Skin infections are common in primary care and have varied manifestations, most often benign. Careful assessment of lesion morphology and distribution, combined with history-taking and evaluation of host factors, generally helps guide management. This article provides a practical approach to five common conditions: impetigo, folliculitis, skin abscesses, dermatophytosis, and scabies. For each, it reviews the main clinical features, differential diagnoses, indications for microbiological sampling, and appropriate treatment. Special emphasis is placed on hygiene measures, management of close contacts, and judicious use of anti-infectious treatments. Recognizing extensive or recurrent disease and warning signs helps identify situations requiring systemic treatment or specialist advice.

Corynebacterium bovis (Cb) is a bacterium that causes a flaking dermatitis characterized histologically by orthokeratosis, acanthosis, intracorneal bacterial colonies and variable dermal inflammation in immunodeficient mice. Although Cb has been shown to establish dermal colonization in rats, its impact on the skin of immunodeficient rats remains poorly defined. This case series characterizes cutaneous lesions in 22 naïve or experimentally manipulated NIH-Fox1[rnu] (nude) rats and evaluates the association between Cb infection and dermatitis over a 5-year period. Histologically, all rats had orthokeratosis and dermatitis/folliculitis, 21/22 had acanthosis, 15/22 had bacterial presence and 9/22 had transepidermal/transfollicular keratinocyte apoptosis. Additional variable findings included furunculosis, pustules, dermal oedema and perivascular dermatitis. Inflammatory infiltrates consisted of CD3-positive lymphocytes and Iba1-positive macrophages located predominantly at the dermoepidermal junction. Corynebacterium bovis was isolated from the skin of 15/22 affected rats, and in-situ hybridization confirmed intracorneal/intrafollicular colonies of Cb in 3/11 rats examined. Nude rats also developed cutaneous lesions that corresponded histologically with a lymphocytic dermatitis, the distribution of which was often independent of Cb colonies. This study documents the first spontaneous Cb infection with dermatitis in nude rats. The frequent isolation of Cb from the skin raises the question of whether alterations in the cutaneous microbiome of nude rats may contribute to the immune modulation of dermatitis, warranting further investigation.

Lower extremity amputation remains a significant clinical challenge, most commonly resulting from diabetes mellitus and peripheral arterial disease, and is associated with high morbidity and mortality. This review briefly summarizes the burden of lower extremity amputation and then focuses on individuals with transtibial amputation who use a prosthesis, with particular attention to residual limb health. Advances in prosthetic technology have improved functional outcomes and quality of life, enabling many individuals to achieve ambulation and, in some cases, return to high levels of physical activity. However, increased prosthetic use introduces unique challenges related to skin integrity, including friction, moisture, and pressure-related injuries within the prosthetic socket. These risks may be amplified in athletes with limb loss, who are exposed to higher mechanical and metabolic demands. This review introduces the concept of adaptive wound care, which emphasizes prevention, early detection, and management of residual limb skin complications in both general and athletic prosthesis users. Common injuries, including friction and shear injuries, pressure injuries, moisture-associated skin damage, folliculitis, contact dermatitis, volume-related injuries, and sport-related trauma, are described along with strategies for their prevention and treatment. Integrating surgical, prosthetic, rehabilitation, and wound care principles is essential to optimize outcomes, enhance function, and reduce complications following lower extremity amputation.

Granulocyte colony-stimulating factor (G-CSF) is known to induce several cutaneous neutrophilic reactions, including Sweet syndrome-like eruptions, neutrophilic panniculitis, neutrophilic eccrine hidradenitis, and sterile folliculitis. We report the case of a male patient with an unclassified malformative syndrome and chronic neutropenia who developed acute painful suppurative nodular scalp lesions while receiving long-term G-CSF therapy and during a period of marked neutrophilia. Histopathological examination showed superficial and deep suppurative neutrophilic folliculitis with follicular abscess formation, follicular epithelial destruction, focal perifollicular fibrosis, neutrophilic epidermotropism, and sparse Gram-positive cocci within deep follicular abscesses. Because the clinical course was acute and a chronic relapsing course, tufted hairs/polytrichia, and unequivocal irreversible cicatricial alopecia were not documented, we do not regard the findings as sufficient for a definitive diagnosis of classic folliculitis decalvans. Rather, the case is best interpreted as G-CSF-associated destructive neutrophilic folliculitis of the scalp with folliculitis decalvans-like features. This case broadens the spectrum of G-CSF-associated follicular reactions and supports the possibility that G-CSF-driven neutrophilia may facilitate severe folliculocentric neutrophilic inflammation, particularly in the setting of bacterial colonization or infection and altered host immunity.

