Search

Nouf F Bin Rubaian,1 Reem S AlOmar,2 Ahmed S Alzahrani,3 Faleh M Alotaibi,3 Mohammed A Alharbi,3 Bader S Alanazi,3 Serene R Almuhaidib,4 Nawaf F Alsaadoon,5 Dunya Alfaraj,6 Nouf A AlShamlan2 1Dermatology Department, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Department of Dermatology, Dammam Medical Complex, Dammam, Saudi Arabia; 5Department of Emergency, King Fahad University Hospital, Al-Khobar, Saudi Arabia; 6Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Nawaf F Alsaadoon, Department of Emergency, King Fahad University Hospital, Al-Khobar, Saudi Arabia, Email Nawafalsaadoon@gmail.comBackground: Numerous dermatological conditions present in the emergency department (ED). Some have subtle presentations, yet most provoke patient suffering. Such conditions need to be identified and managed properly. This study aims to epidemiologically describe the patterns and characteristics of dermatological conditions presenting to a secondary teaching hospital’s ED.Methods: This retrospective chart review study analyses data on dermatological conditions that have presented to the ED between January 2021 and May 2023. The data gathered included sociodemographic variables, date and shift of visit, triage level, dermatological complaint characteristics, management, and discharge status. Comparative analysis was performed, and the level of significance was set at 0.05.Results: The total number of cases was 301. The median age was 12 years (IQR = 4– 30 years), with similar distribution between males and females (50.17% and 49.83% respectively). Most cases had presented to the ED during the morning shift (49.83%). Triage levels IV and V made up 94.69%, and only 5.32% belonged to triage level III. Most presented during the winter season (32.89%). The median visit duration was 312 minutes, and of all cases treated, only 10 required a return visit to the ED. Also, 41.53% were discharged and 58.47% required further management. Maculopapular rashes were the most common finding (35.55%). Bullae/blisters and erythroderma accounted for those that most often required further management. The two most prescribed medications were topical steroids and antihistamines, followed by emollients (32.09% and 15.81%, respectively). Viral infections were the most reported complaint (22.26%) and only two patients complained of erythema multiforme (0.66%).Conclusion: This study found that the majority of cases could have been managed by family physicians at a primary care setting. Also, epidemiological seasonal variations were observed where the majority of patients requiring further management had presented during the autumn season.Keywords: epidemiology, dermatology, emergency department

Nouf F Bin Rubaian,1 Abdelaziz M Elfaki,2 Serene R Almuhaidib,3 Fajar A Aldulijan,4 Raghda S Qasim,3 Khalid Nabil Nagshabandi,5 Heba Yousef Al-Ojail,6 Shayma S Alsubaie7 1Department of Dermatology, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Healing Icon Center, Al Khobar, Saudi Arabia; 3Department of Dermatology, Dammam Medical Complex, Dammam, Saudi Arabia; 4Department of Family Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Eastern Province, Saudi Arabia; 5Department of Dermatology, College of Medicine, King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia; 6Department of Dermatology, King Faisal University, Al Ahsa, Saudi Arabia; 7King Fahad University of Petroleum and Mineral, Interdisciplinary Research Center for Finance and Digital Economy, Dhahran, Saudi ArabiaCorrespondence: Serene R Almuhaidib, Department of Dermatology, Dammam Medical Complex, Dammam, Saudi Arabia, Email SereneAlmuhaidib@gmail.comPurpose: Minimally invasive aesthetic procedures are widely popular among the youth. Despite their prevalence, there is a significant gap in the research concerning the relationship between these procedures and psychological wellbeing, as well as an insufficient exploration of the barriers and motivators influencing their adoption, this study aims to address these gaps.Methods: This cross-sectional study has utilized a secure online survey directed at Saudi university students as the target population. The survey was consisting of 18-item electronic questionnaire including of 4 parts (demographical data, history of psychological illness and screening of current psychological wellbeing using WHO-5 well-being tool, history of doing cosmetic procedure, or willingness to do in the future, barriers and motivators to do cosmetic procedures), and it was distributed across multiple social media platforms.Results: A total of 8443 college students completed the study questionnaire. Exactly 1096 (13%) of the students underwent a cosmetic procedure. The most reported procedures were laser hair removal (9.1%), filler (5.3%), skin boosters (2.8%), and Botulinum toxin A injections (Botox) (2.6%). The most ranked motivators were being painless, with no side effects (8.8 out of 10), followed by being free (8.0 out of 10) and enhancing self-confidence (7.4 out of 10).Conclusion: No significant difference recorded at the overall psychological well-being score between who underwent cosmetic procedures and who did not.Keywords: aesthetic procedures, cosmetic dermatology, cosmetic dermatologic procedures, psychological wellbeing, mental health, college students, Saudi Arabia

