Publications by authors named "Benjamin Stoff"

90 Publications

Image Consent and the Development of Image-Based Artificial Intelligence.

JAMA Dermatol 2022 05;158(5):589

Department of Dermatology, Department of Pathology, and Laboratory Medicine, Emory Center for Ethics, Emory University, Atlanta, Georgia.

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http://dx.doi.org/10.1001/jamadermatol.2022.0689DOI Listing
May 2022

Navigating internet-based misinformation with patients in the clinic.

J Am Acad Dermatol 2022 Mar 26. Epub 2022 Mar 26.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Emory Center for Ethics, Atlanta, Georgia. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2022.03.038DOI Listing
March 2022

Ethics of antibiotic stewardship in dermatology.

J Am Acad Dermatol 2022 Feb 23. Epub 2022 Feb 23.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Emory Center for Ethics, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jaad.2022.02.033DOI Listing
February 2022

Unpaid research fellowships among dermatology residency applicants.

J Am Acad Dermatol 2021 Dec 20. Epub 2021 Dec 20.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2021.12.027DOI Listing
December 2021

Free online dermatology course for medical trainees in Ethiopia: A pilot study.

JAAD Int 2022 Mar 30;6:20-26. Epub 2021 Nov 30.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.

Background: The effectiveness of virtual dermatology curricula in developing countries remains unclear despite an urgent need due to the pandemic and other factors.

Objective: To compare a virtual dermatology curriculum deployed in Gondar, Ethiopia with a traditional in-person course.

Methods: We developed a free, on-line dermatology course. 104 trainees from the University of Gondar, Ethiopia, completed the course. Pre- and post-course surveys measuring self-reported proficiency were administered. End-of-Course surveys were distributed to elicit feedback on the course. Performance on final examinations was compared to a historical control group, which did not participate in the course but received standard in-person training.

Results: Compared to historical controls ( = 236), the pilot cohort ( = 104) averaged over 4 points higher on the final exam ( < .0001). Most participants were satisfied with all aspects of the on-line course and desire at least a component of virtual learning in the future.

Limitations: This pilot study was performed at a single institution, and the participants were not randomized. Further studies in demographically diverse cohorts are needed to validate the results.

Conclusion: This dermatology curriculum is a free, innovative platform that can be adapted for dermatology trainees in resource-limited settings.
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http://dx.doi.org/10.1016/j.jdin.2021.10.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8645434PMC
March 2022

Dupilumab-induced erythema nodosum.

JAAD Case Rep 2022 Jan 17;19:41-43. Epub 2021 Nov 17.

Department of Dermatology, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jdcr.2021.11.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8669247PMC
January 2022

The ethics of using biased artificial intelligence programs in the clinic.

J Am Acad Dermatol 2021 Nov 24. Epub 2021 Nov 24.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Emory Center for Ethics, Atlanta, Georgia. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2021.11.031DOI Listing
November 2021

Ethics of professional courtesy in cosmetic dermatology.

J Am Acad Dermatol 2021 Nov 10. Epub 2021 Nov 10.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Emory Center for Ethics, Emory University School of Medicine, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jaad.2021.10.059DOI Listing
November 2021

American Medical Trainee Perspectives on Ethical Conflicts during a Short-Term Global Health Rotation in Ethiopia: A Qualitative Analysis of 30 Cases.

Am J Trop Med Hyg 2021 11 1;106(2):398-411. Epub 2021 Nov 1.

Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta Georgia.

