Cutis; Cutaneous Medicine for the Practitioner

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Surgical removal of epidermoid cysts can result in "cyst spray," posing a nuisance and risk to the surgeon, staff, and patients. Employing simple techniques at the time of anesthesia administration may decrease exposure to cyst spray. We describe 2 methods that can help: (1) placing an antiseptic-soaked gauze pad over a premarked lesion, or (2) covering the cyst with a clear biohazard bag.

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Skin of color centers (SoCCs) in the United States have helped increase the racial/ethnic diversity of and cultivate cultural competence in practicing dermatologists as well as increase skin of color (SoC) research and education to improve patient care. The objective of this cross-sectional survey study was to provide an in-depth analysis of SoCCs and SoC specialty clinics (SoCSCs) in the United States, including their patient care focus, research, and program diversity. As the US population diversifies, it is important to highlight the programmatic, research, and educational work of existing SoCCs so that they can continue to be supported and so efforts are made to encourage the establishment of future centers at academic medical institutions across the United States...

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Mohs micrographic surgery (MMS) is a well-recognized treatment for nonmelanoma skin cancer worldwide, but Japan has lagged behind many other countries in adopting MMS. We present a series of 5 cases of MMS utilized in Japanese patients. All cases had a favorable outcome, each benefiting from MMS with a smaller final defect or a higher likelihood of cure than standard excision. Slow adaptation of MMS in Japan likely is due to a lack of familiarity with the technique, lack of a training pipeline for physicians, barriers to payment for the procedure, and misconceptions among Japanese physicians...

Long-term practice and performance with a musical instrument predispose musicians to several skin conditions and nail disorders. We conducted a comprehensive literature search of the PubMed, Scopus, and Google Scholar databases for articles on nail alterations in musicians. Complications were divided into modifications of the nail surface and nail plate, soft-tissue abnormalities, and periungual tissue and distal pulp disorders. Health care professionals should be aware of these various modifications related to the use of musical instruments and provide preventive measures...

The US Military has made considerable strides in providing quality health care to transgender and gender diverse service members (TSMs). Current policies ensure continued military readiness and allow TSMs to receive gender-affirming care while continuing to serve. Dermatologists play an important role in the multidisciplinary medical team required for medical gender transition; however, there is considerable discord between medically necessary procedures for dermatologic gender-affirming care and insurance-covered benefits...

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Brazilian peppertree (Schinus terebinthifolia), a member of the Anacardiaceae family, has invaded territory throughout the world, including the southeastern and western United States. Similar to fellow family members poison ivy and poison oak, Brazilian peppertree causes allergic contact dermatitis (ACD) in susceptible individuals. As this pest increases its range, dermatologists living in endemic areas should familiarize themselves with Brazilian peppertree, its effects on the skin, and how to treat any associated ACD...

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A generalized fixed drug eruption (FDE) is an uncommon but potentially dangerous reaction to medication. In this case series, we present 1 patient with a generalized FDE and 2 patients with generalized bullous FDE that resolved with cyclosporine, though 1 patient required close monitoring in the intensive care unit. Immediate acceleration of care upon development and recognition of generalized bullous FDE is essential, as the mortality rate is similar to Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN)...

Nail disorders are common in the pediatric population and affect quality of life. We review inflammatory conditions (ie, nail psoriasis, nail lichen planus [NLP], trachyonychia, nail lichen striatus, nail atopic dermatitis [AD]) as well as infectious conditions (ie, nail disease due to hand, foot, and mouth disease [HFMD] or Kawasaki disease, onychomycosis, acute paronychia). Inflammatory and infectious nail conditions may involve the skin or occur in isolation. By highlighting the distinctive features and clinical presentations of these infectious and inflammatory nail disorders in children, we aim to raise awareness among dermatologists to improve diagnosis and management...

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Isotretinoin is widely used for treatment of severe cystic acne; however, its use is accompanied by mucocutaneous adverse effects. The established protocol for conducting cutaneous procedures on patients undergoing current or recent treatment with isotretinoin recommends a cessation period of at least 6 months to mitigate risks for delayed wound healing and hypertrophic scarring due to medication-induced skin fragility. We present a unique case of isotretinoin-induced skin fragility resulting in blistering and erosions on the palms of a 25-year-old competitive aerial trapeze artist...

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