A multicentre study of follow-up practices for patients diagnosed with squamous cell carcinoma (SCC). Due to a lack of evidence and diverse recommendations across organizations including the AAD and BAD, there is likely substantial variability amongst dermatologist practices. As such, we hope to better understand the practice patterns amongst Canadian dermatologists to help establish the baseline landscape and identify opportunities for improvement. Study objectives are outlined below. We currently have over 10 community and academic dermatologists from across Canada involved in this project. Study Aims and Hypotheses: a) To characterize the practice patterns for follow up of immunocompetent patients by dermatologists after a diagnosis of primary invasive cutaneous SCC. Hypothesis: Variation will be seen in the frequency and duration of follow-up. b) To identify factors associated with the time to the first follow-up skin exam after SCC diagnosis. Hypothesis: Patients who are at higher risk of recurrence, metastasis, or additional skin cancers (older age, advanced tumour stage) will be followed more frequently for skin exam.

Atopic dermatitis (eczema) is frequently associated with food and environmental allergies, but the impact of allergy testing and management on skin disease severity in people with atopic dermatitis is unclear. We will create electronic surveys to evaluate current practices regarding allergy testing for adults with atopic dermatitis and interest in participating in studies of allergy testing. The survey responses will be anonymous; clinicians may provide contact information for future studies. We will ask local, provincial, and national dermatology societies to disseminate the survey via e-mail and social media. The patient survey will be shared via Eczema Society of Canada and Canadian Skin Patient Alliance email lists and social media channels. We will calculate the proportion of responses for each question item, and open-ended responses will be summarized into themes. We will document patterns of care and interest in research on allergy testing as an intervention for atopic dermatitis. These results will further our understanding of current practices among dermatologists and capture the perspectives of adults with atopic dermatitis regarding different types of allergy testing in the management of atopic dermatitis. These results may inform future research on allergy testing for patients with atopic dermatitis.

Morphea is a chronic relapsing autoimmune disease characterized by scarring of the skin/subcutaneous tissue. It affects ~75,000 Canadians. Several clinical subtypes exist, and severe forms (linear, generalized, pansclerotic) have a high risk of extracutaneous involvement, pain, disfigurement, and disability. Many clinical/research gaps in morphea remain. Only 2 single-center registries exist (Morphea in Adults and Children (Texas), National Registry for Childhood-Onset Scleroderma (Pittsburgh)). Current studies are limited by small patients’ number, unequal ethnocultural representation, retrospective data collection, and use of invalidated classifications, making data interpretation/clinical translation difficult. We created the first national morphea patients’ registry (C-MORE) comprised of 36 multidisciplinary physicians across 17 academic sites, aimed to understand morphea’s clinical characteristics, triggers, severity and burden in Canadian patients. The aim of this study is to characterize morphea patients in Canada, their demographics, disease severity/complications, to elucidate the impact of morphea on patients' lives and the risk factors associated with worse disease. This data will be directly relevant to patients as it will instruct clinicians about which patients are at higher risk of complications and should be followed/investigated more thoroughly. Better understanding the burden of disease will help to stimulate research and development in morphea.

The CACTI project is a multicenter observational prospective cohort study based at three Canadian institutions (Women’s College Hospital/University of Toronto, McGill University Health Science Centre, University of British Columbia). It will enroll patients with severe atopic dermatitis with inadequate control from topical therapy and collect biospecimens (blood, microbial swabs, skin biopsies) from consenting participants. It also contains a nested randomized controlled trial comparing two types of phototherapy. This project requires a secure online data platform to collect and centrally store unidentified longitudinal clinical data for participants across the three sites. The central study site is Women’s College Hospital, making a partnership with SkIN Canada seamless. Each site will enter their own data into the database. The platform must also be able to randomize patients eligible for the nested randomized controlled trial. It must also be able to document and track biospecimens collected at the different sites. It should also be able to track storage and laboratory analyses of these samples.