There has been a significant increase in the number of students, residents, and fellows from high-income settings participating in short-term global health experiences (STGHEs) during their medical training. This analysis explores a series of ethical conflicts reported by medical residents and fellows from Emory University School of Medicine in the United States who participated in a 1-month global health rotation in Ethiopia. A constant comparative analysis was conducted using 30 consecutive reflective essays to identify emerging categories and themes of ethical conflicts experienced by the trainees. Ethical conflicts were internal; based in the presence of the visiting trainee and their personal interactions; or external, occurring due to witnessed events. Themes within internal conflicts include issues around professional identity and insufficient preparation for the rotation. External experiences were further stratified by the trainee's perception that Ethiopian colleagues agreed that the scenario represented an ethical conflict (congruent) or disagreed with the visiting trainee's perspective (incongruent). Examples of congruent themes included recognizing opportunities for collaboration and witnessing ethical conflicts that are similar to those experienced in the United States. Incongruent themes included utilization of existing resources, issues surrounding informed consent, and differing expectations of clinical outcomes. By acknowledging the frequency and roots of ethical conflicts experienced during STGHEs, sponsors may better prepare visiting trainees and reframe these conflicts as collaborative educational experiences that benefit both the visiting trainee and host providers.
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http://dx.doi.org/10.4269/ajtmh.21-0179DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8832937PMC
November 2021

Treatment of a perforating dermatosis with apremilast.

JAAD Case Rep 2021 Oct 8;16:155-157. Epub 2021 Sep 8.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jdcr.2021.08.031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8488176PMC
October 2021

Challenging ethical scenarios reported by American Society of Dermatopathology members: A qualitative analysis.

J Cutan Pathol 2022 02 13;49(2):191-196. Epub 2021 Oct 13.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA.

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http://dx.doi.org/10.1111/cup.14137DOI Listing
February 2022

Open notes and dermatopathology reports: A pathway to increasing patient autonomy, not confusion.

J Am Acad Dermatol 2022 05 6;86(5):1186-1187. Epub 2021 Sep 6.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Emory Center for Ethics, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jaad.2021.08.056DOI Listing
May 2022

Limiting pathology workup due to patient cost constraints: Upholding autonomy or committing negligence.

J Am Acad Dermatol 2022 01 11;86(1):256-257. Epub 2021 Aug 11.

Department of Dermatology, Emory University, Atlanta, Georgia; Emory Center for Ethics, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jaad.2021.08.008DOI Listing
January 2022

Costly savings: An ethical analysis of copay assistance programs in dermatology.

J Am Acad Dermatol 2021 12 21;85(6):1665-1666. Epub 2021 Apr 21.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Emory Center for Ethics, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jaad.2021.04.054DOI Listing
December 2021

The ethical use of biosimilars in dermatology.

J Am Acad Dermatol 2021 11 23;85(5):1369-1370. Epub 2021 Mar 23.

Department of Dermatology, Emory University, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jaad.2021.03.059DOI Listing
November 2021

Ethical and professionalism issues in dermatopathology: A cross-sectional survey of American Society of Dermatopathology Members.

J Cutan Pathol 2021 Jun 7;48(6):750-757. Epub 2021 Jan 7.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA.

Background: Data regarding ethical/professional issues affecting dermatopathologists are lacking despite their importance in establishing policy priorities and educational content for dermatopathology.

Methods: A 14-item cross-sectional survey about ethical/professional issues in dermatopathology was distributed over e-mail to members of the American Society of Dermatopathology from June to September 2019.

Results: Two hundred sixteen surveys were completed, with a response rate of 15.3%. Respondents ranked appropriate and fair utilization of healthcare resources (n = 83 or 38.6%) as the most often encountered ethical/professional issue. Conflict of interest was ranked as the most urgent or important ethical/professional issue (n = 83 or 39.3%). One hundred thirty-three (61.6%) respondents felt "somewhat" or "not at all" well equipped to handle ethical dilemmas in practice and 47 (22.8%) respondents identified a major or extreme burden (eg, have considered resigning/retiring) due to ethical challenges.

Conclusions: Areas of priority in ethics and professionalism issues can guide future policy and educational content in dermatopathology.
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http://dx.doi.org/10.1111/cup.13946DOI Listing
June 2021

The Effects of Paternalistic Policies During COVID-19 on Vulnerable Populations.

J Natl Med Assoc 2021 Jun 19;113(3):294-296. Epub 2021 Jan 19.