Nada J Alghamdi,1,* Serene R Almuhaidib,2,* Abdulmajeed S Alharbi,2,* Abdullah Ali N Aljalfan,1,* Khalid M Al-Husain1 1Department of Dermatology, King Fahd University Hospital, Al Khobar, Saudi Arabia; 2College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia*These authors contributed equally to this workCorrespondence: Abdullah Ali N Aljalfan, Department of Dermatology, King Fahd University Hospital, P.O. Box 34246, Al Khobar, Saudi Arabia, Email A.jalfan7@hotmail.comAbstract: Zoledronic acid is a bisphosphonate that can be administered intravenously and used to treat several bone disorders. It decreases bone resorption, thereby improving bone mineral density (BMD) and reducing fractures. The Food and Drug Administration (FDA) has approved zoledronic acid for the prevention and treatment of osteoporosis in postmenopausal females and males and for other conditions. Zoledronic acid is generally well tolerated, with most side effects being musculoskeletal or gastrointestinal. Cutaneous side effects include maculopapular rash and other mild skin reactions. Rare severe skin rashes, such as toxic epidermal necrolysis, have been reported. Here, we report the case of a 64-year-old female with a medical history of breast cancer status post-radical mastectomy and chemotherapy presenting with delayed hypersensitivity reaction to a hyaluronic acid dermal filler two days after receiving zoledronic acid intravenously given to maintain bone density, symptoms completely resolved with oral prednisolone 20 mg once daily and cetirizine 10 mg. Cases of delayed inflammatory reaction to hyaluronic acid soft tissue filler have previously been reported in patients who have received vaccination or those with viral infections. However, to our knowledge, there have been no reports of delayed inflammatory reactions to facial hyaluronic acid injections after zoledronic acid administration.Keywords: delayed inflammation, filler, zoledronic acid, hyaluronic acid

Nouf F Bin Rubaian,1 Bashayer S Al-Awam,2 Samah M Aljohani,1 Serene R Almuhaidib3 1Department of Dermatology, King Fahad University Hospital, Al Khobar, Saudi Arabia; 2Department of Pediatrics, King Fahad University Hospital, Al Khobar, Saudi Arabia; 3Department of Dermatology, Dammam Medical Complex, Dammam, Saudi ArabiaCorrespondence: Serene R Almuhaidib, Department of Dermatology, Dammam Medical Complex, Dammam, Saudi Arabia, Email SereneAlmuhaidib@gmail.comAbstract: Vitamin D-dependent rickets type II (VDDR2) is a rare inherited autosomal recessive disorder wherein the genetic mutation results in a defect in the vitamin D receptor (VDR), thus leading to target resistance to 1.25-dihydroxy vitamin D. This results in hypocalcemia, hypophosphatemia, secondary hyperparathyroidism, and rickets. We report a case of a four-year-old female child with diffuse alopecia starting 2 weeks after birth, along with frontal bossing, hypoplastic teeth, and an unusual presentation of multiple skin-colored papules over the back. Genetic testing confirmed vitamin D-dependent rickets type 2A.Keywords: pseudovitamin D-deficiency, rickets-alopecia syndrome, hypocalcemic vitamin D-resistant rickets, genetic mutation

Ibrahim Albawardi,1 Abdullah H Alqahtani,1 Dana A Aljamea,2 Sara A Aljaafari,2 Fajar A Aldulijan,2 Seereen R Almuhaidib,2 Mohamed Elamin,3 Nourah H Al Qahtani4 1Department of Psychiatry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Biochemistry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Department of Obstetrics and Gynecology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Ibrahim Albawardi, King Fahad University Hospital, Office 155, Building 200, Alburaq Street, Alkhobar, Saudi Arabia, Tel/Fax +966138966877. Ex.: 1554, Email imbawardi@iau.edu.saPurpose: To estimate the prevalence of depression amongst hormonal and non-hormonal contraception users, and the risk factors associated with depression in the sample.Patients and Methods: This is a community-based cross-sectional study conducted in the Kingdom of Saudi Arabia from October to November 2021, covering all regions of Saudi Arabia. All participants were women, living in Saudi Arabia, ≥ 21 years old and ≤ 45 years old, using a contraceptive method, and with no established history of depression.Results: A total of 4853 out of 18,596 met our criteria and were included in this study. Among all sample groups, 29% had moderate to severe depression. Rates of depression and association studies’ results in women using hormonal were higher than those who use non-hormonal birth control methods. Psychiatric disorders, medical illnesses, substance use and depressogenic medication use were all associated with depression in both hormonal and non-hormonal contraception users.Conclusion: The current study shows high prevalence of depression amongst hormonal contraceptive users compared to non-hormonal contraceptive users.Keywords: hormonal contraception, non-hormonal contraception, depression, psychiatric disorders

Competing Interests: There are no conflicts of interest.

