While it's not the area I ended up working in, I learned in accounting school that the employees who never take vacation are held as highly suspicious. People who are in a position to skim off the top tend to never take days off so nobody gets opportunity to see what they're doing.
As to me personally, I remember one year taking all the PTO that was due to me and getting shit on in writing at evaluation time for doing so.
The following year I took zero PTO and got shit on in writing at evaluation time for doing so.
I went to management with copies of both evaluations and said, "since you're gonna shit on me in writing at evaluation time regardless of what I do, you can expect me to take every minute of PTO going forward."
They were at a loss for words and just found other reasons to shit on me in writing at evaluation time.
I spent five and a half years in that environment.