Emory University School of Medicine, Atlanta, GA, USA; Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA. Electronic address:

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http://dx.doi.org/10.1016/j.jnma.2020.11.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817438PMC
June 2021

Distinct compartmentalization of immune cells and mediators characterizes bullous pemphigoid disease.

Exp Dermatol 2020 12 28;29(12):1191-1198. Epub 2020 Oct 28.

Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA.

Bullous pemphigoid (BP) is an autoimmune blistering disease characterized by recruitment of leucocytes into skin and release of damaging enzymes, resulting in epidermal detachment and blister formation. To better understand the role of leukotriene B4 (LTB4) and other inflammatory factors in BP pathophysiology, we conducted microscopic and immunohistochemical analyses of preserved skin biopsy sections and conducted flow cytometry and ELISA analyses of matched blood and blister fluid from BP patients. Neutrophils predominated in BP blister fluid, which also contained monocytes/macrophages and T cells, but few to no eosinophils and B cells. In contrast, BP skin histology showed a different pattern, with abundant neutrophils but eosinophils being the predominant immune cell type. LTB4 pathway and neutrophil activation markers were prevalent in BP skin lesions and strongly associated with perivascular neutrophils. Blister fluid neutrophils, monocytes/macrophages and eosinophils all exhibited increased surface expression of leukotriene A4 hydrolase and neutrophil elastase (P = .002 for both). Blister fluid was also enriched in interleukins (IL)-1α, IL-1β, IL-8, IL-10, IL-18, monocyte colony-stimulating factor (M-CSF) and vascular endothelial growth factor (VEGF). Our findings suggest differential leucocyte recruitment from blood into dermis and from dermis into blister, which correlates with disease activity, and presents potential new treatment opportunities for BP.
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http://dx.doi.org/10.1111/exd.14209DOI Listing
December 2020

Pembrolizumab-induced lichen planus pemphigoides in a patient with metastatic Merkel cell carcinoma.

JAAD Case Rep 2020 Oct 19;6(10):1045-1047. Epub 2020 Sep 19.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jdcr.2020.03.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7509362PMC
October 2020

Single-blinded peer review: Pitfalls with potential bias.

J Am Acad Dermatol 2021 08 13;85(2):529-530. Epub 2020 Aug 13.

Emory University, Department of Dermatology, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jaad.2020.08.037DOI Listing
August 2021

Joint AAD-NPF Guidelines of care for the management and treatment of psoriasis with topical therapy and alternative medicine modalities for psoriasis severity measures.

J Am Acad Dermatol 2021 Feb 30;84(2):432-470. Epub 2020 Jul 30.

Dermatology Research and Education Foundation, Irvine, California.

Psoriasis is a chronic, inflammatory, multisystem disease that affects up to 3.2% of the United States population. This guideline addresses important clinical questions that arise in psoriasis management and care and provides recommendations based on the available evidence. The treatment of psoriasis with topical agents and with alternative medicine will be reviewed, emphasizing treatment recommendations and the role of dermatologists in monitoring and educating patients regarding benefits as well as risks that may be associated. This guideline will also address the severity assessment methods of psoriasis in adults.
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http://dx.doi.org/10.1016/j.jaad.2020.07.087DOI Listing
February 2021

S-100 protein and SOX10-positive breast carcinoma mimicking metastatic melanoma.

J Cutan Pathol 2020 Dec 14;47(12):1187-1191. Epub 2020 Sep 14.

Department of Dermatology, Emory University, Atlanta, Georgia, USA.

