Jama derm. 2023;159 (3):247-248. doi:10.1001/jamadermatol.2022....

3 May 2023 ... JAMA JAMA Network Open JAMA Cardiology JAMA Derm

Disclaimer: Dr Barbieri is the CME/Clinical Review and Education Editor of JAMA Dermatology but was not involved in any of the decisions regarding review of the manuscript or its acceptance. References 1. Lainscak M , Pelliccia F , Rosano G , et al. Safety profile of mineralocorticoid receptor antagonists: spironolactone and eplerenone. …Importance Knowledge regarding differences in dermatologic care for patients with a broad range of dermatologic conditions is limited.. Objective To elucidate nationwide differences in use of outpatient dermatologic care.. Design, Setting, and Participants Retrospective analysis of nationally representative data from the 2007 to 2015 Medical Expenditure …10.1001/jamadermatol.2020.4616 While current evidence supports UV exposure as an important risk factor for cutaneous melanoma in fair-skinned populations, the evidence …JAMA Dermatology. Home New Online Current Issue For Authors. Podcast. Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA …This website is not endorsed or sponsored by ABC, NBC, JAMA Dermatology or CBS. The trademarks above are registered trademarks of their respective owners ...JAMA Dermatology. Home New Online Current Issue For Authors. Podcast. Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA …Investigators at 4 pediatric dermatology centers (University of California, San Francisco; Indiana University; Medical College of Wisconsin; and Northwestern University/Ann & Robert H. Lurie Children’s Hospital of Chicago) used secure photograph archives to identify all patients younger than 12 years who had head and neck segmental and indeterminate …Disclaimer: Dr Micheletti is an Images in Dermatology Editor and Dr Shinkai is Editor of JAMA Dermatology, but they were not involved in any of the decisions regarding review of the manuscript or its acceptance. Data Sharing Statement: See Supplement 2. Additional Contributions: We thank Neil Shear, MD, PhD, of the University of Toronto, for his …Kanade Shinkai, MD, PhD, Department of Dermatology, University of Calfornia, San Francisco, 1701 Divisadero St, San Francisco, CA 94115 ( [email protected]. In this Viewpoint, JAMA Dermatology editors review the skin findings seen in association with coronavirus disease 2019 (COVID-19), how best to …Dupilumab is a theoretically novel therapy for bullous pemphigoid (BP). However, its effectiveness and safety have yet to be confirmed in a large-scale study. To assess the efficacy and safety of dupilumab in patients with BP and evaluate factors that potentially affect short-term and long-term outcomes. Design, Setting, and ParticipantsA ... JAMA Dermatology. It has been 200 years since Thomas Bateman first described molluscum contagiosum (MC) in 1817, and clinicians and patients are still waiting for an evidence-based, effective therapy. 1 However, during the past 2 years, large randomized clinical trials investigating therapies for MC, including a study by Dr Browning and …JAMA Network is a consortium of peer-reviewed medical publications that includes JAMA® and the JAMA Network journals. JAMA Dermatology does not hold itself responsible for statements made by any contributor. All articles published, including opinion articles, represent the views of the authors and do not reflect the policy of the Journal, the …Wollenberg A , Barbarot S , Bieber T , et al; European Dermatology Forum (EDF), the European Academy of Dermatology and Venereology (EADV), the European Academy of Allergy and Clinical Immunology (EAACI), the European Task Force on Atopic Dermatitis (ETFAD), European Federation of Allergy and Airways Diseases Patients’ Associations (EFA), the European Society for Dermatology and ... JAMA Network is a consortium of peer-reviewed medical publications that includes JAMA® and the JAMA Network journals. JAMA Dermatology does not hold itself responsible for statements made by any contributor. All articles published, including opinion articles, represent the views of the authors and do not reflect the policy of the Journal, the ... 1 Division of Dermatology, Department of Internal Medicine, Dell Medical School, The University of Texas at Austin. 