Full Guidelines-From the Medical Board of the National Psoriasis Foundation: Perioperative management of systemic immunomodulatory agents in patients with psoriasis and psoriatic arthritis.

BACKGROUND: Systemic immunomodulatory agents are indicated in the treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis. Perioperative use of these medications may increase the risk of surgical site infection (SSI) and complication. OBJECTIVE: To evaluate the risk of SSI and complication in patients with chronic autoimmune inflammatory disease receiving immunomodulatory agents (tumor necrosis factor-alfa [TNF-α] inhibitors, interleukin [IL] 12/23 inhibitor, IL-17 inhibitors, IL-23 inhibitors, cytotoxic T-lymphocyte-associated antigen-4 costimulator, phosphodiesterase-4 inhibitor, Janus kinase inhibitors, tyrosine kinase 2 inhibitor, cyclosporine (CsA), and methotrexate [MTX]) undergoing surgery. METHODS: We performed a search of the MEDLINE PubMed database of patients with chronic autoimmune inflammatory disease on immune therapy undergoing surgery. RESULTS: We examined 48 new or previously unreviewed studies; the majority were retrospective studies in patients with rheumatoid arthritis and inflammatory bowel disease. CONCLUSION: For low-risk procedures, TNF-α inhibitors, IL-17 inhibitors, IL-23 inhibitors, ustekinumab, abatacept, MTX, CsA, and apremilast can safely be continued. For intermediate- and high-risk surgery, MTX, CsA, apremilast, abatacept, IL-17 inhibitors, IL-23 inhibitors, and ustekinumab are likely safe to continue; however, a case-by-case approach is advised. Acitretin can be continued for any surgery. There is insufficient evidence to make firm recommendations on tofacitinib, upadacitinib, and deucravacitinib.

Interdigital Toe Web Space Erythrasma in a Young Child: A Case Report.

Erythrasma is a common superficial skin infection in adults. However, there is a paucity of reported cases in the pediatric population. Here we report a case of interdigital pedal erythrasma presenting in a four-year-old child as itchy, scaly maceration.

A Case Report of Sebaceous Filaments.

This report details a case of a 16-year-old African American girl who presented with a two-year history of white spicules on her face without associated symptoms, including pruritus or pain. On physical examination, there were many 1-2 mm discreet white to yellow filamentous spicules on the mid and lower face. Histopathology scrapings showed cornified cells and calcification consistent with sebaceous filaments. Sebaceous filaments are a rare condition that presents as white-to-yellow spicules distributed in highly sebaceous areas on the face. It is caused by sebum accumulation and cornified keratinocytes surrounding hair follicles, resulting in visible excretions. Treatment of sebaceous filaments is targeted at reducing the size of sebaceous glands which subsequently decreases excretions and improves skin appearance. Despite low incidence, sebaceous filaments are likely under-reported. It is important for dermatologists to recognize and treat sebaceous filaments in patients who present with this condition to improve their appearance and quality of life. The present patient was successfully treated with topical tretinoin.

Do We Need to Monitor for Graves' Disease After a Diagnosis of Pemphigoid Gestationis?

Pemphigoid gestationis (PG) is a rare autoimmune bullous disease that occurs during pregnancy or the postpartum period. PG has been associated with an increased risk of Graves' disease possibly due to shared genetic factors and immune system fluctuations during pregnancy. However, the evidence supporting the association between PG and Graves' disease is mixed. Although dermatologists are cautioned to watch for Graves' disease in patients with a history of PG, this guidance is based on a single cohort where most patients were diagnosed with Graves' disease prior to PG onset. Recent data failed to find an association between Graves' disease and PG but did not capture the lifetime risk of Graves' disease in these patients. Future studies could focus on long-term follow-up of females with PG, shedding light on the lifetime risk profiles of these patients.

Topical Tacrolimus and Alcohol-Induced Facial Flushing: A Case Report and Literature Review.

Flush reactions can be incited by various factors including inherent mutation, drugs, and diseases. A medication that is commonly used in dermatology but less associated with alcohol-induced facial flushing is topical tacrolimus. We present the case of a 44-year-old man experiencing this phenomenon on a distant, non-application site and a review of cases published in the literature.

Acneiform Eruption Secondary to Over-the-Counter Vitamin B12.

Treating an acneiform eruption requires the discovery of its etiology. Often, the removal of the offending agent can lead to the resolution of the eruption, resulting in an excellent prognosis. Herein, we present a rare case of a vitamin B12-induced acneiform eruption occurring in a 68-year-old female due to an over-the-counter supplement.

Rowell Syndrome in a Middle-Aged Woman: A Case Report.

Rowell syndrome (RS) is characterized by the presentation of lupus erythematosus (LE) with erythema multiforme (EM)-like lesions. It is thought to display a characteristic serologic pattern consisting of a "speckled-type" antinuclear antibody (ANA), positive anti-Ro/SSA or anti-La/SSB, or positive rheumatoid factor (RF). We report the case of a patient with subacute cutaneous lupus erythematosus (SCLE) who presented with EM-like lesions responsive to oral corticosteroids.

Lichen Sclerosus of the Lip.

In this case report, we outline a case of a 36-year-old woman who presented to the dermatology clinic with a history of a hypopigmented macule on her lip. After conducting hepatitis C antibody testing and a shave biopsy, the patient was diagnosed with lichen sclerosus. Because of the increased risk for squamous cell carcinoma, she underwent an anogenital exam, where no lesions were found.