Cutis最新文献

Accurate specimen identification is critical in the everyday practice of dermatology. Formalin, which is used to preserve tissue samples, also acts as a solvent and can cause fading of the ink used to label specimen containers. Herein, we identify commonly used pens and markers with various inks that are susceptible or resistant to accidental formalin exposure to ensure durability of specimen labeling.

Personal electronic devices including smartphones, headphones, fitness watches, and continuous glucose monitors (CGM) increasingly are integrated into daily life, driven by consumer interest in data tracking and wellness. Prolonged skin contact with these devices has emerged as a source of allergic contact dermatitis (ACD). This review explores the potential allergenicity of personal electronic devices, with the most commonly reported allergens including (meth)acrylates, metals, and rubber compounds. These allergens may be present in device components, casings, and adhesives. Exposure to mechanical friction and sweat as well as prolonged skin contact potentially enhance the risk for ACD. Diagnostic challenges are compounded by incomplete ingredient disclosure by manufacturers. With the personal electronic device market projected to experience massive growth, health care providers must be vigilant in recognizing and managing ACD related to these devices.

As the field of medicine changes to align with technological advancements, government regulations, and insurance reimbursement, dermatology residents are faced with the increasingly difficult task of selecting the practice model that best fits their personal and professional goals. Private practice can provide greater autonomy and higher earning potential but requires strong business acumen and carries major financial risks. Academic dermatology prioritizes teaching, research, and collaboration but often generates less compensation and has increased institutional responsibilities. Hybrid models, Veterans Affairs (VA) positions, and rural practice present additional options with varying degrees of flexibility and support. Although career decisions may seem overwhelming, dermatology residents can choose the right path and achieve a fulfilling career by educating themselves about practice models, clearly assessing personal goals, and identifying supportive mentors.

Epidermolysis bullosa acquisita (EBA) and bullous systemic lupus erythematosus (BSLE) are autoimmune mechanobullous diseases that are caused by autoantibodies directed against type VII collagen. The functionality of type VII collagen is vital to the skin and mucous membranes because it makes up the anchoring fibrils that adhere the epithelium to the underlying connective tissue. Dystrophic epidermolysis bullosa (DEB), which bears some clinical similarities to EBA and BSLE, is caused by mutations in the type VII collagen gene (COL7A1) that may be dominant or recessive, leading to partial or total loss of the anchoring fibrils. Differentiating all 3 of these rare diagnoses variably requires thorough personal and family histories, histopathology, immunopathology, autoantibody profile, electron microscopy, and gene mutation analysis. Treatment of EBA and BSLE involves antineutrophil and immunosuppressive drugs that often give unsatisfactory responses. Rituximab has been successful in resistant cases. Until recently, the treatment of DEB and other heritable epidermolysis bullosa (EB) diseases caused by disparate mutations was limited to supportive care, prevention of trauma to skin and wound infections, regular dressing changes, and skin cancer surveillance. Three major treatment advances recently were approved for DEB and junctional EB.

Fluoroscopy-induced chronic radiation dermatitis (FICRD) is a rare complication of prolonged radiation exposure during noninvasive fluoroscopic procedures. The condition develops due to radiation-induced tissue damage, leading to inflammatory cytokines causing long-term tissue remodeling. Fluoroscopy-induced chronic radiation dermatitis can pose diagnostic challenges, as it can manifest months to years after the procedure-thus, patients may not associate skin findings with prior fluoroscopy. The diagnostic challenge may be further compounded because FICRD may have clinical manifestations that mimic other common dermatologic diseases; however, specific patient characteristics, morphology, and most importantly the location of the lesions should prompt an investigation into the patient's history of fluoroscopic procedures. Management of FICRD should be based on its clinical manifestations but may remain resistant to treatment.