2 LIVESTRONG Cancer Institutes, Dell Medical School, ... JAMA Dermatology. PMID: 33325988 DOI: 10.1001/jamadermatol.2020.4616 Abstract Importance: While current evidence supports UV exposure as an important risk …AE is an autosomal recessive disorder due to a variation in the intestinal zinc transporter gene SLC39A4 affecting the ZiP4 transporter. Classically, AE is characterized by a triad of perioral, flexural, and acral dermatitis, alopecia, and diarrhea, which is present in one-third of cases. Other clinical signs include paronychia, glossitis ...Importance Pubic hair grooming is an increasingly prevalent trend. Several studies have sought to characterize its prevalence, associated demographics, and motivations. Objective To characterize current pubic hair grooming practices in the United States.. Design, Setting, and Participants In this cross-sectional study, a nationally representative survey was …JAMA Dermatology. Key Points. Question What is the efficacy and safety of bimekizumab in individuals with moderate to severe hidradenitis suppurativa (HS)? Findings In this double-blind, placebo-controlled, phase 2 randomized clinical trial including 90 randomized patients with HS (73 completed the trial), bimekizumab demonstrated clinically …JAMA Network is a consortium of peer-reviewed medical publications that includes JAMA® and the JAMA Network journals. JAMA Dermatology does not hold itself responsible for statements made by any contributor. All articles published, including opinion articles, represent the views of the authors and do not reflect the policy of the Journal, the …The JAMA Dermatology Patient Page is a public service of JAMA Dermatology. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA Dermatology suggests that you consult your …JAMA Dermatology citation style guide with bibliography and in-text referencing examples: ✓Journal articles ✓Books ✓Book chapters ✓Reports ✓Web pages.Dec 1, 2018 · Little evidence exists to guide the management of moderately dysplastic nevi excisionally biopsied without residual clinical pigmentation but with positive histologic margins (hereafter referred to as moderately dysplastic nevi with positive histologic margins). To determine outcomes and risk for the development of subsequent cutaneous melanoma ... JAMA Dermatology. Key Points. Question What is the association of secukinumab with active tuberculosis (TB) development, TB reactivation, and latent tuberculosis infection (LTBI) activation? Findings In this pooled cohort study of 12 319 patients with psoriasis, psoriatic arthritis, or ankylosing spondylitis, spontaneous reporting of new LTBI while …JAMA Dermatology. Key Points. Question What is the short-term and long-term comparative efficacy among biologics and oral agents for plaque psoriasis? Findings In a network meta-analysis of 60 clinical …Histopathology revealed psoriasiform epidermal hyperplasia with confluent parakeratosis and epidermal pallor consistent with acrodermatitis enteropathica (AE). Oral zinc supplementation was initiated at a dose of 3 mg/kg, with rapid improvement. This case report describes a woman in her 20s with painful, red skin lesions present for 6 months ... Importance There is a paucity of evidence to guide physicians regarding prevention strategies for cutaneous squamous cell carcinoma (CSCC) in solid organ transplant recipients (SOTRs).. Objective To examine the development and results of a Delphi process initiated to identify consensus-based medical management recommendations for …JAMA Dermatology. Key Points. Question What is the efficacy and safety of bimekizumab in individuals with moderate to severe hidradenitis suppurativa (HS)? Findings In this double-blind, placebo-controlled, phase 2 randomized clinical trial including 90 randomized patients with HS (73 completed the trial), bimekizumab demonstrated clinically …Authors of manuscripts based on clinical images should consult the instructions for. Provide a short title that briefly describes the disease entity or case presentation and does not include the diagnosis. Do not include the patient's race, ethnicity, or country of origin in the title or first line of the article.JAMA Dermatology. Home New Online Current Issue For Authors. Podcast. Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA …JAMA Dermatology. Key Points. Question Can 2-photon fluorescence microscopy enable rapid point-of-care diagnosis of nonmelanoma skin cancer through real-time imaging of unprocessed fresh tissue biopsies? Findings In this pilot comparative effectiveness research study using 2-photon fluorescence microscopy on 15 biopsies of known non-melanoma …1 Division of Dermatology, Department of Internal Medicine, Dell Medical School, The University of Texas at Austin. 2 LIVESTRONG Cancer Institutes, Dell Medical School, ... JAMA Dermatology. PMID: 33325988 DOI: 10.1001/jamadermatol.2020.4616 Abstract Importance: While current evidence supports UV exposure as an important risk …Histopathology revealed psoriasiform epidermal hyperplasia with confluent parakeratosis and epidermal pallor consistent with acrodermatitis enteropathica (AE). Oral zinc supplementation was initiated at a dose of 3 mg/kg, with rapid improvement. This case report describes a woman in her 20s with painful, red skin lesions present for 6 months ... Here's the deets on postpartum acne, how to treat it, and when you should head to a derm for professional help. We include products we think are useful for our readers. If you buy ...JAMA Dermatology. Home New Online Current Issue For Authors. Podcast. Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA …Importance Cutaneous squamous cell carcinoma (cSCC) has metastatic potential, but the prognostic value of current staging systems in nonselected patients is uncertain.. Objective To assess the effect of risk factors for metastasis and to evaluate validity and usefulness of 4 staging systems for cSCC using population-based data.. Design, Setting, and …JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959)Dermatology | JAMA Network. Explore the latest in dermatology, including diagnosis and management of allergic, inflammatory, autoimmune and genetic diseases of the skin. 17 Feb 2023 ... The goal of this fellowship is to support the development of an early-career academic dermatologist to equip them with the skills to take on ...Generalized pruritus is a distressing symptom that can occur in several dermatologic and systemic disorders. 1 Generalized pruritus of unknown origin is that which affects patients without any underlying dermatologic or systemic disorder and is unassociated with rash. It most commonly occurs in older patients and persists for long periods, from months to years.JAMA Dermatology. Home New Online Current Issue For Authors. Podcast. Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA …Key Points. Question What is the association of cutaneous immune-related adverse events (cirAEs) with mortality in treatment with immune checkpoint inhibitor (ICI) therapy for patients with cancer?. Findings In this retrospective cohort study of 7008 patients with cancer who developed cirAEs after treatment with anti–programmed cell death 1 or …JAMA Dermatology. Full Text. Key Points. Question What were the outcomes for patients with clinically and histologically confirmed Hailey-Hailey disease who were treated with superficial radiotherapy? Findings In this case series of 13 patients with Hailey-Hailey disease, 56 of 62 separate body areas (90%) and 9 of 13 patients (69%) responded with …JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) 1 Dec 2021 ... JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA ... Dermatology (CLEAR Derm). View Large ...JAMA Dermatology’s mission is to elevate the art and science of health and diseases of skin, hair, nails, and mucous membranes, and their treatment, to enable dermatologists …Generalized pruritus is a distressing symptom that can occur in several dermatologic and systemic disorders. 1 Generalized pruritus of unknown origin is that which affects patients without any underlying dermatologic or systemic disorder and is unassociated with rash. It most commonly occurs in older patients and persists for long periods, from months to years.21 Jun 2023 ... JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology ...JAMA Dermatology. Home New Online Current Issue For Authors. Podcast. Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA …Medicine Matters Sharing successes, challenges and daily happenings in the Department of Medicine ARTICLE: Factors Associated With Overuse of Health Care Within US Health System AU...10.1001/jamadermatol.2020.4616 While current evidence supports UV exposure as an important risk factor for cutaneous melanoma in fair-skinned populations, the evidence …6 Jul 2022 ... JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA ... Acta Derm Venereol. 2020;100(19): ...Investigators at 4 pediatric dermatology centers (University of California, San Francisco; Indiana University; Medical College of Wisconsin; and Northwestern University/Ann & Robert H. Lurie Children’s Hospital of Chicago) used secure photograph archives to identify all patients younger than 12 years who had head and neck segmental and indeterminate …Dec 1, 2018 · Little evidence exists to guide the management of moderately dysplastic nevi excisionally biopsied without residual clinical pigmentation but with positive histologic margins (hereafter referred to as moderately dysplastic nevi with positive histologic margins). To determine outcomes and risk for the development of subsequent cutaneous melanoma ... JAMA Dermatology. Home New Online Current Issue For Authors. Podcast. Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA …JAMA Dermatology. Key Points. Question Is patient age associated with rate of lymph node positivity in clinically localized thin melanoma? Findings In this cohort study of a national data set of 8772 patients undergoing curative resection of thin melanoma, older age was significantly associated with reduced risk of lymph node metastases. Patients …JAMA Dermatology. Key Points. Question What are the safety, efficacy, and biomarker responses of dupilumab treatment in patients with erythrodermic atopic dermatitis (AD)? Findings In this post hoc analysis of 209 patients with erythrodermic AD in 6 randomized, placebo-controlled clinical trials, dupilumab treatment (either as …Traditional Chinese Medicine (TCM) aims to promote health by bringing the body’s systems into balance. Learn how this ancient approach can be a helpful part of eczema management. P...Disclaimer: Dr Adamson is an Associate Editor and Web Editor of JAMA Dermatology, but he was not involved in any of the decisions regarding review of the manuscript or its acceptance. References: 1. Chen ST , Geller AC , Tsao H . Update on the epidemiology of melanoma. Curr Dermatol Rep. 2013;2(1):24-34. doi:10.1007/s13671 ...Dermatology image-based AI algorithms must consider the unique features of dermatology data, which currently include a lack of standardization among imaging modalities and the risk of bias from noisy labels or demographically unrepresentative data. 2,14-16 These guidelines are intended as requirements for the consideration of study …JAMA Dermatology. Key Points. Question Does the 9-valent human papillomavirus vaccine have therapeutic utility for cutaneous squamous cell carcinoma? Findings A woman in her 90s with multiple cutaneous squamous cell carcinomas was treated with the 9-valent human papillomavirus vaccine systemically and intratumorally. This approach led to regression …Key Points. Question What were the treatment patterns for alopecia areata (AA) in adults in the US from 2015 to 2020?. Findings In this cohort study of 45 483 adults with AA, on the basis of US medical and pharmacy claims data, most common treatments for AA included intralesional, topical, intramuscular, and oral corticosteroids. Importance Pubic hair grooming is an increasingly prevalent trend. Several studies have sought to characterize its prevalence, associated demographics, and motivations. Objective To characterize current pubic hair grooming practices in the United States.. Design, Setting, and Participants In this cross-sectional study, a nationally representative survey was …Also known as pernio-likepseudo-chilblain, acute acro-ischemia, and “COVID toes,” the pattern of acral lesions is described as erythematous to purple purpuric macules, papules, and/or vesicles. Its close temporal appearance with the COVID-19 pandemic suggests that the two are associated. Galván Casas et al confirmed that 29 of 71 cases of ...This association was stronger among those studies conducted for dermatologic indications as well as among JAK1-specific, combined JAK1 and JAK2, and tyrosine kinase 2–specific inhibitor treatments. Meaning These findings suggest that patients should be properly counseled on the potential adverse effect of acne before beginning treatment with ... Evidence Review A panel of national experts in pediatric dermatology, procedural/cosmetic dermatology, plastic surgery, scars, wound healing, acne, and isotretinoin was convened. A systematic PubMed review of English-language articles published from 1982 to 2017 was performed using the following search terms: isotretinoin, 13-cis-retinoic acid, Accutane, …JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) 23 Mar 2022 ... JAMA Dermatology—The Year in Review, 2021 ... In the face of uncertainty and an ever-evolving global pandemic, JAMA Dermatology continued to ...Importance Although isotretinoin may rarely be associated with laboratory abnormalities such as hypertriglyceridemia, the optimal approach to laboratory monitoring is uncertain, and there is wide variation in clinical practice.. Objective To establish a consensus for isotretinoin laboratory monitoring among a diverse, international cohort of clinical and research …Dec 1, 2018 · Little evidence exists to guide the management of moderately dysplastic nevi excisionally biopsied without residual clinical pigmentation but with positive histologic margins (hereafter referred to as moderately dysplastic nevi with positive histologic margins). To determine outcomes and risk for the development of subsequent cutaneous melanoma ... JAMA Dermatology. Home New Online Current Issue For Authors. Podcast. Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA …In this issue of JAMA Dermatology, Boesjes et al 1 share their experience with patients with presumed atopic dermatitis (AD) who, shortly after dupilumab initiation, experienced worsening skin symptoms unlike their previous disease. Skin biopsies were characterized by atypical T-cell lymphocytic infiltrates. Although some of these patients developed …JAMA Dermatology. Home New Online Current Issue For Authors. Podcast. Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA …JAMA Dermatology. Key Points. Question What is the efficacy and safety of berdazimer gel, 10.3%, in the treatment of molluscum contagiosum (MC)? Findings This phase 3 randomized clinical trial of 891 patients with MC found greater complete lesion clearance in patients treated with berdazimer gel vs vehicle (32.4% vs 19.7%). Mild …Key Points. Question Are nutritional supplements or dietary interventions safe and effective for patients with hair loss?. Findings In this systematic review of 30 studies of nutritional interventions, the highest-quality evidence suggests the potential effectiveness of Viviscal, Nourkrin, Nutrafol, Lamdapil, Pantogar, Capsaicin and isoflavone, omega 3 and 6 with antioxidants, apple ... Chronic pruritus is a debilitating symptom that is associated with numerous dermatologic, neurologic, and systemic diseases. It is often resistant to treatment and can cause a severe reduction in quality of life. 1 Currently, to our knowledge, there is a lack of US Food and Drug Administration–approved therapies for pruritus, so treatment can be difficult and relies on …JAMA Dermatology. Key Points. Question What is the efficacy and safety of bimekizumab in individuals with moderate to severe hidradenitis suppurativa (HS)? Findings In this double-blind, placebo-controlled, phase 2 randomized clinical trial including 90 randomized patients with HS (73 completed the trial), bimekizumab demonstrated clinically …JAMA Dermatology. Home New Online Current Issue For Authors. Podcast. Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA …9 Aug 2023 ... Kwatra, MD, Department of Dermatology, Johns Hopkins University School of Medicine, 1550 Orleans St, Koch CRBII, Room 206, Ste 216, Baltimore, ...Hidradenitis suppurativa (HS) is relatively common, with the prevalence of 0.05% to 4.10%, yet many patients receive inadequate treatment. To review the diagnosis, epidemiology, and treatment of HS with an emphasis on advances in the last 5 years. A literature search was conducted using PubMed, MEDLINE (Medical Subject Headings …Explore the latest in dermatology, including diagnosis and management of allergic, inflammatory, autoimmune and genetic diseases of the skin.Generalized pruritus is a distressing symptom that can occur in several dermatologic and systemic disorders. 1 Generalized pruritus of unknown origin is that which affects patients without any underlying dermatologic or systemic disorder and is unassociated with rash. It most commonly occurs in older patients and persists for long periods, from months to years.12 Jul 2023 ... JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA ... Acta Derm Venereol. 2008;88(3):211 ...JAMA Dermatology. Home New Online Current Issue For Authors. Podcast. Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA …. JAMA Dermatol. 2022;158 (1):16-25. doi:10.1001/jamaderJAMA Dermatology. Home New Online Current Issue For Autho This association was stronger among those studies conducted for dermatologic indications as well as among JAK1-specific, combined JAK1 and JAK2, and tyrosine kinase 2–specific inhibitor treatments. Meaning These findings suggest that patients should be properly counseled on the potential adverse effect of acne before beginning treatment with ... JAMA Dermatology. Key Points. Questions What is the drug survival of adalimumab, ustekinumab, secukinumab, guselkumab, ixekizumab that is associated with effectiveness and safety in patients with psoriasis in the UK and Ireland, and are there any patient factors that are associated with survival of each biologic differently that could help treatment … JAMA Dermatol. JAMA Dermatology is a monthly peer-reviewed medi JAMA Dermatology’s mission is to elevate the art and science of health and diseases of skin, hair, nails, and mucous membranes, and their treatment, to enable dermatologists to deliver evidence-based, high-value medical and surgical dermatologic care. The journal publishes a broad range of innovative studies and trials that shift research and ... A, Measure Up 1. B, Measure Up 2. C, AD Up. Nominal P values are calculated using Cochran-Mantel-Haenszel test with the adjustment of baseline vIGA-AD categories (3; 4). ). Based on nonresponder imputation incorporating multiple imputation to handle missing data due to COVID-19 or nonresponder imputation only if there were no missing data due to COVI JAMA Dermatology Clinicopathological Cha...

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