previously published by our group [7]. As before, we utilized a wrist pain case with a melanoma moulage painted on the second digit of the SP's hand where it would be easily visible during an examination of the hands (Fig.1). Four non-Hispanic white (referred to as white) actors and 4 African American actors presented our case after a board-certified dermatologist (CH) reviewed the moulage for realism.During the SP training sessions, a dermatologist (CH) helped coach the SPs on how to answer questions about the clinical history and symptoms of the simulated melanoma. The SP was instructed not to mention the lesion unless the student noticed the moulage. It is only if the student mentions the simulated lesion that the SP would answer specific questions posed by the student. The SPs were to provide the following information if asked by the student: the lesion was noticed approximately 6-8 months prior, the lesion has been growing in size; the patient grew up in Florida with heavy sun exposure, had no prior history of skin cancer, experienced no symptoms of pain or bleeding, and noticed no other changes in any other nevi.
Psoriasis is a chronic inflammatory disorder effecting the skin and joints. Additionally, multiple comorbidities exist, including cardiovascular, metabolic, and psychiatric. The chronic nature of psoriasis is often frustrating for both patients and physicians alike. Many options for treatment exist, though successful disease management rests largely on patients through the application of topical corticosteroids, Vitamin D analogs, and calcineurin inhibitors, amongst others and the administration of systemic medications such as biologics and methotrexate. Phototherapy is another option that also requires active participation from the patient. Many barriers to effective self-management of psoriasis exist. Successful treatment requires the establishment of a strong doctor-patient relationship and patient empowerment in order to maximize adherence to a treatment regimen and improve outcomes. Improving patient adherence to treatment is necessary in effective self-management. Many tools exist to educate and empower patients, including online sources such as the National Psoriasis Foundation and online support group, Talk Psoriasis, amongst others. Effective self management is critical in decreasing the physical burden of psoriasis and mitigating its multiple physical, psychological, and social comorbidities, which include obesity, cardiovascular disease, alcohol dependence, depression, anxiety, and social anxiety.
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