.023; p < .0001). Spikes were observed in 76 videos (55.47%), 68.15% of which were classified as procedural. Conclusions These data indicate that audience retention increases as video length decreases, and that viewers are essentially interested in practical information. Consequently, to increase audience retention, dermatologists should design succinct videos and deliver procedural knowledge that creates value for the public.

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Introduction: Dermatological information on social media is dominated by misleading and potentially harmful content from nonexperts. Literature suggests that, to address this issue, dermatologists should develop an online presence. However, successful presence of dermatologists on social media has been criticized for focusing on cosmetic dermatology and not representing the broad spectrum of the specialty. Objectives: The aim of this study was to systematically analyze which dermatological topics interest the public most, and to find out whether it is feasible for a dermatologist to become influential on social media while presenting all dermatological topics equally. Methods: The study was performed on an educational dermatology YouTube channel. The 101 videos published in a two-year period were divided into cosmetic (51 videos) and medical dermatology (50 videos). Student’s t-test was conducted to determine whether there were significant differences in views. Medical dermatology videos were then classified into three categories: Acne, facial dermatoses (excluding acne) and other dermatological diseases. A Kruskal-Wallis test was used to compare these three categories and cosmetic dermatology. Results: When comparing cosmetic and medical dermatology, no significant differences were found. When comparing the four categories, cosmetic dermatology and acne were found to generate significantly more views that other dermatological diseases. Conclusions: The public seems to be particularly interested in cosmetic dermatology and acne. This might make it challenging to become successful on social media while presenting a balanced portray of dermatology. However, focusing on popular topics can provide a real chance to be influential and protect vulnerable people from misinformation.

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