LAUSR

In this edition of the BJD we are proud to present our second spotlight on qualitative research, building on the BJD’s mission to publish cutting-edge qualitative research in dermatology. Our first spotlight in 2017 showcased six methodologically diverse qualitative papers. With almost 3000 downloads and 46 citations to date, these articles are helping to establish the BJD as the go-to journal for qualitative research on skin. Given the success of our first spotlight, we announced a second call for submissions of qualitative research in spring 2018. Again we sought to capture high-quality studies that explored novel topics, designs or approaches and were of obvious relevance to dermatological science. Our readership did not disappoint! Authors responded to our challenge with a wider range of submissions and almost double the number submitted last time, showing the growing interest in qualitative research in this field. Our second spotlight for summer 2019 showcases 10 studies, comprising a complementary mix of six original articles and four research letters. These papers involve interdisciplinary authorship teams from dermatology, psychology, general practice, nursing, public health and applied health services research in Australia, Germany, the Netherlands, the Republic of Ireland, the U.K. and the U.S.A. Importantly the studies that form the 2019 spotlight show the power of this type of research in accessing the perspectives of groups that have traditionally been seldom heard in dermatology and also in reaching sensitive issues that would be difficult to capture with more quantitative approaches. The first three papers, offer vivid insights into the experiences of under-researched groups. Gilhooley and colleagues examined experiences of skin disease and relationships with healthcare providers among Irish Traveller women. Focus groups highlighted aspects of care that women valued. For example, women identified that relationships are better when professionals are open to exploring cultural influences on women’s willingness to consult about skin disease. The perspectives of Bavarian farmers on keratinocyte carcinoma prevention were gathered by Zink et al. through indepth interviews analysed with qualitative content analysis. This study uncovered unique beliefs among farmers that maintained inadequate sun-protective behaviour. The demands of daily agricultural work and the need to maximize working outdoors in good weather, for example, greatly limited sunprotective behaviour. Thus, raising awareness of keratinocyte carcinoma and ultraviolet radiation is insufficient on its own and strategies to increase self-efficacy among this group must entail prevention approaches integrated into routine farm life. Motivations among ‘sexual-minority men’ for starting and stopping indoor tanning were examined in focus groups with exploratory thematic analysis by Admassu and colleagues. Appearance and dating-related concerns were key drivers in tanning behaviours, findings that should inform public health messages for specific at-risk groups. All of these studies demonstrate the capacity of qualitative methods to access the views of so-called ‘hard-to-reach’ groups and creatively explore challenging topics in specific settings. Six papers, demonstrate qualitative methods’ capacity to access psychological and social issues that are difficult to reach with traditional questionnaire/survey research, and the capability to investigate the portrayal and experience of the skin in the online world. Fox et al. explored the unique perspective of carers on their journey through advanced melanoma diagnosis, death and bereavement. In-depth interviews with grounded theory explored this sensitive topic to reveal the ongoing uncertainty of disease progression, treatment and outcomes, compounded by unclear expectations of emerging immune and targeted therapies. Planning for deterioration and death was often neglected, suggesting health professionals may help carers manage uncertainty by actively discussing prognostic ambiguity. Davey and colleagues used an online qualitative survey to investigate experiences of living with alopecia areata. This ‘wide-angle lens’ not only facilitated a broad geographically spread sample, but the high degree of anonymity in the method enabled people struggling with appearance/social