Infection prophylaxis in periorbital Mohs surgery and reconstruction: a review and update to recommendations.

Mohs micrographic surgery and reconstruction is considered by many as the gold standard for treatment of cutaneous malignancies arising in the periorbital region. It has a high rate of tumor clearance and a low rate of postsurgical complications. One of the most common complications is surgical site infection. Although surgical site infection occurs in less than 3% of patients, it may result in significant morbidity. Considerable research efforts have been devoted to identifying risk factors associated with the development of a postsurgical infection. We examine the impact of endogenous factors (which determine the efficacy of a patient's immune system), exogenous factors (which influence a patient's exposure to bacterial pathogens), and antimicrobial interventions on the incidence of surgical site infection and propose evidence-based recommendations.

Corneal ulceration and episcleritis associated with Wiskott-Aldrich syndrome.

PURPOSE: To present anterior segment ophthalmic manifestations of Wiskott-Aldrich syndrome (WAS), a rare X-linked primary immune-deficiency. OBSERVATIONS: A 15-year old male with WAS presented with multiple corneal ulcers of the left eye. Once resolved, this was followed by separate episodes of episcleritis in the left eye and corneal infiltrates of the right eye. Successful treatment included topical antibiotics and anti-inflammatories. CONCLUSIONS: Ocular manifestations of WAS, due to secondary infection and inflammation, may be severe. This case report emphasizes the importance of prompt ophthalmic evaluation and treatment of these patients.