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Background: Primary care physicians encounter many patients who present with lumps and bumps on their fingers, hands, and wrists. Some benign lesions including ganglion cysts, epidermal inclusion cysts, and giant cell tumors of the tendon sheath that are benign and can be managed by primary care clinicians most of the time in an outpatient setting.Methods: We conducted a narrative of review of literature on the clinical presentation, diagnosis, prognosis, and management of common types of lumps and bumps found on the fingers, hand, and wrist.Conclusions: Based on the literature review and our clinical practice, we provide indications for referral to plastic surgeons or other specialists for these lesions.

Therapeutic, IV.

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The pedicled reverse-flow lateral arm flap provides reliable soft tissue coverage of traumatic elbow defects with minimal donor-site morbidity.

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Early in 2020, the pandemic resulted in an enormous demand for personal protective equipment (PPE), which consists of face masks, face shields, respirators, and gowns. At our institution, at the request of hospital administration, the Lifespan 3D Printing Laboratory spearheaded an initiative to produce reusable N95 masks for use in the hospital setting. Through this article, we seek to detail our experience designing and 3D printing an N95 mask, highlighting the most important lessons learned throughout the process. Foremost among these, we were successful in producing a non-commercial N95 alternative mask which could be used in an era when N95 materials were extremely limited in supply. We identified five key lessons related to design software, 3D printed material airtightness, breathability and humidity dispersal, and ability for communication. By sharing our experience and the most valuable lessons we learned through this process, we hope to provide a helpful foundation for future 3D-printed N95 endeavors.

BACKGROUNDSarcoidosis is a granulomatous disease of unknown etiology that most often impacts the lungs. Cutaneous manifestations of sarcoidosis are seen among 9%-37% of patients. Subcutaneous sarcoidosis is a rare presentation of cutaneous sarcoidosis with estimates of frequency ranging from 1.4%-16%. To date, very few articles and case reports have been written about this subject. In this paper, we describe a case of subcutaneous sarcoidosis and perform a review of the literature to determine if there are commonalities among patients who present with subcutaneous sarcoidosis.CASE SUMMARYA 38-year-old female, with a past medical history of arthritis and recurrent nephrolithiasis, presents with an 8-mo history of 4 firm, asymptomatic, skin-colored nodules on her left and right upper extremities and neck. Needle biopsy and post-excisional pathology report both revealed well-formed, dense, non-caseating granulomas localized to the subcutaneous tissue. Chest computed tomography revealed mild mediastinal lymphadenopathy. A diagnosis of subcutaneous sarcoidosis was made, and the lesions were surgically removed.CONCLUSIONCommonalities among patients presenting with subcutaneous sarcoidosis include: middle-aged female, lesions localizing to the upper or lower limbs, lymphadenopathy or pulmonary infiltration on chest imaging, elevated serum angiotensin-converting enzyme.