Disseminated Blastomycosis in an African American immunocompetent pediatric patient: Lessons learned.

Disseminated blastomycosis can be challenging to diagnose given possible involvement of nearly any extrapulmonary organ system and the limitations of fungal diagnostic testing. Certain racial groups are at increased risk of disseminated fungal infections, even in immunocompetent patients. We describe a case of disseminated blastomycosis with cutaneous involvement in an African American adolescent with delayed diagnosis. Dermatologists can play an important role in the timely diagnosis of this disease entity by performing appropriate cutaneous biopsy techniques and should be involved early in these cases.

Risk factors for the development of acne in healthcare workers during the COVID-19 pandemic.

The COVID-19 pandemic has led to many healthcare workers having prolonged contact with tight-fitting masks, leading to maskne. "Maskne" is defined as acne secondary to mask use. There are limited studies on maskne during the COVID-19 pandemic. The objective of this study is to identify risk factors for the development of maskne amongst healthcare workers. A cross-sectional survey was completed by 227 medical students, resident physicians, and nursing students at Johns Hopkins Medicine, with 68.7% of participants reporting development of maskne. Surgical masks and respirators were the most prevalent mask types worn at work. The most common prevention methods were the use of mild cleansers and moisturizers. Chi-squared analysis was used for data analysis. The results of this study indicate that gender (p = 0.003) and duration of mask use (p = 0.048) are significant risk factors for maskne development. These factors are non-modifiable, but may be used for more targeted education for prevention.

Time to treatment and complexity of Mohs micrographic surgery.

The impact of time to treatment (TTT) on the surgical management of keratinocyte carcinoma, specifically the complexity of Mohs micrographic surgery (MMS), is incompletely understood. We performed a retrospective chart review of patients undergoing MMS for keratinocyte carcinoma between July 1, 2019 and February 28, 2021 to examine associations between TTT and surgical characteristics. The median TTT for the 1571 patients treated with MMS during the study period was 42 days (interquartile range 28-61 days). In adjusted analyses, increasing TTT was not associated with increasing utilization of flap or graft repairs. Although a 42-day increase in TTT was associated with a 17.6 mm2 increase in the post-operative surgical defect size after MMS, TTT was not associated with linear repair length or flap/graft repair area. In conclusion, TTT was not independently associated with the type of repair or repair length after MMS, suggesting that the complexity of Mohs reconstruction is not influenced by TTT within the time range studied in this cohort.