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<article xmlns:xlink="http://www.w3.org/1999/xlink" article-type="letter" dtd-version="2.0">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JDERM</journal-id>
      <journal-id journal-id-type="nlm-ta">JMIR Dermatol</journal-id>
      <journal-title>JMIR Dermatology</journal-title>
      <issn pub-type="epub">2562-0959</issn>
      <publisher>
        <publisher-name>JMIR Publications</publisher-name>
        <publisher-loc>Toronto, Canada</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">v5i1e31943</article-id>
      <article-id pub-id-type="pmid">37632875</article-id>
      <article-id pub-id-type="doi">10.2196/31943</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Letter to the Editor</subject>
        </subj-group>
        <subj-group subj-group-type="article-type">
          <subject>Letter to the Editor</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>The Dermatologist on Social Media: When the Pros Outweigh the Cons. Comment on “Risks and Benefits of Using Social Media in Dermatology: Cross-sectional Questionnaire Study”</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="editor">
          <name>
            <surname>Leung</surname>
            <given-names>Tiffany</given-names>
          </name>
        </contrib>
      </contrib-group>
      <contrib-group>
        <contrib id="contrib1" contrib-type="author">
          <name name-style="western">
            <surname>Concilla</surname>
            <given-names>Anthony</given-names>
          </name>
          <degrees>BSc</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0002-7257-4156</ext-link>
        </contrib>
        <contrib id="contrib2" contrib-type="author">
          <name name-style="western">
            <surname>Laughter</surname>
            <given-names>Melissa R</given-names>
          </name>
          <degrees>MD, PhD</degrees>
          <xref rid="aff2" ref-type="aff">2</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0001-7010-7901</ext-link>
        </contrib>
        <contrib id="contrib3" contrib-type="author">
          <name name-style="western">
            <surname>Presley</surname>
            <given-names>Colby L</given-names>
          </name>
          <degrees>DO</degrees>
          <xref rid="aff3" ref-type="aff">3</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0002-3646-7732</ext-link>
        </contrib>
        <contrib id="contrib4" contrib-type="author">
          <name name-style="western">
            <surname>Anderson</surname>
            <given-names>Jaclyn</given-names>
          </name>
          <degrees>MD</degrees>
          <xref rid="aff4" ref-type="aff">4</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0003-1389-3453</ext-link>
        </contrib>
        <contrib id="contrib5" contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Rundle</surname>
            <given-names>Chandler W</given-names>
          </name>
          <degrees>MD</degrees>
          <xref rid="aff5" ref-type="aff">5</xref>
          <address>
            <institution>Department of Dermatology</institution>
            <institution>Duke University</institution>
            <addr-line>40 Duke Medicine Circle</addr-line>
            <addr-line>Durham, NC, 27705</addr-line>
            <country>United States</country>
            <phone>1 9196843432</phone>
            <email>chandler.rundle@duke.edu</email>
          </address>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0002-7624-8147</ext-link>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <label>1</label>
        <institution>College of Osteopathic Medicine</institution>
        <institution>Philadelphia College of Osteopathic Medicine</institution>
        <addr-line>Philadelphia, PA</addr-line>
        <country>United States</country>
      </aff>
      <aff id="aff2">
        <label>2</label>
        <institution>Transitional Year Residency</institution>
        <institution>Dell Medical School</institution>
        <institution>The University of Texas at Austin</institution>
        <addr-line>Austin, TX</addr-line>
        <country>United States</country>
      </aff>
      <aff id="aff3">
        <label>3</label>
        <institution>Division of Dermatology</institution>
        <institution>Lehigh Valley Health Network</institution>
        <addr-line>Allentown, PA</addr-line>
        <country>United States</country>
      </aff>
      <aff id="aff4">
        <label>4</label>
        <institution>Department of Pathology</institution>
        <institution>School of Medicine</institution>
        <institution>Stanford University</institution>
        <addr-line>Stanford, CA</addr-line>
        <country>United States</country>
      </aff>
      <aff id="aff5">
        <label>5</label>
        <institution>Department of Dermatology</institution>
        <institution>Duke University</institution>
        <addr-line>Durham, NC</addr-line>
        <country>United States</country>
      </aff>
      <author-notes>
        <corresp>Corresponding Author: Chandler W Rundle <email>chandler.rundle@duke.edu</email></corresp>
      </author-notes>
      <pub-date pub-type="collection">
        <season>Jan-Mar</season>
        <year>2022</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>25</day>
        <month>2</month>
        <year>2022</year>
      </pub-date>
      <volume>5</volume>
      <issue>1</issue>
      <elocation-id>e31943</elocation-id>
      <history>
        <date date-type="received">
          <day>9</day>
          <month>7</month>
          <year>2021</year>
        </date>
        <date date-type="accepted">
          <day>4</day>
          <month>2</month>
          <year>2022</year>
        </date>
      </history>
      <copyright-statement>©Anthony Concilla, Melissa R Laughter, Colby L Presley, Jaclyn Anderson, Chandler W Rundle. Originally published in JMIR Dermatology (http://derma.jmir.org), 25.02.2022.</copyright-statement>
