Described embodiments include a device. The device includes a hand-holdable housing carrying a writing element, a cleanliness sensor, and a cleanliness notification circuit. The device includes the writing element configured to form a mark on a surface in response to a touch or movement of the writing element with respect to the surface. The device includes the cleanliness sensor configured to detect an indicator of a pathogen present on a hand of a person holding the hand-holdable housing. The device includes the cleanliness notification circuit configured to output a signal responsive to the detected indicator of a pathogen on the hand of the person.