Mask Acne (Maskne): A New Variant of Acne Mechanica

Mask acne (maskne) is the new variant of acne mechanica, associated with personal protective equipment usage in healthcare workers. Widespread daily use of facial masks for many hours during the COVID-19 pandemic has been linked to the development of new acne or exacerbation of the previous acne over the masked area, with a distinct pattern, referred to as the “O” zone area around the mouth. Maskne can be caused by friction, irritation, local increase in skin temperature, and humidity, the same mechanism as observed in acne mechanica. Keywords: Maskne; Pathophysiology; Diagnosis; Treatment; Prevention

Maskne: Exacerbation or Eruption of Acne During the COVID-19 Pandemic

Although the COVID-19 outbreak has decreased dermatology outpatient clinic visits, acne remains the most common condition among patients requesting an appointment. The widespread use of face masks may be a contributing factor to acne mechanica and folliculitis mechanica, where stopping the mechanical insult is essential to treatment. However, COVID-19 poses a unique challenge as mask wearing is crucial to limiting viral exposure. Although reported cases of mask-associated facial dermatoses are largely documented in healthcare workers, the general population is being affected by “maskne”. Pathogenesis and treatment options are discussed and the importance of counseling patients on proper skin hygiene is highlighted. As mask use increases, dermatologists should anticipate this trend in acne flare-ups.

Fiddler’s neck: Cultural influences modify clinical presentation influences

<p>Fiddler’s neck which is also referred to as a “violin hickey” is a benign dermatologic occupational disease associated with the use of certain instruments like the violin, viola, cello etc. It is believed to be a type of allergic contact dermatitis, manifesting as an acute or chronic eczematous lesion typically at the submandibular and/or supraclavicular region on the side of neck. It can present as erythema, oedema and/or vesicles in the acute stage and as scaling, lichenification, hyperpigmentation and scarring in the chronic stage. Acne mechanica has also been considered by some authors as a presentation of fiddler’s neck. Occasionally, there may be associated swelling redness or a cystic lesion that makes it difficult to differentiate from lymphedema or a salivary gland tumor. PubMed search for articles about this entity resulting in instrument-induced dermatitis yielded few results of this forgotten entity which mimics a love bite (love hickey). For diagnosis, history of the usage of a string instrument which is held between the shoulder and neck, local physical examination and a positive patch test are pre-requisites. Management of fiddler’s neck includes application of topical mild steroid, emollient, proper instrument handling, neck padding, changing the material and polish of the instrument, and/or reducing the amount of playing time. Surgical intervention is usually not advisable unless cystic or tumorous lesions are the manifesting feature. The authors intend to revisit this entity and report an improvised modality that is being used by these instrumentalists in India which may help in prevention of this condition.</p>