We present a case detailing a 70-year-old female with a history of triple-negative breast carcinoma (TNBC) of the left breast and contralateral stage pT2a nodular melanoma of the right upper arm who underwent sentinel lymph node biopsy of the right axilla demonstrating a metastatic epithelioid tumor that was strongly positive for S-100 protein and SOX10. The tumor cells were negative for HMB-45 and Melan-A and positive for CK7 and other breast markers (GCDFP15, mammaglobin, and GATA3). While concerning for metastatic melanoma based on clinical history and initial immunohistochemistry, tumor morphology and subsequent immunohistochemistry was supportive of metastatic breast adenocarcinoma. This case demonstrates a rare but perilous diagnostic pitfall of triple-negative breast carcinomas that strongly and diffusely express S-100 protein and SOX10 mimicking melanoma.
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http://dx.doi.org/10.1111/cup.13822DOI Listing
December 2020

Guiding principles for prioritization of limited in-person dermatology appointments during the COVID-19 pandemic.

J Am Acad Dermatol 2020 Oct 16;83(4):1228-1230. Epub 2020 Jul 16.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Veterans Affairs Health System, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jaad.2020.07.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7363593PMC
October 2020

Approach to VIPs during the COVID-19 pandemic and beyond.

J Am Acad Dermatol 2020 10 8;83(4):1231-1232. Epub 2020 Jul 8.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Emory Center for Ethics, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jaad.2020.07.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342046PMC
October 2020

Dermatology resident application photos: A trigger of implicit bias?

J Am Acad Dermatol 2021 04 28;84(4):1210-1211. Epub 2020 Apr 28.

Department of Dermatology, School of Medicine, Emory University, Atlanta, Georgia; Emory Center for Ethics, Emory University, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jaad.2020.04.115DOI Listing
April 2021

Dissecting drug pricing: Supply chain, market, and nonmarket trends impacting clinical dermatology.

J Am Acad Dermatol 2020 08 21;83(2):691-699. Epub 2020 Apr 21.

Division of Dermatology, Department of Medicine, J.H. Stroger, Jr, Hospital of Cook County, Chicago, Illinois; Department of Dermatology, Rush Medical College, Chicago, Illinois.

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http://dx.doi.org/10.1016/j.jaad.2020.04.063DOI Listing
August 2020

Applying the ethical principles of resource allocation to drugs in limited supply during a public health crisis.

J Am Acad Dermatol 2020 07 21;83(1):170-171. Epub 2020 Apr 21.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Emory Center for Ethics, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jaad.2020.04.078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194708PMC
July 2020

Ethical outpatient dermatology care during the coronavirus (COVID-19) pandemic.

J Am Acad Dermatol 2020 05 26;82(5):1272-1273. Epub 2020 Mar 26.

Department of Dermatology, University of Minnesota, Minneapolis, Minnesota. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2020.03.047DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195559PMC
May 2020

Educational video promotes durable knowledge about actinic keratoses in patients with field cancerization: a pseudorandomized, single-blind, controlled pilot study.

J Dermatolog Treat 2022 Feb 16;33(1):240-246. Epub 2020 Apr 16.

Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA.

Background: Diffuse actinic keratoses (AKs) have multiple treatment options. Patient understanding of treatment options may enhance patient autonomy, satisfaction, treatment adherence, and clinical outcomes. Delivering effective and consistent verbal counseling on AK treatment can be challenging.

Objective: We investigated the effect on patient knowledge of implementing, prior to standard counseling, a novel video decision aid explaining diffuse AK treatment options.

Methods & Materials: Participants were recruited from an academic Mohs surgery clinic and randomized to receive the video decision aid plus standard verbal counseling (video) or standard verbal counseling alone (control). Both groups completed baseline, immediate post-intervention, and 1-2 week delayed durable knowledge assessments. Secondary endpoints included participant satisfaction and verbal counseling duration.

Results: Thirty-one eligible patients (16 control, 15 video) participated. No baseline differences existed between the groups. The video group had significantly higher mean durable knowledge scores than the controls (video 10.00 ± 1.48, control 8.36 ± 1.69,  = .018). Patients were highly satisfied with the video. Verbal counseling duration did not significantly differ between groups.

Conclusion: A video decision aid for treatment of diffuse AKs improved durable patient knowledge.
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http://dx.doi.org/10.1080/09546634.2020.1747591DOI Listing
February 2022
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