      <copyright-year>2022</copyright-year>
      <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
        <p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Dermatology Research, is properly cited. The complete bibliographic information, a link to the original publication on http://derma.jmir.org, as well as this copyright and license information must be included.</p>
      </license>
      <self-uri xlink:href="https://derma.jmir.org/2022/1/e31943" xlink:type="simple"/>
      <related-article related-article-type="commentary-article" id="v4i1e24737" ext-link-type="doi" xlink:href="10.2196/24737" vol="4" page="e24737" xlink:type="simple">https://derma.jmir.org/2021/1/e24737</related-article>
      <kwd-group>
        <kwd>Instagram</kwd>
        <kwd>Twitter</kwd>
        <kwd>TikTok</kwd>
        <kwd>Facebook</kwd>
        <kwd>internet</kwd>
        <kwd>social media</kwd>
        <kwd>dermatologist</kwd>
        <kwd>generational differences</kwd>
        <kwd>information quality</kwd>
        <kwd>patient education</kwd>
        <kwd>online content</kwd>
        <kwd>risk</kwd>
        <kwd>benefit</kwd>
        <kwd>dermatology</kwd>
        <kwd>cross-sectional</kwd>
        <kwd>survey</kwd>
        <kwd>online health information</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <p>We applaud Bressler et al [<xref ref-type="bibr" rid="ref1">1</xref>] for their cross-sectional study determining the risks and benefits of social media use by practicing dermatologists and dermatology residents. This study found that 93.8% of survey respondents used a variety of social media sites [<xref ref-type="bibr" rid="ref1">1</xref>]. Respondents were stratified by employment, and usage patterns and perspectives were recorded. Here, we aim to reframe the findings of Bressler et al [<xref ref-type="bibr" rid="ref1">1</xref>] as an opportunity to encourage dermatologists to use social media to combat misinformation, serve as public health advocates, and support patients’ wellness.</p>
    <p>While this study successfully characterizes opportunities for dermatologists to interact on social media (eg, patient education, care opportunities, improved quality of information), the gravity of these findings was not explored, as dermatologists are a significant minority of contributors to social media information. For example, Wells et al [<xref ref-type="bibr" rid="ref2">2</xref>] found that board-certified dermatologists were responsible for only 12% (26/219) of analyzed Instagram content related to skin of color. Similarly, an analysis of psoriasis-related content on Twitter found that only 3% (17/574) of accounts belonged to dermatologists [<xref ref-type="bibr" rid="ref3">3</xref>]. These findings show that dermatologists’ contributions pale in comparison to nondermatologists, and highlight the need for dermatologists to expand their presence on social media.</p>
    <p>An additional, unique aspect of Bressler et al’s [<xref ref-type="bibr" rid="ref1">1</xref>] study is the measure of dermatologists’ perspectives. The study emphasizes that dermatologists were more pessimistic than optimistic on social media use, citing perceived risks of misinformation, poor substitution of care, and increased visibility of non–evidence-based products (<italic>P</italic>&#60;.001) [<xref ref-type="bibr" rid="ref1">1</xref>]. The juxtaposition between dermatologists’ optimism and pessimism, in conjunction with a relative paucity of participation by dermatologists, is concerning. Dermatologists could embrace the opportunity to directly combat the spread of misinformation and poor patient care while simultaneously increasing access to health care, education, and up-to-date public health initiatives. Instagram, the “most valuable platform” (as determined by a single survey question), presents opportunities for interaction with the public via photos, videos, and reels. Presley et al [<xref ref-type="bibr" rid="ref4">4</xref>], for example, recorded the metrics for the top TikTok (another video-based platform) posts and found that educational posts had the highest mean user engagement, supporting the utilization of social media for the dissemination of medical education.</p>
    <p>Bressler et al [<xref ref-type="bibr" rid="ref1">1</xref>] also highlight concern for professional education, privacy breaches, and the necessity of better guidelines for physicians to interact on social media. However, the American Medical Association provides guidelines, outlining that physician interactions on social media should parallel the interactions expected of them in person. Maintaining professionalism, patient confidentiality, and combating misinformation in a clear and respectful manner are pearls for physician conduct on social media platforms [<xref ref-type="bibr" rid="ref5">5</xref>]. Users should avoid sharing or improperly storing patient health information (ie, tattoos, scars), state their conflicts of interest or affiliations, and include disclaimers with recommendations.</p>
    <p>While dermatologists are minor contributors in the scheme of social media, it is more important than ever for this group to advocate for their patients and profession. While there are potential negatives with social media use, it is important that we recognize and face these barriers as a means to provide clear, accurate information to our patients while simultaneously providing greater access to high-quality care.</p>
  </body>
  <back>
    <app-group/>
    <fn-group>
      <fn fn-type="conflict">
        <p>None declared.</p>
      </fn>
    </fn-group>
    <fn-group>
      <fn fn-type="other">
        <p>
          <bold>Editorial Notice</bold>
        </p>
        <p>The corresponding author of <italic>"Risks and Benefits of Using Social Media in Dermatology: Cross-sectional Questionnaire Study"</italic> declined to respond to this letter.</p>
      </fn>
    </fn-group>
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</article>
