Rocky Mountain spotted fever contracted along a Canadian road trip: A case report.

Rocky Mountain spotted fever, a potentially fatal tick-borne disease thought to be confined to specific climates and geographic locations, is expanding its reach due to climate change. This is demonstrated by a 73-year-old woman who contracted Rocky Mountain spotted fever outside endemic areas during travel in Canada. Presenting with fevers, arthralgia, weakness, non-bloody diarrhea, conjunctivitis, mild cough, and a rash, this patient was initially started on moxifloxacin (400 mg PO/day) for suspected pneumonia. Treatment was changed to doxycycline (100 mg PO twice daily for 7 days) after dermatology was consulted, and Rocky Mountain spotted fever was thought to be higher on the differential. Rocky Mountain spotted fever was confirmed, and the patient responded well to antibiotics, improving by discharge. The disease's expansion into previously thought nonendemic areas is thought to be linked to milder winters and more extreme dry summers, facilitating pathogen development and tick lineage expansion.

Cutaneous candidiasis mimicking acute generalized exanthematous pustulosis: A case report.

Disseminated cutaneous candidiasis is a rare manifestation of candidiasis that arises most commonly from Candida albicans. It is described as a widespread erythematous papulopustular skin infection that typically affects premature newborns or immunocompromised patients. While candidal infections usually respond well to antifungal therapy, the clinical presentation of disseminated cutaneous candidiasis can often mimic a variety of other dermatologic conditions, that can lead to delayed diagnosis and treatment. We present a 67-year-old comorbid male patient with widespread erythema and superficial pustules resembling acute generalized exanthematous pustulosis (AGEP) that was actually an unexpected manifestation of disseminated cutaneous candidiasis. Prompt initiation of a topical and oral antifungal regimen contributed to marked improvement. Given the high frequency of drug eruptions in comorbid patients receiving multiple medications, alternate diagnoses like infections should be included in the differential diagnosis.

Pityriasis rubra pilaris partially responsive to treatment with upadacitinib: A case report.

Pityriasis rubra pilaris is a rare inflammatory dermatosis characterized by orange-red confluent plaques, hyperkeratotic follicular papules, palmoplantar keratoderma, and, in some cases, erythroderma. The etiology of pityriasis rubra pilaris is unclear. This condition is often treated with oral retinoids and topical corticosteroids, and more recently, biological agents have become the mainstay of treatment. However, there is a paucity of high-quality evidence on the safety and effectiveness of these agents, and the disease often remains refractory to therapy. Herein, we present a case of pityriasis rubra pilaris with a favorable response to treatment with upadacitinib, a Janus kinase inhibitor, which has not been previously reported in the literature for the management of this condition.

Upadacitinib-induced paradoxical face and scalp dermatitis: A case report of a novel sequela.

Atopic dermatitis is a chronic, pruritic inflammatory cutaneous condition that can carry significant morbidity. Severe or recalcitrant atopic dermatitis is often treated with immunosuppressants, biologics, or immune-modulating small molecule therapies. The Janus kinase-signal transducer and activator of transcription pathway is highly implicated in atopic dermatitis pathogenesis, and agents that inhibit Janus kinase signalling are new to the atopic dermatitis landscape. Upadacitinib is a JAK1 inhibitor that has a good safety and efficacy profile and is increasingly being prescribed for atopic dermatitis. We report a case of a 35-year-old male with extensive atopic dermatitis that initially improved significantly on upadacitinib, then after 6 months developed a severe crusted dermatitic eruption on the head favouring a seborrheic distribution. While the pathogenesis of this paradoxical reaction is unclear, this phenomenon may involve a shift to a more Th1/Th17-mediated immune response.

Cutaneous sarcoidosis in eyebrows cosmetically pigmented with microblading method: A case report and review of the literature.

Microblading is a novel method of semi-permanent makeup, which has achieved popularity in the last few years. We present the case of a patient who developed cutaneous sarcoidosis after microblading of her eyebrows. A 45-year-old female presented with a 6-month history of pruritic erythematous granulomatous plaques on bilateral eyebrows corresponding to the site of microblading 1.5 years prior. A tissue biopsy was preformed which was consistent with cutaneous sarcoidosis. An extensive work-up including assessment by respirology, rheumatology, and ophthalmology did not reveal any evidence of systemic sarcoidosis. The patient was treated with intralesional triamcinolone injections and tacrolimus ointment twice daily, with complete resolution. To our knowledge, this is the first case of cutaneous sarcoidosis associated with microblading in the literature. Dermatologists should be aware of popular and novel cosmetic procedures and the potential complications that arise from these interventions.

An unusual case of pediatric embryonal rhabdomyosarcoma with subsequent diagnosis of neurofibromatosis type 1.

A 10-month-old girl presented with a 4-month history of a rapidly growing lesion on the lower lip. Initial assessment and Doppler ultrasound supported a diagnosis of pyogenic granuloma. However, emergent biopsy revealed an embryonal rhabdomyosarcoma, a highly malignant tumor commonly associated with cancer-susceptible syndromes including neurofibromatosis type 1 (NF1). Despite having no apparent clinical features of NF1 at initial presentation, she was later found to have multiple café-au-lait spots and a subsequent diagnosis of NF1 was made.

Implementation of Ultraviolet Radiation Safety Measures for Outdoor Workers.

Ultraviolet radiation (UVR) poses a major risk for outdoor workers, putting them at greater risk for skin cancer. In the general population, the incidence of both melanoma and nonmelanoma skin cancers is increasing. It is estimated that 90% of skin cancers in Canada are directly attributable to UVR exposure, making this cancer largely preventable with the appropriate precautions. A scoping review was conducted on the barriers and facilitators to UVR safety in outdoor workers to elucidate why these precautions are not in use currently. We discuss these results according to the Hierarchy of Controls as a means to outline effective and feasible prevention strategies for outdoor workers. In doing so, this review may be used to inform the design of future workplace interventions for UVR safety in outdoor workers to decrease the risk of skin cancer in this vulnerable population.