ABSTRACT
"Maskne" is a new term coined during the 2020 COVID-19 pandemic. It refers to a subset of acne mechanica, deserving consideration in view of widespread reusable fabric mask-wearing to control the pandemic worldwide. Understanding of underlying pathophysiology directly relates to the novel skin microenvironment and textile-skin friction created by mask-wearing, distinct from nontextile-related acne mechanica previously linked to wearing of headgear. Specifically, the occlusive microenvironment leads to microbiome dysbiosis, which is linked to various dermatological conditions. Additional textile-skin interactions include factors such as breathability, stickiness sensations, moisture saturation, and hygiene maintenance. Increased skin temperatures can trigger sweat/heat-related dermatoses, and ear loops potentially trigger pressure-induced dermatoses. Important therapeutic considerations include increased skin irritation potential of conventional acne treatments under occlusion, exacerbation of chronic dermatoses, that is, perioral dermatitis, rosacea, and eczema, and susceptibility of these same patient groups to heightened discomfort with mask-wearing. Cotton, as the traditional fabric of choice for dermatology patients, has limited benefits in the context of face masks - increased subjective discomfort relates to increased moisture saturation and stickiness, inevitable because of high biofluid load of the nasal and oral orifices. Prolonged textile-skin contact time, directly proportional to the risk of maskne, can be an opportunity for the application of biofunctional textiles.
Subject(s)
COVID-19 , Microbiota , Humans , Masks , Pandemics , SARS-CoV-2Subject(s)
Delusional Parasitosis , Pyrimidines/administration & dosage , Risperidone/administration & dosage , Aged , Delusional Parasitosis/diagnosis , Delusional Parasitosis/drug therapy , Delusional Parasitosis/physiopathology , Delusional Parasitosis/psychology , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Psychotropic Drugs/administration & dosage , Retrospective Studies , Singapore/epidemiology , Symptom Assessment , Treatment OutcomeABSTRACT
Current treatments for hidradenitis suppurativa (HS) include prolonged courses of antibiotics, retinoids, immunosuppressants, and biologics. Severe cases that are resistant to prolonged medical treatment pose a therapeutic challenge. We propose radical excision and lateral thoracic flap reconstruction as a treatment option for such cases. In our experience with two patients, good aesthetic and functional outcomes were achieved, with a high level of patient satisfaction. The availability of suitable flap coverage allows for wide resection of all of the hair-bearing skin, leading to a low incidence of residual disease and subsequent recurrence. Following excision of the affected tissue, the ideal reconstructive method in the axilla provides suitable coverage without unacceptable donor site morbidity and also avoids axillary contractures. A long lateral thoracic flap with delay has excellent coverage with minimal donor tissue sacrifice. With a suitable flap coverage option, the management paradigm of intractable HS should shift from prolonged medical treatment to allow decisive radical excision, which will improve the quality of life for patients.
Subject(s)
Colitis, Ischemic/etiology , Lymphoma, T-Cell/complications , Splanchnic Circulation , Vascular Neoplasms/complications , Biomarkers, Tumor/metabolism , Colectomy , Colitis, Ischemic/diagnosis , Colitis, Ischemic/surgery , Enterostomy , Fatal Outcome , Humans , Intestinal Mucosa/pathology , Lymphoma, T-Cell/metabolism , Lymphoma, T-Cell/pathology , Neoplasm Proteins/metabolism , Vascular Neoplasms/metabolism , Vascular Neoplasms/pathologySubject(s)
Carcinoma, Basal Cell/surgery , Facial Neoplasms/surgery , Skin Neoplasms/surgery , Adult , Aged , Female , Humans , Male , Middle Aged , Retrospective Studies , Singapore , Time FactorsSubject(s)
Back/pathology , Skin Diseases/diagnosis , Thorax/pathology , Collagen , Fibrosis/diagnosis , Fibrosis/pathology , Humans , Male , Middle Aged , Skin Diseases/pathologySubject(s)
Herpesvirus 4, Human/genetics , Lymphoma, Extranodal NK-T-Cell/virology , Lymphoma, T-Cell, Cutaneous/virology , RNA, Viral/isolation & purification , Skin Neoplasms/virology , Aged , Antineoplastic Agents/therapeutic use , Biopsy , Diagnostic Errors , Humans , Lymphoma, Extranodal NK-T-Cell/diagnosis , Lymphoma, Extranodal NK-T-Cell/pathology , Lymphoma, Extranodal NK-T-Cell/therapy , Lymphoma, T-Cell, Cutaneous/diagnosis , Lymphoma, T-Cell, Cutaneous/pathology , Lymphoma, T-Cell, Cutaneous/therapy , Lymphoma, T-Cell, Peripheral/diagnosis , Male , Predictive Value of Tests , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Skin Neoplasms/therapy , Skin Transplantation , Thigh , Treatment OutcomeABSTRACT
Allopurinol hypersensitivity syndrome(AHS) is a severe form of cutaneous adverse reaction that is associated with significant morbidity and mortality. We report a case of AHS with the cutaneous manifestation of acute generalised exanthematous pustulosis(AGEP). A 47 year old gentleman, with no previous skin disease, presented with a generalized mildly pruritic erythematous rash on the trunk and all 4 limbs, with patches of superficial non-follicular pustules. Our patient fulfilled both criteria for AGEP and AHS.