In the United States, orthopaedic surgeons have a legal obligation to obtain informed consent from patients before performing surgery; it is a process that includes a signed written document.There are specific legal requirements that vary somewhat by state but generally include disclosure and documentation of the diagnosis, an explanation of the recommended procedure, a conversation about the risks and benefits of the procedure, and a discussion about alternative treatments.Inadequate disclosure of risks and alternatives is associated with increased indemnity risk.Studies have shown that many consent processes and forms are suboptimal.

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Effective leadership is imperative for dermatologists and clinically has been shown to improve team efficacy, patient outcomes, and staff engagement, as well as reduce physician burnout and medical errors. Dermatologists are expected to exercise leadership in a variety of contexts during their professional careers, but despite the demonstrated benefit of effective leadership on improving clinical outcomes and reducing burnout, there is a lack of formal leadership training in residency programs, especially in the field of dermatology. The purpose of this review is to elucidate the current understanding of effective leadership for dermatologists, with a focus on leadership models and select strategies that dermatologists may implement in their daily practice to become more efficacious leaders. This review also seeks to provide a summary of existing opportunities for leadership in the field of dermatology. A narrative review was performed in 2022 examining leadership models as determined by the top results in PubMed with search term "Leadership Models". These models were then related to the field of dermatology. In addition, existing leadership opportunities, as determined through PubMed and Google searches, were reviewed and summarized. There are several medical and non-medical leadership models that can be applied to the field of dermatology. There are many opportunities to gain leadership experience for dermatologists and dermatologists in training; however, there is still a demonstrated need for more opportunities. Through the application of basic leadership principles, dermatologists will experience improved satisfaction and enhanced outcomes.

Immunohistochemical staining can be of great utility in differentiating various cutaneous spindle cell neoplasms, particularly when the histomorphologic appearance of the lesions is inconclusive. Nuclear staining for ETS-related gene (ERG), a highly sensitive endothelial cell marker, has seldom been studied in the context of cutaneous spindle cell neoplasms. Little is known about its specificity for vascular differentiation. In this pilot study, immunohistochemical analysis for ERG was performed on 15 dermatofibromas (DF), 10 keloids, and 9 dermatofibrosarcoma protuberans (DFSP) tumors. Consistent nuclear expression of ERG was found in DF [100% (15/15) of the lesions demonstrated > 50% labeling of tumor cells with moderate to strong intensity]. However, ERG expression was largely absent in DFSP [89% (8/9) of the lesions demonstrating <50% labeling staining, generally of mild intensity] and hypertrophic scarskeloids [80% (8/10) without expression]. On the basis of the results of this pilot study, immunohistochemical staining for ERG may prove useful in helping to differentiate DF from DFSP and hypertrophic scars in the context of partial biopsy sampling. If replicated in a larger number of samples, this finding could mitigate the use of costly sequencing panels and potentially avoid unnecessary reexcisions in certain contexts.

Informed consent is a legal and ethical obligation of healthcare providers, and there are several steps that must be followed for informed consent to be obtained. Numerous challenges exist to obtaining informed consent including gaps in health literacy, language barriers, impaired decision‐making capacity, and inadequacy of informed consent forms. Dermatologists must understand the importance and process for obtaining informed consent to protect patients as well as avoid litigation. This narrative review provides an overview of the process of obtaining informed consent, insight into the top challenges that clinicians may face with suggested recommendations, and a brief review of litigation from improper consent among dermatologists.