P1901Melanoma cancer registry reporting practices of US dermatologists

Seema Kini, Emory University, Atlanta, GA, United States; Suephy Chen, MD, MS,Emory University, Atlanta, GA, United States; Todd Cartee, MD, Emory University,Atlanta, GA, United States

Melanoma (MM) is one of the most lethal cutaneous malignancies and the eighthmost common cancer in the United States. Underreporting and reporting delay arebelieved to be a significant source of inaccuracy in current estimates of MMincidence. Despite a legal mandate and established reporting procedures for newcases of MM to state cancer registries in all 50 states, many physicians remainunaware of this obligation. Dermatologists attending the Cutaneous OncologySymposium at the 2010 American Academy of Dermatology conference weresurveyed regarding characteristics of their clinical and MM-reporting practices. Chi-square analysis was used to compare categorical variables and multivariate logisticregression was used to develop a predictive model at the 0.10 significance level. Ofthe 424 dermatologists surveyed, 111 (26%) completed the survey. Seven subjectswere excluded as they practiced outside of the United States. The 104 subjectsincluded in the final dataset represented 30 US states, were mostly (64%) male, andhalf (51%) had practiced [20 years. Half (50%) did not believe/know they wereobligated to report new diagnoses of MM to their state cancer registry and 58 (56%)did not report/know of someone in their practice who reports MM to their statecancer registry. Dermatologists who diagnose fewer than than 10 newMMs over thepast year were more likely to be unaware of the reporting requirement (OR, 2.17;90% CI, 0.79-6.00) than thosewho diagnosemore than than 20 cases of MM per year.Similarly, dermatologists who do not evaluate their own histology (OR, 4.11; 90% CI,0.95-17.85) or do not send specimens to an out of state pathology lab (OR, 2.40; 90%CI, 0.95-6.08) had an increased odds of not reporting MM to a cancer registry. Thisstudy highlights a lack of awareness (‘‘knowledge gap’’) of the obligation to reportMM diagnoses to a central cancer registry and a paucity of actual reporting(‘‘practice gap’’) among diagnosing clinicians. Educational efforts may need to betargeted towards specific dermatology populations such as those who diagnosefewer than 10 MMs per year. Further studies incorporating a broader survey of agreater number of dermatologists are clearly warranted to investigate MM reportingpractices among dermatologists in the United States.

FEBRUARY

cial support: None identified.

Commer

P1902A survey of skin conditions and concerns in South Asian Americans:Results of a community-based survey

Sejal Shah, MD, St. Luke’s Roosevelt Hospital Center, New York, NY, UnitedStates; Aanand Geria, MD, Howard University Hospital, Washington, District ofColumbia, United States; Andrew Alexis, MD, MPH, St. Luke’s Roosevelt HospitalCenter, New York, NY, United States; Dhaval Bhanusali, MD, Stony Brook MedicalCenter, Coram, NY, United States; Rajiv Nijhawan, MD, St. Luke’s RooseveltHospital Center, New York, NY, United States

South Asians (SAs) represent a rapidly growing part of the US population, increasing188% from 1990 to 2000 (from 0.27% to 0.78%). Studies investigating the epidemi-ology of skin disorders in SA Americans are lacking. We conducted a community-based survey study to determine common skin conditions and concerns among thispopulation. Secondary endpoints were to assess skin cancer awareness, sunprotective behaviors, and bleaching cream use in this population. Surveys weredistributed to SA adults in the New York City area. One hundred ninety surveys werecompleted. More than half (54%) of responders were female and 46% were male.The five most common dermatologic diagnoses included: acne (37%), eczema(22%), fungal infection (11%), warts (8%), and moles (8%). The five most commonskin concerns included: dry skin (25%), hair loss (22%), uneven tone (21%), darkspots (18%), and acne (17%). Fifty-five percent of those surveyed were not sure ordid not believe that skin cancer occurs in people with darker skin. Although 64% ofresponders believed that skin cancer was related to sun exposure, 12% did not thinkthe two are related and 24% were unsure. Seventy-five percent of those surveyed‘‘sometimes,’’ ‘‘rarely,’’ or ‘‘never’’ practiced sun protective behaviors. The mostcommon protective technique usedwas sunscreen (43%) followed by seeking shade(28%). Furthermore, awareness about the relationship between skin cancer and sunexposure and skin cancer in darker skin was likelier in those living in the US for morethan 20 years (P ¼ .001 and .014, respectively). Most (91%) felt that ‘‘fair’’ or‘‘medium’’ skin was most attractive; only 4% found ‘‘dark’’ or ‘‘very dark’’ skinattractive. Twenty-one percent of respondents had used or were currently usingbleaching creams. Our results suggest that skin conditions and concerns in thispopulation are similar to those seen in other skin of color populations. In addition,beauty appears to be defined by fair skin, which may explain some of the commonskin concerns and the relatively high rate of bleaching cream use. Although themajority of those surveyed thought that skin cancerwas related to sun exposure, lessthan 50% believed that skin cancer could occur in darker skin and only one quarterregularly practiced sun protection. These findings highlight the need for moreeducation on sun protection and skin cancer in this population.

cial support: None identified.

