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Introduction: Outdoor workers are at increased risk for developing skin cancer compared to the general population due to environmental conditions at work sites and riskier behavior regarding skin cancer risk factors. In many populations, sun protection education is associated with increased use of sun protective measures. This study aimed to assess outdoor workers’ knowledge of sun safety and evaluate the impact of educational measures on the awareness of photoprotection practices. Methods: A group of medical students visited construction sites in Birmingham, AL, to deliver 15-minute presentations on the risks of prolonged UV exposure and the prevention of photodamage. Identical 10-question surveys were given to each participant before and after the presentation. Participants rated their level of agreement with statements on photoprotection and skin cancer. Results: The survey response rate was 79%. Analysis revealed an average pre-presentation score of 3.01 and a post-presentation score of 3.73. Two-sample paired t-tests for each question yielded statistically significant results (p

This evidence-based review highlights cutaneous infections of bacterial, viral, and fungal origin that are frequently encountered by clinicians in all fields of practice. With a focus on treatment options and management, the scope of this article is to serve as a reference for physicians, regardless of field of specialty, as they encounter these pathogens in clinical practice.

Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition that poses a significant diagnostic and therapeutic challenge for clinicians, as the underlying etiology and pathogenesis remains unclear. The host of genetic mutations and immune dysfunction has been identified to be involved in the pathogenesis of HS during recent years. These genetic defects, including monogenetic mutations altering subunits of γ-secretase, a protease that functions through Notch signaling to maintain skin appendages, promote epithelial stability, suppress/terminate innate immune responses (ie, Toll-receptors), further have the propensity to induce aberrant cytokine responses that create to a proinflammatory environment, consequently induce hyperkeratosis and promote expression of pro-inflammatory, locally destructive matrix metalloproteinases. Cytokine-driven inflammation propagates the disease state of HS and contributes to the formation of painful subcutaneous nodules, abscesses, and eventually, fistulas and draining sinus tracts. A closer look at genetic mutations linked to the disease may explain the immune perturbations seen in HS. An understanding of the immune cells and inflammatory markers expressed in affected individuals provides insight into disease pathogenesis and can help identify therapeutic targets.

Nail manifestations are 1 of the several extrapulmonary findings associated with COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Nail changes, however, have been largely ignored and not yet summarized. This article is intended to increase awareness of nail manifestations of SARS-CoV-2, which occur weeks to months after acute infection and the periungual pernio-like changes may occur concomitantly with infection. An electronic search was carried out in PubMed (Medline), Science Direct, and Scopus databases. The following keywords and all of their possible combinations were used to identify studies: “SARS-CoV-2,” “COVID-19,” “Coronavirus,” “2019-ncov,” “nail,” and “nails.” Six case reports were included in this study. Manifestations identified included red half-moon sign, transverse orange nail lesions, Mees’ lines, and Beau’s lines. Though largely nonspecific, these findings can be recognized with the onset of symptom onset or as late as 16 weeks following the disease. Some of these findings are shared with other conditions associated with a proinflammatory state. Nail changes offer unique insight into the pathophysiologic basis for SARS-CoV-2 and they may serve as diagnostic clues.

For nearly a century, the definitive treatment of many corneal dystrophies and ectactic disorders was limited to penetrating keratoplasty, but over the past 2 decades, a surge of surgical innovation has propelled the treatment of many corneal diseases to more targeted approaches with significantly better visual outcomes. Anterior stromal diseases were first changed through endothelial-sparing techniques, such as deep anterior lamellar keratoplasty, but have more recently transitioned to stromal-sparing approaches. Ultraviolet corneal crosslinking strengthens the cornea and halts progression of keratoconus in >90% of cases. Intracorneal ring segment and corneal allogenic ring segment implantation offer methods to flatten ectatic corneas. However, Bowman layer transplantation – inlay and more recently onlay techniques – has shown promise for treating advanced keratoconus and preventing keratoplasty. The advent of endothelial keratoplasty radically changed the treatment of corneal endothelial dysfunction, and Descemet membrane endothelial keratoplasty specifically offers an average postoperative visual acuity of 20/25 (0.8) with only 8.8% of grafts requiring retransplantation in the first 5 years. Here, we review the rapid innovations for surgical treatment of corneal diseases, spanning from endothelial keratoplasty and endothelial regeneration to anterior lamellar keratoplasty and stromal augmentation, highlighting key steps which may be moving us closer to a “postkeratoplasty” world.

