Outcomes of Upper Lip Mohs Surgery Repairs Using Standardized Scar Scales With Particular Emphasis on Vermillion Border Involvement.

Background: The lips are a common location for skin cancer, and thus, a common site for Mohs micrographic surgery (MMS). As an important cosmetic and functional facial unit, MMS defects and reconstruction can affect patient perception on functional and aesthetic outcomes.

Objective: The objective of this study was to compare aesthetic and functional outcomes after upper lip MMS between patients with vermillion sparing repairs (VSR) versus vermillion crossing repairs (VCR).

Comparison of infection control practices in a Dutch and US hospital using the infection risk scan (IRIS) method.

Background: The infection risk scan (IRIS) is a tool to measure the quality of infection control (IC) and antimicrobial use in a standardized way. We describe the feasilibility of the IRIS in a Dutch hospital (the Netherlands, NL) and a hospital in the United States (US).

Methods: Cross-sectional measurements were performed.

Prevention of hospital-acquired respiratory viral infections: Assessment of a multimodal intervention program.

A multimodal program focused on preventing nosocomial respiratory viral infections. Definite cases per 1,000 discharges increased 1.3-fold in hospital units screening visitors for respiratory viral symptoms during the 2017-2018 respiratory virus season but not during the 2016-2017 season.

Incontinentia Pigmenti Coxsackium.

Late recurrences of first-stage inflammatory vesiculobullous lesions of incontinentia pigmenti (IP) are uncommon but have been reported to occur in the setting of infections, fevers, and vaccinations. This phenomenon has not been described in the setting of atypical hand, foot, and mouth disease (HFMD). In addition, atypical HFMD often has a predilection for areas of previous inflammation or trauma, such as areas of atopic dermatitis (eczema coxsackium).

Follicular Mucinosis in a Male Adolescent with a History of Acute Myelogenous Leukemia and Graft-versus-Host Disease.

Although many cases of follicular mucinosis are idiopathic, numerous others are associated with mycosis fungoides or, rarely, other neoplastic or inflammatory disorders. There are only three reported cases, all in adults, of follicular mucinosis arising in association with acute myelogenous leukemia, two of which involved mycosis fungoides-associated follicular mucinosis, including one case in which the patient had a preceding bone marrow transplant. We present the first reported case of follicular mucinosis arising in an adolescent with acute myelogenous leukemia and acute graft-versus-host disease after an allogeneic bone marrow transplantation.

Coral contact dermatitis.

Corals can elicit both toxic and allergic reactions upon contact with the skin. Clinical presentations vary depending on whether the reaction is acute, delayed, or chronic. Literature concerning cutaneous reactions to corals and other Cnidarians is scarce.

Localized chronic fibrosing vasculitis in a tattoo: a unique adverse tattoo reaction.

Decorative tattoos are associated with a variety of adverse cutaneous reactions. We describe a unique fibrosing vasculitic reaction to red tattoo ink. The histopathology was similar to that in localized chronic fibrosing vasculitis (LCFV), but sharply limited to sites of red tattoo ink injection and associated with florid verrucoid epidermal hyperplasia.

A slowly enlarging mass on the finger.

An otherwise healthy 71-year-old woman presented with an asymptomatic mass on her right 4th finger that had been slowly enlarging over the past 2 years. On physical examination, there was a tan-pink, freely mobile, rubbery 9-mm papule with a central keratotic plug located over the extensor aspect of the proximal interphalangeal joint of the right 4th finger. A 3-mm punch biopsy of the lesion was performed.

Factors associated with hand hygiene compliance at a tertiary care teaching hospital.

Objective: To identify factors associated with hand hygiene compliance during a multiyear period of intervention.

Design: Observational study.

Setting: A 719-bed tertiary care teaching hospital.

Reducing Clostridium difficile incidence, colectomies, and mortality in the hospital setting: a successful multidisciplinary approach.

Background: Health care associated Clostridium difficile infections are a major cause of morbidity and mortality in hospitals. In the United States, from 2000 through 2009, discharge diagnoses from hospitals in the United States that included C. difficile increased from 139,000 to 336,600, and the yearly national excess hospital cost associated with hospital-onset C.

Update on nail cosmetics.

Nail cosmetics are used by millions of people worldwide who desire smooth, lustrous nails. The nail cosmetic industry continues to expand to meet increasing consumer demand. In 2011 alone, consumers spent $6.

Melanonychia.

Melanonychia, or melanin-derived brown-to-black nail pigmentation, is a diagnostic challenge for clinicians. The most serious disease of the nail unit, melanoma, primarily presents with melanonychia. However, melanonychia most often occurs as a result of benign etiologies such as nail matrix melanocytic activation, nail matrix melanocytic hyperplasia, and nail invasion by melanin-producing pathogens.

Peripheral venous catheter-related Staphylococcus aureus bacteremia.

Objective: Better understand the incidence, risk factors, and outcomes of peripheral venous catheter (PVC)-related Staphylococcus aureus bacteremia.

Design: Retrospective study of PVC-related S. aureus bacteremias in adult patients from July 2005 through March 2008.

Impact of chlorhexidine bathing on hospital-acquired infections among general medical patients.

Background: A paucity of data exists regarding the effectiveness of daily chlorhexidine gluconate (CHG) bathing in non-intensive care unit (ICU) settings.

Objective: To evaluate the effectiveness of daily CHG bathing in a non-ICU setting to reduce methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enteroccocus (VRE) hospital-acquired infections (HAIs), compared with daily bathing with soap and water.

Design: Quasi-experimental study design; the primary outcome was the composite incidence of MRSA and VRE HAIs.

A novel technique for identifying opportunities to improve environmental hygiene in the operating room.

Environmental cleaning and disinfection is essential for optimizing safe patient care in the OR; however, perioperative staff members have not had an easy-to-use, objective method for determining whether high-touch, potentially contaminated surfaces have been cleaned during terminal room cleaning. To address this issue, members of the Healthcare Environmental Hygiene Study Group used a transparent, removable, environmentally stable disclosing agent and handheld ultraviolet light to determine whether potentially contaminated surfaces had been contacted by a wet disinfection cleaning cloth during terminal cleaning of ORs. Results from the project showed that 237 of 946 targeted surfaces (25%) had the disclosing agent removed (ie, were cleaned).

A cluster of community-acquired methicillin-resistant Staphylococcus aureus infections in hospital security guards.

We investigated a cluster of methicillin-resistant Staphylococcus aureus soft-tissue infections in 5 security guards employed in a hospital emergency department. An epidemiologic investigation and molecular subtyping of isolates revealed that the source was a patient and that a community-acquired methicillin-resistant S. aureus strain (USA-300) was transmitted to healthcare workers through physical contact.

Potential economic impact of hospital-acquired infections in uninsured patients: a preliminary investigation.

We studied uninsured patients admitted to Rhode Island Hospital from January 1 through June 30, 2005, and from January 1 through June 30, 2006. The mean total hospital charge for an uninsured patient with a hospital-acquired infection was $18,487; for those without such an infection, it was $4,951 (P < .001).