Purpose: Lower socioeconomic status is associated with decreased sun protection practices. This survey study investigated practices and beliefs surrounding sun protection based on health insurance. Methods: 401 surveys were administered May to June 2019 at two dermatology clinics in Sacramento, California. 384 surveys by private insurance, Medi-Cal (California's Medicaid), and Medicare coverage were analyzed. Results: Patients with Medi-Cal are twice as likely to rarely or never use sunscreen (OR=2.37; 95% CI 1.45-3.87; P<0.001) compared to those with private insurance. Patients with Medi-Cal or Medicare are less likely to use sunscreen (P<0.001), protective clothing (P=0.025), and sun avoidance (P=0.028). Medi-Cal patients more often used tanning beds (OR=4.90; 95% CI 1.30-18.50; P=0.019). Over half of patients with Medi-Cal agreed it is worth getting burned for a tan (54.6%, OR=2.54; 95% CI 1.41-4.62; P=0.0021). There were no significant differences in opinion that sunscreen is a hassle to apply or expensive. Groups did not differ significantly in ethnicities or skin type. Conclusion: Those with Medi-Cal are less likely to use all forms of sun protection and more likely to value tanning. Negative opinions of sunscreen and perceived knowledge and concern for skin cancer were similar, pointing to additional factors influencing these disparities.

Dermatomyositis (DM) is the most common idiopathic inflammatory condition defined by distinct skin manifestations and varying systemic manifestations. Due to its heterogeneity, the true prevalence is difficult to determine, but current estimates are between 1/10,000-50,000 persons. The cutaneous manifestations of dermatomyositis can be defined as: Pathognomonic: Gottron papules, Gottron sign, and heliotrope rash. Characteristic: nailfold changes, shawl sign, V-sign, Holster sign and scalp involvement. Compatible: poikiloderma, periorbital edema and facial swelling. Less common: vesiculobullous, necrotic or ulcerative lesions, cutaneous vasculitis, and calcinosis cutis. Rare: mechanic’s hands, flagellate erythema, deck chair sign, follicular hyperkeratosis, panniculitis, mucinosis, erythroderma, and oral mucosal changes. Nonspecific: Raynaud Systemic manifestations are variable, including myopathy, cardiopulmonary involvement, gastrointestinal disease, and malignancy.