Commer

2011

P1903Translation into Brazilian-Portuguese language, cross-cultural adaptation,and validation of a disease-specific quality of life questionnaire: Acne-specific quality of life questionnaire (Acne-QoL)

Cristhine Kamamoto, MD, Federal University of S~ao Paulo, S~ao Paulo, Brazil;Edileia Bagatin, MD, Federal University of S~ao Paulo, S~ao Paulo, Brazil; JaneTomimori, Federal University of S~ao Paulo, S~ao Paulo, Brazil; Karime Hassun, MD,Federal University of S~ao Paulo, S~ao Paulo, Brazil

Purposes: (1) To translate into Brazilian-Portuguese language and provide a cross-cultural adaptation of a disease-specific quality of life questionnaire, Acne-specificquality of life questionnaire (Acne-QoL) in patients with facial acne; (2) to correlatethe quality of life scores according Acne-QoL to demographic factors in patientswith facial acne; (3) to verify the validity of the Acne-QoL Brazilian-Portuguese (BP)version among patients with facial acne; and (4) to analyze the reliability of Acne-QoL BP version through the assessment of internal consistency and test-retestreproducibility.

Methods: Measurement properties were assessed through the following methods:(1) validity: by correlations between clinical factors and Acne-QoL scores, as well asthe correlation between Acne-QoL BP version domain scores and SF-36 domainscores (one-way analysis of variance, Pearson and Spearman correlation coefficients,and linear regression analysis); (2) internal consistency (Cronbach a cofficient); and(3) test-retest reproducibility (intraclass correlation coefficient and Wilcoxon test).

Results: A sample of 80 participants were classified in mild (33.8%), moderate(36.2%), and severe facial acne (30%) according to classification proposed by theAAD. The Acne-QoL mean score was 46.86 6 22.21 and mean domains score were12.436 7.19 (self-perception), 12.286 6.93 (role-social), 116 6.6 (role-emotional),and 11.166 5.11 (acne symptoms). The SF-36 domains varied from 66.47 and 93.72.Patients with young age, male gender, and shorter acne duration presentedsignificant higher Acne-QoL scores. The Acne-QoL BP version domain scores weresimilar among acne severity groups except for ‘‘role social’’ domain. The indepen-dent variables entered into linear regression model were: age and severity (self-perception domain and total score); age, gender and severity (role social domain),and age and duration (role emotional and sympton domains). Acne-QoL domainsdemonstrated correlations with themselves, overall score and ‘‘role social’’ and‘‘health mental’’ domains SF-36. Internal consistency (0.925-0.952) and test-retestreproducibility were considered statistically acceptable (0.768-0.836).

Conclusion: The Brazilian-Portuguese version of Acne-QoL is a reliable and validoutcomemeasure to be used in facial acne studies. It can also be proposed as a usefulinstrument to assess quality of life and treatment outcomes of patients with facialacne.

cial support: None identified.

Commer

P1904Occupational skin disorders: A health services analysis of workers’compensation cases, 2004-2008

Nita Kohli, MD, MPH, University of California Los Angeles, Division ofOccupational and Environmental Medicine, Los Angeles, CA, United States; PaulPapanek, MD, MPH, Kaiser Permanente Los Angeles Medical Center, Departmentof Occupational Health, Los Angeles, CA, United States; Philip Harber, MD, MPH,University of California Los Angeles, Division of Occupational and EnvironmentalMedicine, Los Angeles, CA, United States

Background: Skin disorders represent approximately 10% to 15% of total workplaceinjuries and are the most commonly reported category of occupational illnesses notresulting from acute or repetitive trauma (NIOSH). Contact dermatitis is reported toaccount for more than 90% of workers’ compensation claims for occupational skindisorders.

Purpose: This study characterizes occupational skin disorders, their relativefrequency, patterns by occupation, treatment length, and disability in a largeoccupational medicine multisite practice setting.

Methods: Data were abstracted from workers’ compensation cases treated at KaiserPermanente occupational health clinics throughout southern California.

Inclusion criteria: Dermatologic ICD-9 codes with dates of injury from January 1,2004 through December 31, 2008. The data were analyzed descriptively, summa-rizing the nature of visits; and the relationship between predictor variables, such aspersonal characteristics and job, with the dermatologic diagnoses was ascertainedusing chi-square and general linear model analysis.

Results: Occupational skin disorders accounted for 1% of all workers’ compensationcases seen in Kaiser’s southern California occupational health clinics. Among these,burns accounted for 65% of cases, followed by dermatitis (20%). Except in personalcare jobs, burns comprised the highest category of claims across all occupations,including office jobs (61%). More lost work days per case occurred for skininfections than for other skin disorders (4 days; P ¼ .035). There was a significantdifference between job types with regards to number of visits (P ¼ .017), length ofdisability (P¼.001), and interval to first visit (P¼.001). Workers in construction andproduction had themost visits (average 4) and disability days per case (average 9 and4 days, respectively). Interval to first visit was longer for personal care workers thanfor other occupations (56.2 days; P ¼.001), and for males versus females (27.1 daysvs 19.1 days; P ¼ .001).

Conclusion: Occupational skin disorders do not appear to occur as frequently asprevious literature reports have indicated. Contrary to the literature, the majority ofoccupational skin disorders reported in this large series were burns rather thandermatitis. Occupation matters, and plays a significant role in healthcare utilization,lost work time, and disability management. Dermatologists should consider these asimportant health outcomes.

cial support: None identified.

Commer

J AM ACAD DERMATOL AB81