Ocular infection with HSV-1 continues to be a serious clinical problem despite the availability of effective antivirals. Primary infection with HSV-1 can involve ocular and adenaxial sites and can manifest as blepharitis, conjunctivitis, or corneal epithelial keratitis. After initial ocular infection, HSV-1 can establish latent infection in the trigeminal ganglia for the lifetime of the host. During latency, the viral genome is retained in the neuron without producing viral proteins. However, abundant transcription occurs at the region encoding the latency-associated transcript, which may play significant roles in the maintenance of latency as well as neuronal reactivation. Many host and viral factors are involved in HSV-1 reactivation from latency. HSV-1 DNA is shed into tears and saliva of most adults, but in most cases this does not result in lesions. Recurrent disease occurs as HSV-1 is carried by anterograde transport to the original site of infection, or any other site innervated by the latently infected ganglia, and can reinfect the ocular tissues. Recurrent corneal disease can lead to corneal scarring, thinning, stromal opacity and neovascularization and, eventually, blindness. In spite of intensive antiviral and anti-inflammatory therapy, a significant percentage of patients do not respond to chemotherapy for herpetic necrotizing stromal keratitis. Therefore, the development of therapies that would reduce asymptomatic viral shedding and lower the risks of recurrent disease and transmission of the virus is key to decreasing the morbidity of ocular herpetic disease. This review will highlight basic HSV-1 virology, and will compare the animal models of latency, reactivation, and recurrent ocular disease to the current clinical data.

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Given the rates of pruritic tattoos and tattoo regret, there is an opportunity, and trust among people with tattoos, for dermatologists to manage these complications.

Background Photograph editing has become popular for individuals using social media like Instagram. However, it is unknown if the use of social media and photograph editing applications by young adults has an association with seeking dermatologic care. Aims To assess the frequency of photograph editing among a cohort of young adults using Instagram and the association with seeking dermatologic care. Methods A population‐based survey was administered to undergraduate students from April 2019 to May 2019 through an online platform. Results Of the 257 responses, 228 (88.7%) reported that they edited a photograph prior to posting on Instagram. Of those who reported editing a photograph, 145 (63.6%) edited a skin lesion, 104 (45.6%) whitened teeth, and 70 (30.7%) altered the size of their body. Of those who edited skin lesions, 128 (88.3%) edited acne/acne scars. Those who felt the editing made them more aware of their skin lesions were significantly more likely to feel they needed to see a dermatologist (P = .02, 95% CI). Conclusion Photograph editing is common among young adults using Instagram, especially in individuals with acne/acne scars. The effect of this behavior may be a motivating factor for individuals seeking dermatologic care.

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