Dermatophyte infections including tinea incognita and Majocchi granuloma as well as Malassezia folliculitis may manifest as follicular papules or pustules in acne-prone areas, leading to frequent misdiagnosis as acne vulgaris, particularly after topical corticosteroid use alters their clinical appearance. Early recognition of these entities is important to reduce morbidity and prevent inappropriate therapy, especially corticosteroids, which may exacerbate the infection and delay appropriate treatment. This review highlights dermatophyte infections as an underrecognized mimic of acne vulgaris, emphasizing key clinical distinguishing features, common diagnostic pitfalls, and a practical approach to evaluation.

This evidence-to-recommendation (EtR) framework underpins the Agency for Care Effectiveness Clinical Guideline (ACG) for bacterial skin and soft tissue infections (SSTIs), providing rationale and justifications for its recommendations on diagnosis and antibiotic prescribing in primary and community care. Based on the Grading of Recommendations Assessment, Development and Evaluation framework, five evidence-based recommendations were developed to guide practitioners in making appropriate decisions on the diagnosis, assessment and management of SSTIs, including cellulitis, erysipelas, impetigo, folliculitis, ecthyma, furuncles, carbuncles and skin abscesses. As SSTIs are a leading indication for use of oral antibiotics in primary care, recommendations focus on principles for prescribing antibiotics for specific bacterial SSTIs, including whether antibiotics are indicated and when to prescribe topical, oral or intravenous formulations. The EtR framework consolidates the evidence and considerations that informed the ACG recommendations, including balance of benefits and risks, certainty of evidence, patient preferences and values, resources and feasibility considerations, and acceptability. The ACG can be found at https://go.gov.sg/acg-ssti.

Myocarditis can closely mimic acute myocardial infarction (AMI), particularly in young patients without atherosclerotic risk factors. We report a 27-year-old man with recurrent severe chest pai7n, transient ST-segment elevations, and markedly elevated high-sensitivity troponin-T, in whom coronary angiography was repeatedly normal. Serial cardiac magnetic resonance and 18F-fluorodeoxyglucose positron-emission tomography revealed a migratory pattern of myocardial inflammation, with new lesions emerging as earlier ones resolved, fulfilling criteria for recurrent myocarditis. Recurrent oral ulcers, folliculitis, arthralgias, and pathergy-like skin reactions raised suspicion for Behçet's disease. Treatment with vasodilators, colchicine, corticosteroids, and azathioprine produced sustained clinical and biochemical remission. This case highlights the importance of considering myocarditis in young patients with recurrent angina-like symptoms and normal coronaries, the value of serial multimodal imaging in detecting migratory inflammation, and the recognition of Behçet's disease as a rare underlying cause of recurrent myocarditis.

Tapinarof is an aryl hydrocarbon receptor agonist approved for the treatment of atopic dermatitis (AD) and psoriasis. While common adverse events include headache and folliculitis, comedones and perifollicular hyperpigmentation are under-recognized. Here, we report eight patients with AD or psoriasis who developed comedones and/or perifollicular hyperpigmentation during therapy. Lesions developed primarily at application sites; however, in one patient, lesions occurred at a distant site. Lesions appeared on the face in six patients, the legs in one and the arms in one. Time of onset ranged from 1 to 8 months after initiation of tapinarof therapy. Tapinarof was discontinued in all cases. Three patients were treated with topical adapalene/benzoyl peroxide, with partial improvement in one and minimal improvement in two. One patient showed gradual improvement without additional treatment, whereas the remaining five showed no or minimal improvement during follow-up. Our cases provide important information on under-recognized adverse events during tapinarof therapy.