Background: Herpes Zoster (HZ), also known as Shingles, is a commonly occurring infection especially among the elderly. It is due to the reactivation of the dormant virus in the sensory ends that were present since the primary infection with the virus., Objective: Our study aims at assessing the knowledge, attitudes practices beliefs and current barriers towards the Shingrix vaccine to fully understand where we stand and come up with proper recommendations to services these at-risk individuals and ultimately have a positive impact on the healthcare system., Methods: Questionnaire based cross sectional study using a translated version of a previously developed and tested questionnaire., Results: more than 8000 participants responded to the survey. The vast majority had chicken pox before and did hear about the vaccine from different sources. Most of the participants had minimal knowledge regarding the vaccine and were willing to take it regardless of some safety concerns., Conclusion: more efforts need to be conducted to enhance vaccine uptake in at risk populations in Saudi Arabia., Competing Interests: The authors declare no conflicts of interest., (© 2024 Nouf F. Bin Rubaian, Nada Alghamdi, Nada Alquorain, Serene R. Almuhaidib, Nouf A. AlShamlan, Assim M. AlAbdulKader, Moataza M. Abdel Wahab, Malak A. Al-Shammari.)

Erythema nodosum (EN) is a skin lesion that presents due to an inflammation of the subcutaneous fat, which is manifested clinically as a sudden onset of tender erythematous lesions. These lesions are typically localized to the pretibial surface. The cause of EN is mainly idiopathic, other causes are drugs, infections, autoimmune diseases, and inflammatory bowel disease. As vaccines are rarely known to cause EN, we are reporting a case of a 19-year-old female with a delayed recurrent reaction following the second dose of the COVID-19 vaccine., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alghamdi et al.)

Despite the numerous reports of cutaneous manifestations associated with vaccines for coronavirus disease 2019 (COVID-19), the relationship between COVID-19 vaccines and cutaneous side effects remains unevaluated. In this review, we examine these manifestations and their management. Reported dermatoses included injection-site reaction (early and delayed), type I allergic reaction, morbilliform eruption, pityriasis rosea, Sweet syndrome, lichen planus, psoriasis, herpes zoster reactivation, erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis (TEN). The most common COVID-19 vaccination-related cutaneous manifestations are delayed local reactions, approximately 66% of which are associated with the Moderna vaccine, and 33% with the Pfizer vaccine. Aside from mild injection-site reactions, severe reactions include anaphylaxis and TEN. Most reactions, except for Stevens-Johnson syndrome and anaphylaxis, though unpredictable and unpreventable are mild and can be treated symptomatically. Findings from this review should allow primary care physicians and dermatologists to reach faster diagnosis and initiate prompt intervention., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Family and Community Medicine.)

Pityriasis rosea (PR) is an acute self-limiting exanthematous skin disorder characterized by the presence of a primary solitary lesion called a herald patch and the subsequent development of diffuse papulosquamous lesions within 1 to 2 weeks. This is a case of COVID-19 vaccine-induced PR in the age group (12-18 years) that was recently approved for vaccination. We report a case of a 15-year-old otherwise healthy female with a history of 2 weeks of single oval primary plaque appearing on the right wrist 2 days after receiving the second dose of Pfizer-BioNTech vaccine, followed by diffuse and mild itchy skin eruptions spreading over the abdomen, back, chest, and extremities. The patient had no other symptoms and no PR risk factors. The patient was placed on 800 mg acyclovir five times a day and improved markedly after 1 week. As vaccine-induced PR/PR-like eruptions (PR-LE) is an uncommon phenomenon, we recommend further studies to determine the association between PR/PR-LE and COVID-19 vaccination., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Bin Rubaian et al.)

Genital lymphedema usually develops after 4-30 years of chronic hidradenitis suppurativa (HS). However, our patient exhibited signs of it as early as 2 years after being diagnosed with HS. Renal amyloidosis is a rarely reported complication of HS. Unfortunately, our patient was asymptomatic but was found to have end-stage renal disease secondary to advanced renal amyloidosis. We report a case of a 42-year-old Indian gentleman who had HS for 9 years presenting with 2 rare complications: penoscrotal lymphedema and end-stage renal disease secondary to renal amyloidosis. The patient was treated with prednisolone and adalimumab to treat both his HS and renal amyloidosis, and was referred to general surgery to manage his genital lymphedema. We recommend following adult patients with moderate-to-severe HS and clinical duration of greater than 3 years and screening for amyloidosis before they reach end-stage organ disease, similar to what happened to our patient with end-stage renal disease., (Copyright: © Saudi Medical Journal.)

Café au lait macules (CALMs), if solitary, are benign lesion with no clinical meaning, and are common in the general population. Multiple CALMs may be the hallmark of some disorders and need to be assessed by an interprofessional team. The diagnosis and evaluation of a patient with a suspected condition may include a team of pediatric neurologists, dermatologists, ophthalmologists, geneticists, and orthopedic surgeons. To evaluate the progression of the disease, an annual follow-up is required., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family and Community Medicine.)