IMPORTANCESkin cancer is the most common malignancy occurring after organ transplantation. Although previous research has reported an increased risk of skin cancer in solid organ transplant recipients (OTRs), no study has estimated the posttransplant population-based incidence in the United States. OBJECTIVE To determine the incidence and evaluate the risk factors for posttransplant skin cancer, including squamous cell carcinoma (SCC), melanoma (MM), and Merkel cell carcinoma (MCC) in a cohort of US OTRs receiving a primary organ transplant in 2003 or 2008. DESIGN, SETTING, AND PARTICIPANTS This multicenter retrospective cohort study examined 10 649 adult recipients of a primary transplant performed at 26 centers across the United States in the Transplant Skin Cancer Network during 1 of 2 calendar years (either 2003 or 2008) identified through the Organ Procurement and Transplantation Network (OPTN) database. Recipients of all organs except intestine were included, and the follow-up periods were 5 and 10 years.MAIN OUTCOMES AND MEASURES Incident skin cancer was determined through detailed medical record review. Data on predictors were obtained from the OPTN database. The incidence rates for posttransplant skin cancer overall and for SCC, MM, and MCC were calculated per 100 000 person-years. Potential risk factors for posttransplant skin cancer were tested using multivariate Cox regression analysis to yield adjusted hazard ratios (HR).RESULTS Overall, 10 649 organ transplant recipients (mean [SD] age, 51 [12] years; 3873 women [36%] and 6776 men [64%]) contributed 59 923 years of follow-up. The incidence rates for posttransplant skin cancer was 1437 per 100 000 person-years. Specific subtype rates for SCC, MM, and MCC were 812, 75, and 2 per 100 000 person-years, respectively. Statistically significant risk factors for posttransplant skin cancer included pretransplant skin cancer (

Skin cancer risk is elevated in solid organ transplant recipients (OTRs). Studies of skin cancer awareness and sun-protection behaviors in pediatric transplant recipients (pOTRs) have not been reported. We measured effects over time of a multimodal educational intervention on knowledge of sun-protection practices and skin cancer risk, engagement in sun-protection behaviors, and self-efficacy and perceived barriers to photoprotection in pOTRs, their guardians, and a comparison group of children and guardians. Knowledge about skin cancer risk increased in pOTRs and their guardians (P ≤ .01) and frequency of pOTRs’ sun-protection behaviors reported by pOTRs and their guardians also improved.

Lesbian, gay, bisexual, and transgender (LGBT) individuals experience numerous health care disparities, some of which are specific to dermatology. For example, LGBT individuals tend to experience higher rates of sexually transmitted infections (eg, HIV, syphilis), and those with chronic skin diseases (eg, acne vulgaris, psoriasis) tend to cite a lower quality of life and higher rates of depression. Transgender and gender-diverse individuals also report having poor access to gender-affirming, minimally invasive procedures such as laser hair removal.Workforce diversity is essential to ensure a pipeline of physicians equipped through personal experiences and diverse learning environments to improve care for all populations. 1 However, LGBT physicians may be less likely to pursue competitive, high-income specialties 2 and face unique professional barriers 1 that may limit their visibility, including higher levels of mistreatment during medical training, fears of discrimination in residency applications and job placement, and discrimination from patients. This study used data from an American Academy of Dermatology (AAD) member satisfaction survey to assess LGBT identity and disclosure among US dermatologists.Methods | This survey study was deemed exempt by the University of Minnesota Institutional Review Board because it was a secondary analysis of previously collected, deidentified data. The study followed the American Association for Public Opinion Research (AAPOR) reporting guideline.We conducted a secondary analysis of the AAD 2020 Member Satisfaction Survey, a cross-sectional survey distributed in print and electronically to 10 060 member dermatologists between January 3 and January 31, 2020 (eAppendix in the Supplement). Survey respondents who lived outside the US, were retired or semiretired, or were adjunct or lifetime AAD members were excluded. Dermatologists were defined as LGBT if they self-identified as nonheterosexual (based on response options of "lesbian, gay, or homosexual," "bisexual," or "something else") or transgender. We compared the following: (1) demographic factors by LGBT identity using a Wilcoxon-type trend test or χ 2 tests, (2) calculations of LGBT identity prevalence among all participants and in sex-stratified analyses, and (3) disclosure of LGBT identities in personal or professional settings. To assess nonresponse bias, we compared demo-

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