Most skin surgery needs no antibiotic, and petrolatum is enough for clean wounds

The edition in brief

A JAAD continuing-education review of antibiotic prophylaxis for excisional and Mohs surgery restates that most dermatologic procedures are clean with low infection rates, that routine systemic prophylaxis is not needed, and that plain petrolatum is preferred over topical antibiotics on clean wounds; prophylaxis is reserved for defined high-risk patients and sites. In 277 patients with stage IIB to IVB mycosis fungoides or Sézary syndrome from the international PROCLIPI cohort, the Cutaneous Lymphoma International Prognostic Index (age over 60, raised LDH, N3 nodes, large-cell transformation) separated median progression-free survival of 4.64, 2.72 and 0.89 years across low, intermediate and high risk, adding to stage alone. A randomised telehealth programme for 364 melanoma survivors and their sunburn-prone children improved sun-protective behaviour but did not reduce sunburn over time. A phase 2 trial in 57 adults with severe alopecia areata found deuruxolitinib 8 mg twice daily produced more regrowth than 16 mg once daily. The FDA recorded a supplement to the baricitinib application; the notice does not state its content. The pearl: screen before any JAK inhibitor.