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Surgical excision of urethral prolapse is a reasonable treatment option in patients who have tried conservative management without relief, as well as in those who present with severe symptoms. Possible complications following excision include postoperative bleeding and recurrence, and patients must be counseled accordingly. In this work, we propose a treatment algorithm for symptomatic urethral prolapse.

Recent attention has been paid to the increasing ethnic and racial diversity of the American population, which sharply contrasts with the lagging number of dermatology clinicians from groups that are underrepresented in medicine (UIM; including African Americans, Hispanics, Native Americans, and Pacific islanders). While approximately 16% of the US population identifies as Hispanic and 13% identify as African American, only 4% of dermatologists identify as Hispanic and 3% as African American. 1 This discrepancy between the diversity in the American population and the dermatologists who will provide care to them will only become more marked as the ethnic diversity of our country continues to evolve.For this reason, there have been several calls to action to increase the number of UIM clinicians in dermatology. [2][3][4] These demands for change note that the lack of diversity in dermatology is multifactorial, suggesting that unconscious bias, lack of mentorship, limited exposure to dermatology at the medical school level, and lack of community outreach may contribute. 3 The lack of diversity in dermatology is a critical issue that will take many years to correct. While many authors have discussed the importance of increasing ethnic diversity in medicine, studying "positive deviants" (in this case, academic departments that have improved diversity) may help us to identify approaches to increase diversity. After reviewing our institution's experience in achieving a more diverse dermatology workforce, we propose that there are steps that dermatology departments can take to tackle this important issue.First, increasing the visibility of minority resident and faculty physicians in dermatology residency programs, leadership positions, and patient care can show poten-tialUIMapplicantsthatacademicdepartmentscanbesupportive environments for their professional development. Furthermore, increasing diversity in the training environment will ultimately help enhance the preparedness of all clinicians to serve our diverse population in the future. Departmental commitments to clinical and research initiatives that focus on issues that disproportionally affect populations of color also demonstrate support for diverse populations. Last, attention should be paid to building the "pipeline" of UIM students at all levels who are exposed to dermatology. We have successfully taken these steps at our institution, and we believe that the following approach is effective and reproducible.

Systematised epidermal naevi are hamartomas developing from neural ectoderm that can be quite extensive, typically with involvement of the face, neck, scalp, arms, legs and trunk. Involvement of the gastrointestinal tract is rare. We report on a 38-year-old Caucasian woman with systematised epidermal naevus syndrome who presented with previously undescribed involvement of the oesophagus, as well as the right side of her scalp, forehead, cheeks, chin, oral mucosa, neck, arms and trunk.