Friday, July 21, 2017

The Dermatology of Greyscale

Game of Thrones is back! *fangirl scream*

In honor of the show's return, I was poking around in the scientific literature for a fitting article. I found an interesting little note in a dermatology journal concerning "greyscale."

Greyscale (also known as "Prince Garin's curse or "grey death") is a relatively uncommon but fatal disease in Westeros. It typically affects children living in cold, damp climates but everyone is susceptible. It is characterized by hardened and calcified skin that feels stone-like and cracks as a result of the body's movement. Severely affected areas have a scaly appearance. In advanced stages of the disease, the skin further hardens and becomes mottled grey and black as it dies, giving it a stony appearance. In the final stages, the internal organs harden, eventually spreading to the brain and causing insanity. Greyscale is very fast to contract but slow to kill, often taking many years. During those years, as the infection spreads over the entire body, an infected person becomes known as one of the "Stone Men." Children have a slightly better chance of surviving an infection, but it is rare. Should a person survive the disease, they are immune from contracting it again but are left disfigured.

A short but entertaining piece in JAMA Dermatology discusses possible epidemiological aspects of greyscale. (note: may contain minor spoilers from this point on)

Greyscale is often compared to leprosy (Hansen's disease), a bacterial infection caused by Mycobacterium leprae. But greyscale differs in that it is spread by skin (or possibly object) contact and has no leonine facies, dermal plaques and patches, neuropathy, etc. Well, what do we know? First, we know of the case of Shireen Baratheon, daughter of Stannis Baratheon and child survivor of greyscale. She has lingering skin changes described by the article as "ichthyotic plaques in a somewhat Blaschkoid pattern limited to the left side of the face and body." We also know that the Stone Men have disseminated skin changes and are mentally unstable, with aggressive behavior. But perhaps the most interesting and telling case is that of Jorah Mormont. Following skin-to-skin contact with a Stone Man, Jorah developed a skin lesion within only a day.  Leprosy, and most other infectious agents, are not nearly this contagious. The article hypothesizes that greyscale may actually be a virus that is as contagious as smallpox. In Shireen, it presented like a genodermatosis, which is genetically based, perhaps like a mosaic form of epidermodysplasia verruciformis. In the end, the clinical data and pathology reports coming out of Westeros are thin. With this new season, perhaps we can further follow Jorah's disease progression and maybe his cure as well.

Lipoff, J.B. (2016) Greyscale - A Mystery Dermatologic Diseas on HBO's Game of Thrones. JAMA Dermatology. 152(8):904. DOI: 10.1001/jamadermatol.2015.5793

Details about greyscale and image via Game of Thrones Wiki.

Tuesday, June 20, 2017

Should You Ask a Question During Seminar?

There needs to be a box for "Do you need the seminar to end so you can refill your coffee?"
Of course, the answer to that is always "Yes."

Thursday, June 8, 2017

The Photosynthesis Song

I love this. Photosynthesis is pretty great.

Friday, May 26, 2017

The Ugliness Penalty: Does It Literally Pay to Be Pretty?

There are economic studies that show that attractive people earn more money and, conversely, unattractive earn less money. I’m pretty sure that I’ve heard something along those lines before, but I had no idea they were called the “beauty premium” and the “ugliness penalty.” How wonderful and sad at the same time. But while these seem like pretty commonplace ideas, there is no real evidence as to why they exist. A new paper published in the Journal of Business and Psychology tested three of the leading explanations of the existence or the beauty premium and ugliness penalty: discrimination, self-election, and individual differences. To do this, the researchers used data from the National Longitudinal Survey of Adolescent Health. This is a nationally representative sample that includes measurements of physical attractiveness (5-point scale) at four time points to the age of 29. People were placed into 5 categories based on physical attractiveness, from very attractive to very unattractive. They statistically compared every combination they could think of and came up with many tables full of tiny numbers, as well as some interesting results.


It is what it sounds like: ugly people are discriminated against and paid less. And it isn’t just from employers, it can also be from co-workers, customers, or clients that prefer to work with or do business with pretty people. Or it could be a combination, like an employer that hires someone pretty because they know that others will respond to them better. Because there is a monotonically positive association between attractiveness and earnings (an overly academic way of saying that one is linked to the other), it can be tested.

The results painted a somewhat different picture than you might expect. There was some evidence of a beauty premium in that pretty people earned more than average looking people. However, the researchers found that attractiveness and earnings were not at all monotonic. In fact, ugly people earned more than both average and attractive people, with “very unattractive” people winning out in most cases. So no ugliness penalty and no discrimination there. Good, we don’t like discrimination. Rather, the underlying productivity of workers as measured by their intelligence and education accounted for the associations observed. Basically, ugly people were smarter (and yes, IQ was a variable).


This occurs in the absence of discrimination. A person self-sorts themselves into an attractiveness group based on how attractive they perceive themselves to be and may choose their occupation accordingly. If a pretty person chooses an occupation that has higher earnings (or vice versa), then there is a positive association between attractiveness and earnings both across and within occupations.

Once again, the results were unexpected. The self-selection hypothesis was refuted. Ugly people earned more than pretty people. In fact, very unattractive people earned more than both regular unattractive and average looking people. This is where the researchers start calling this effect “the ugliness premium.” Good term.

Individual Differences

This one posits that a pretty and ugly people are genuinely different. Try looking at it in the context of evolutionary biology. Physical attractiveness is based on facial symmetry, averageness, and secondary sexual characteristics, which all signal genetic and developmental health. Many traits can be quantified very accurately with today’s computers. There are standards of beauty both within a single culture and across all cultures. Studies have also shown that attractive children receive more positive feedback from interpersonal interactions, making them more likely to develop an extraverted personality. If health, intelligence, and personality, along with other measures of productivity, are statistically controlled then attractiveness should be able to be compared to earnings.

Again, there was absolutely no evidence for either the beauty premium or the ugliness penalty. Rather, there was some support for the ugliness premium. Now keep in mind, this was not as much a this-higher-than-that, but more of a this-different-from-that type of hypothesis. So there actually is strong support that there are differences. There was a significantly positive effect of health and intelligence on earnings. Also, the “Big Five” personality factors – Openness, Conscientiousness, Extroversion, Agreeableness, and Neuroticism (or OCEAN…cute) – were significantly correlated with physical attractiveness. Pretty people were more OCEA and less N. This may be why looks appear to have an effect on earnings.

Overall, not what you thought it would be, huh? Me either. The importance of intelligence and education as it correlates with attractiveness would be an interesting next step. I wonder if it reflects the time at which these data were taken. We are seeing the Rise of the Nerds, where intelligence is outpacing beauty in terms of success. Had they analyzed data from another decade, would the ugliness penalty find support?

Kanazawa, S., & Still, M. (2017). Is There Really a Beauty Premium or an Ugliness Penalty on Earnings? Journal of Business and Psychology DOI: 10.1007/s10869-017-9489-6

image via Linked4Success

Friday, May 19, 2017

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