Fibroelastolytic papulosis

Fibroelastolytic papulosis (FEP) is an extremely rare condition that has been documented in both women and men, all older than 40 years at the time of presentation. Histology is characterized by normal, decreased, or absent elastic fibers in the papillary dermis sometimes accompanied by a thickening of collagen fibers. The pathogenesis of FEP is unknown. However, it is believed that FEP is related to intrinsic aging. Few clinical case are presented and discussed and based on the clinical and histologic overlap in these and previous cases designated as PXE-PDE and WFPN, we believe these diseases are best described under the rubric of FEP

The Skin Cancer Objective Structured Clinical Examination (SCOSCE): A multi-institutional collaboration to develop and validate a clinical skills assessment for melanoma

BACKGROUND: Assessing medical students on core skills related to melanoma detection is challenging in the absence of a well-developed instrument. OBJECTIVE: We sought to develop an objective structured clinical examination for the detection and evaluation of melanoma among medical students. METHODS: This was a prospective cohort analysis of student and objective rater agreement on performance of clinical skills and assessment of differences in performance across 3 schools. RESULTS: Kappa coefficients indicated excellent agreement for 3 of 5 core skills including commenting on the presence of the moulage (k = 0.87, 95% confidence interval 0.77-0.96), obtaining a history for the moulage (k = 0.84, 95% confidence interval 0.74-0.94), and making a clinical impression (k = 0.80, 95% confidence interval 0.68-0.92). There were no differences in performance across schools with respect to 3 of 5 core skills: commenting on the presence of the moulage (P = .15), initiating a history (P = .53), and managing the suspicious lesion (P value range .07-.17). Overall, 54.2% and 44.7% of students commented on the presence of the moulage and achieved maximum performance of core skills, respectively, with no difference in performance across schools. LIMITATIONS: Limitations include overall sample size of students and schools. CONCLUSION: The Skin Cancer Objective Structured Clinical Examination represents a potentially important instrument to measure students\u27 performance on the optimal step-by-step evaluation of a melanoma