Pediatric lichen planopilaris (LPP) is a clinical variant of lichen planus (LP) that can lead to scarring hair loss without prompt intervention. While various therapies exist, intralesional and topical corticosteroids remain the mainstay of treatment in pediatric LPP. Refractory cases may require systemic therapies, selection of which may prove challenging due to the lack of data regarding pediatric disease and effective treatment regimens. The objective of this case study is to present a new instance of pediatric LPP and identify all reported cases of pediatric LPP with an emphasis on treatment and response. J Drugs Dermatol. 2021;20(7):779-782. doi:10.36849/JDD.5729.

This evidence-based review highlights cutaneous infections of bacterial, viral, and fungal origin that are frequently encountered by clinicians in all fields of practice. With a focus on treatment options and management, the scope of this article is to serve as a reference for physicians, regardless of field of specialty, as they encounter these pathogens in clinical practice.

The purpose of this study was to assess outcomes in a real-world nonclinical trial setting of antivascular endothelial growth factor (VEGF) injections alone vs. focal laser combined with anti-VEGF injections in patients with branch retinal vein occlusion- (BRVO-) related macular edema (ME). This study included 88 BRVO with ME patients who were treated over three years at both a tertiary referral center in the Birmingham metropolitan area and satellites in rural Alabama. One group received only anti-VEGF injections (n = 56); the other group received both anti-VEGF injections and focal laser (n = 32). The following outcome measures were evaluated: initial and final visual acuities (VA), initial central subfield thickness (CST) on OCT, number of injections, number of lasers, percentage of patients with a gain of 3 lines of VA, percentage of patients with VA better than or equal to 20/40, and percentage of patients with VA worse than or equal to 20/200. We found that there was no difference in initial VA ( p = 0.913 ) or CST ( p = 0.961 ) between the two groups. The injection only group required a median of 7 injections, while the combination group required a median of 4 injections, but this was not a statistically significant difference ( p = 0.117 ). There was no difference in final VA ( p = 0.414 ) or any of the other visual outcomes between the two groups. In conclusion, focal laser did not decrease the number of injections required or improve the VA in BRVO-related ME. Although visual outcomes were similar in both groups, focal laser does not appear to be of additional benefit in BRVO-related ME in the anti-VEGF era.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that is clinically defined by lesions ranging from painful, deep seated nodules to abscesses, draining sinus tracts, and ultimately, irreversible fibrotic scars. While the etiology remains unclear, a number of mechanisms ranging from genetics to aberrations of the immune system have been proposed. In addition, HS has a number of associations and may occur in conjunction with several diseases that span a host of medical specialties. The estimated prevalence ranges are from 1% to 4%; however, a large degree of under-reporting and misdiagnosis of this condition likely underestimates its true clinical significance. The debilitating consequences of missed diagnoses or improper management leads to severe pain and irreversible cutaneous manifestations (i.e., fistulae, sinus tracts, disfiguring scarring). HS has been found to significantly impair patients' quality of life to a greater degree when compared with other skin conditions. Early recognition and treatment are critical for a favorable prognosis, and diagnostic delays may be related to variable presentations within numerous comorbidities. Here we provide an in-depth, clinical-based review of HS, highlighting the clinical presentation, pathophysiology, grading systems, epidemiology, and comorbidities, in hopes of shedding light on an often misunderstood disease and ultimately moving closer to a more conclusive understanding of its various presentations and association.