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Hamad Al FahaadDepartment of Dermatology, College of Medicine, Najran University, Najran, Saudi ArabiaIntroduction: Keratitis–ichthyosis–deafness (KID) syndrome is a rare congenital multisystem disorder affecting certain tissues of ectodermal origin such as epidermis, cochlea, and cornea, leading mainly to palmoplantar hyperkeratosis, ichthyosiform scaling, deafness, and blindness. The author reports for the first time in the Middle East three family members suffering from KID syndrome in the southwestern part of Saudi Arabia.Case presentation: Three patients from one family (ages 26, 16, and 14 years) of apparently normal parents, with the two eldest being females and the youngest being male. All three patients were referred from a peripheral hospital to our dermatology clinic due to recurrent cutaneous fungal infections on their trunk, forearms, legs, and nails. On full assessment, they also found to have nearly similar cutaneous problems manifested by palmoplantar hyperkeratosis, generalized ichthyosiform scaling, subungual hyperkeratosis, and nail dystrophies. All patients suffered from total hearing loss in both ears since childhood as confirmed by pure tune audiometry. However, there was no blindness in any case; blepharitis with marked photophobia was the only ocular complaint. All these features are classically suggestive of KID syndrome.Keywords: connexin 26, GJB2, ichthyosis, KID syndrome, palmoplantar hyperkeratosis

Cancer is a major health problem in both developed and developing countries. This study was designed to evaluate the referral system for cancer patients, and to assess the information which is received by cancer patients about their disease in tertiary hospitals in Riyadh, KSA. A cross sectional study was conducted on 73 cancer patients who received treatment in two tertiary hospitals in Riyadh; King Fahd Medical city and King Khalid University Hospital in March 2012. The study included any man or woman above 15 years old, who had been diagnosed with any type of cancer, and received treatment in the tertiary hospital for any time period. All the participants were recruited from the chemotherapy department and outpatient clinic. Data was collected through questionnaire interview with all patients or their relatives by the study investigator. QLQ-INFO25 questionnaire was used. There were 30 (44.8%) patients who had been referred to KFMC or KKUH, and 37 (55.2%) patients who had been admitted without referral. The main cause of referral was to confirm the diagnosis 76.7%, then to receive chemotherapy 16.7%. Time duration to the acceptance was 40% less than one week, 36% one to two weeks, 3.3% three to four weeks, 13.3% one to two months, and 6.7% more than two months. 70% of cancer patients gave their case report by hand to the tertiary hospital, 23.3% sent their case report by fax, and 3.3% sent the case report by email. 25 (83.3%) cancer patients were satisfied with the referral system of cancer patients in Saudi Arabia. The global score of the information module "QLQ-INFO25" was 67. The mean score was 31.3 (46.8) and standard deviation was 12.1. From this study, we conclude that, the referral system for cancer patients in Saudi Arabia needs to be electronic, unified in all hospitals, fair with all cancer patients, time effective, connect all tertiary hospitals and have a two way direction between secondary and tertiary hospitals. All medical facilities should provide the disease information to cancer patients by transparency and honesty. Health educators and social workers have an important role in psychological support to cancer patients. [ABSTRACT FROM AUTHOR]