No abstract

Context During the COVID-19 pandemic, dermatologists within the Beaumont Farmington Hills’ Dermatology program noticed an increase in conditions associated with mask wearing, such as “maskne” (acne in a mask distribution, thought to be caused by mask wearing), as well as worsening of previously diagnosed dermatologic conditions. Objectives The goal of our study was to explore various factors that impacted mask-related skin changes and how these skin changes affected quality of life. Methods A cross-sectional study was performed. The primary 10-item survey instrument administered was the Dermatology Life Quality Index (DLQI). Respondents were asked a series of 10 additional questions concerning the degree to which abnormal mask-related skin conditions affect their skin symptoms, possible embarrassment/self-consciousness, and perceived impact of mask-related skin changes. A series of descriptive statistics, cross-tabulation charts, and graphical examinations of data was utilized to evaluate sample subgroup and outcome distributional patterns. Pearson r bivariate correlation coefficients between possible collinear predictive measures on the primary study outcome were calculated. A series of simple inferential chi-squared (Χ2) tests of independence were also conducted. Results A total of 370 out of 430 (86.0%) Beaumont Health employees noticed some degree of skin changes since the work-hours face mask requirement was instituted, while 378 out of 430 (87.9%) felt that their skin was better when not wearing a mask. The majority of respondents, 283 (65.8%), reported having at least a little symptomatic skin (i.e., itchy, painful, sore, stinging) during the prior week. Furthermore, 72.3% reported that they were at least a little embarrassed or self-conscious of their skin. Chi-squared analysis of composite DLQI score categories by the number of types of masks utilized (Pearson X2=19.0, df=8, p=0.015), and some degree of symptomatic skin (Pearson X2=156.4, df=4, p<0.001) were found to be statistically significant. Conclusions A large number of healthcare workers are affected by mask-related skin changes. Further research should be directed at better understanding how skin changes associated with mask wearing impact one’s quality of life and mental health.

<p>Eruptive xanthomas are localized lipid deposits in the skin or subcutaneous tissue that are associated with both primary and secondary hyperlipidemia. Typical presentation manifests as small yellow papules on the buttocks or extensor surfaces. Xanthomas can be diagnosed clinically with an extensive history and physical examination, however, can be confirmed via biopsy and histological findings. It is essential to identify the underlying cause of the skin lesions and take appropriate measures to prevent future hyperlipidemia-induced consequences. Here we report a 42-year-old female with eruptive xanthomas on her trunk and extremities. Previous visits to the primary care provider and emergency department resulted in diagnoses of viral exanthems. The consulted dermatologist ordered laboratory tests remarkable for extreme hypertriglyceridemia, hypercholesterolemia, and hyperglycemia. Lifestyle modification in conjunction with cholesterol and triglyceride lowering medications led to the resolution of abnormal laboratory findings and remission of eruptive xanthoma lesions.</p>

The effects of many dermatologic syndromes are not exclusive to the skin. Disorders commonly involve a complex interplay between multiple organ systems, thus not relying solely on the dermatologist for proper work up, diagnosis, and treatment. Morphea is one such rare disease which involves progressive loss or atrophy of subcutaneous tissue, muscle, and bone with a relatively mysterious etiology. The initial lesion of morphea can be subtle and appear as a pink to red plaque without any additional symptomatology. A biopsy at this early stage is non-specific and will only show the presence of a T cell infiltrate, vascular swelling, and edema. This active or progressive stage will continue for years before "burning out," or halting progression, although still affecting underlying tissues. Many times, the sclerosis becomes severe enough to cause deformity and secondary systemic symptoms. Five general subtypes of morphea exist, including: plaque-type, linear, deep, guttate, and nodular. In this paper, the authors report a case report of a rare subtype of linear morphea called Parry Romberg syndrome, also known as progressive hemi-facial atrophy (PHA). PHA usually involves at least one branch of the trigeminal nerve unilaterally. The authors will emphasize the importance of a multidisciplinary approach to diagnose and treat this disorder while also considering the multiple theories surrounding its pathophysiology.

Equestrian perniosis is a rare form of perniosis that is predominantly seen in young female equestrians who ride in cold temperatures. Tight fitting clothing, age under 35 years, and smoking can contribute to the disease manifestation. The diagnosis can be determined from a thorough history and physical examination. However, a biopsy can be taken to confirm the diagnosis. Although many cases are self-limiting and resolve within a few days to weeks of diagnosis, nifedipinie can be considered as a therapeutic measure for persistent cases. Measures such as wearing loose fitting clothing and horseback riding in warmer temperatures and for shorter time periods can prevent recurrence.