Background Photograph editing has become popular for individuals using social media like Instagram. However, it is unknown if the use of social media and photograph editing applications by young adults has an association with seeking dermatologic care. Aims To assess the frequency of photograph editing among a cohort of young adults using Instagram and the association with seeking dermatologic care. Methods A population‐based survey was administered to undergraduate students from April 2019 to May 2019 through an online platform. Results Of the 257 responses, 228 (88.7%) reported that they edited a photograph prior to posting on Instagram. Of those who reported editing a photograph, 145 (63.6%) edited a skin lesion, 104 (45.6%) whitened teeth, and 70 (30.7%) altered the size of their body. Of those who edited skin lesions, 128 (88.3%) edited acne/acne scars. Those who felt the editing made them more aware of their skin lesions were significantly more likely to feel they needed to see a dermatologist (P = .02, 95% CI). Conclusion Photograph editing is common among young adults using Instagram, especially in individuals with acne/acne scars. The effect of this behavior may be a motivating factor for individuals seeking dermatologic care.

Pembrolizumab, an anti-programmed cell death-1 (PD-1) antibody preparation, has been shown to induce various dermatologic adverse events which may present with delayed onset or even after discontinuation of therapy. We report a 78-year-old female patient with a stage II lung adenocarcinoma treated with pembrolizumab, who developed lichenoid eruptions and multiple cutaneous plaque/nodular eruptions as pseudoepitheliomatous hyperplasia, during and up to 2 months after discontinuation of pembrolizumab therapy. Multiple skin biopsies revealed epidermal hyperplasia with hyperkeratosis, hypergranulosis, diffuse to patchy lichenoid lymphocyte infiltrate with scattered eosinophils and neutrophils, confluent to scant dyskeratosis of the lower epidermis, minimal to overt invagination, and cystic proliferation of squamous epithelium to papillomatosis with hypergranulosis and keratosis. Overall, multiple patterns were present with similarities to lichenoid drug eruption, lichen planus, early invasive squamous cell carcinoma, early keratoacanthoma, and verruca. However, the findings ultimately supported a diagnosis of hypertrophic lichen planus. All the lesions resolved with oral prednisone, hydroxychloroquine, and topical triamcinolone acetonide ointment 0.1%. In summary, our case shows that pembrolizumab can induce lichenoid eruption with pseudoepitheliomatous hyperplasia, and these lesions can clinically and pathologically mimic early invasive squamous cell carcinomas or keratoacanthomas. K E Y W O R D Shypertrophic lichen planus, PD-1, pembrolizumab, pseudoepitheliomatous hyperplasia

have no conflicts of interest to declare. IRB approval status: Reviewed and approved by Tulane Institutional Review Board.

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