Tanning bed hygiene: microbes found on tanning beds present a potential health risk.

discontinuation of his etanercept for 2 weeks. The other patient, who underwent a root canal while taking etanercept, described a wound site infection that was treated with a single course of antibiotics. This patient did not stop taking her etanercept in light of the infection. There were no reports of bacteremia or sepsis. Five of the six patients whose antieTNF-a agent was held before surgery experienced psoriasis flares within days of the missed dose. Though the sample sizes are too small to draw conclusions about the empiric safety of perioperative antieTNF-a use, this pilot study highlights the current practices in dermatology based on the perceived safety of continuing these drugs before surgery. Because there is currently no established standard of care regarding the perioperative use of these agents, the decision of whether or not to continue thedrugs during this time is left to the discretion of the prescribing physician. The lack of objective data available to guide these decisions means that they are likely to be based primarily on the individual physician’s own comfort with using the drugs. A prospective study will be useful to determine the true safety of continuing antieTNF-a agents perioperatively. Whether prophylactic antibiotic use improves any increased infection risk will be another important question to answer. It will also be important to weigh the risks associated with the high likelihood of a psoriasis flare if an antieTNF-a agent is discontinued against those related to the possible increase in postsurgical complications if the agent is continued.