Twelve months of paired patient and provider intake forms from a monthly, resident-run free dermatology clinic in urban Cleveland have produced one of the few structured datasets on the skin health needs of uninsured and underinsured patients — a population the dermatology literature rarely captures. The short report, led by dermatology resident Amy Johnson with co-authors Jennifer E. Murphy and Kelly Scarberry of University Hospitals Cleveland Medical Center, appears in Archives of Dermatological Research (2026, vol. 318, issue 1, article 477).

For patients without insurance or a regular dermatologist, the authors note, a stubborn rash or an unexplained mole can go unexamined for months or even years. Their clinic-level analysis offers a data-driven portrait of what surfaces when those patients finally reach specialist care.

What did the study measure?

The team collected both patient-completed and provider-completed intake forms at every session of the free clinic for a full year, then analyzed them for recurring patterns. The dataset covered:

• Patients' zip codes of residence
• History of skin cancer
• Most common chief concerns as reported by patients
• Most common clinical findings recorded by providers
• Basic demographics of the patient population

The paired-form design is a low-cost, reproducible quality improvement tool. Patient forms capture self-reported worries, insurance status and demographics; provider forms capture clinical impressions and diagnoses. Comparing the two lets researchers test whether what patients worry about matches what clinicians actually find — discrepancies can drive patient education, while concordance validates triage assumptions. Murphy generated the tabular summaries in the manuscript, and Scarberry provided oversight and guidance on study design.

Why a single-clinic report?

The study grew out of preliminary observations at volunteer dermatology events affiliated with an academic hospital. Those early events suggested that eczematous dermatitis and disorders of the skin appendages — hair, nails and sweat glands — appear disproportionately among people who lack regular dermatologic care or carry inadequate insurance. Rather than rely on anecdote, the team systematized data collection across a full year of clinic sessions.

The existing literature gave them reason to. Current reports on free dermatology clinics are piecemeal, the authors write, consisting mostly of individual institutions describing their own clinical experiences, and they vary widely in both the conditions encountered and the treatment capabilities available on site. A clinic that can dispense medications operates very differently from one offering only diagnoses and referrals.

The authors argue that single-clinic reports remain valuable precisely because they let organizers of new or growing clinics borrow proven operational elements — a triage workflow that reduces wait times, or a formulary that covers the majority of diagnoses seen — without reinventing them. The study functions less as a definitive epidemiological survey and more as a practical blueprint built from real-world operational data.

How does it fit the access-to-care picture?

The report situates itself within a small but growing body of work on free dermatologic care. A nationwide cross-sectional survey published in the Journal of the American Academy of Dermatology in 2019, cited by the authors, examined dermatology services at free medical clinics across the United States and found specialist care at such facilities is far from guaranteed. A 2024 scoping review in JMIR Dermatology further documented dermatology's role in student-run clinics nationwide, highlighting both the educational value for trainees and the service gap these clinics fill.

The Cleveland clinic adds a resident-run model to that mix, positioning dermatology trainees as primary providers under faculty oversight.

Why do zip codes and skin tone matter here?

Health equity considerations run throughout the report. The authors place their clinic in Cuyahoga County, Ohio, and reference the county's 2022 Community Health Needs Assessment. They also cite prior research showing that limited English proficiency is associated with delays in melanoma diagnosis — a point that sharpens why zip code-level analysis matters. Mapping where patients travel from can reveal geographic clusters of unmet need and direct clinic outreach accordingly.

In a specialty where visual examination of the skin is the core diagnostic tool, access barriers translate directly into later diagnoses of potentially serious conditions, including skin cancers. Skin of color appears among the article's keywords, and the authors note that dermatologic conditions can present differently across skin tones. Patients from underserved urban communities may face compounded barriers of cost, transportation, language and historical distrust of the medical system. A free clinic staffed by trainees who see the same population month after month, the report suggests, can build a continuity of care that episodic volunteer events cannot.

What are the limits?

The authors are candid about scope. They describe the work as a preliminary, single-institution contribution and explicitly state that no datasets were generated or analyzed beyond the clinic's own intake records.

Their aspiration, though, is concrete: they hope the data will inform other clinics serving similar patient demographics and enable a more customized, evidence-driven approach to uninsured and underinsured populations. In a health care system where dermatology remains among the hardest specialties to access without insurance, even a modest, well-documented clinic analysis can help convert goodwill into measurable, repeatable care — and provide the comparable data point other programs need to design their own.