Multiple side effects of Efalizumab in a Saudi female with chronic persistent psoriasis followed by severe rebound after Efalizumab discontinuation

We are reporting a case of 23-year-old Saudi female with persistent chronic plaque psoriasis who was given subcutaneous Efaluzimab 0.8 mg/kg/week for 14 weeks. During that period the patient developed multiple adverse reactions followed by severe rebound. The case is presented to highlight the importance of managing patients on Efalizumab carefully and closely

Dermatoses in obese female schoolchildren in Al Khobar area, eastern Saudi Arabia

The aim of this study was to determine the most frequent skin disorders in obese female schoolchildren in primary and intermediate schools in the Al-Khobar area, Eastern Saudi Arabia. This was a cross-sectional study conducted in the Al-Khobar area. It involved 2239 female schoolchildren randomly selected from 30 regular public and private primary and preparatory schools. A multi-stage stratified random sampling technique with proportional allocation was used. Data was collected using clinical examination and anthropometric measurements. The skin diseases that were most common in obese schoolchildren were: dandruff, acne, xerosis, acanthosis nigricans, folliculitis, alopecia, stria distensae [stretch marks] and callosity. obesity is associated with specific skin disorders. Health education programs on skin diseases and obesity should be provided to all schoolchildren, their families and teachers

Vulvar basal cell carcinoma misdiagnosed for 4 years

Vulvar basal cell carcinoma is a rare cutaneous neoplasm occurring mainly in white postmenopausal females. It can be misdiagnosed due to its nonspecific physical appearance. Here, we report a 59-year-old white female who had vulvar basal cell carcinoma misdiagnosed for 4 years

Childhood solitary collagenoma

Familial cutaneous collagenoma is an inherited connective tissue nevus, which presents with asymptomatic symmetrically distributed skin nodules on the trunk or upper limbs. Here, we describe a case of a 12-year-old girl with collagenom, affecting the lower back.

Cutaneous hyperpigmentation following nonpermanent henna tattoo

Decorative henna skin painting can provoke severe reactions in the skin. We report 3 cases of unusual and persistent hyperpigmentation following nonpermanent henna tattoo, which alerted us to identify an additional side effect

Successful treatment of chronic persistant vesicular hand dermatitis with topical pimecrolimus

Hand dermatitis is a common chronic skin condition that has many clinical forms including contact, hyperkeratotic, frictional, nummular, atopic, pompholyx and chronic vesicular hand dermatitis. Topical steroids are the first line agents used. Here, we report the successful response to topical pimecrolimus 1% cream in a patient with steroid resistant chronic vesicular hand dermatitis

Subungual epidermoid inclusions

Subungual epidermoid inclusions are protrusions of the nail bed epithelium into the upper most bed stroma. They may be associated with hyperplasia of the bed epithelium resulting in subungual keratosis, onycholysis or even clubbing. An 11-year-old girl presented to our dermatology clinic with a one year history of progressive increase in the size of the distal part of her left thumb associated with mild pain on pressure. The diagnosis became evident perioperatively, which showed multiple subungual epidermoid inclusions

Naxos disease in an Arab family is not caused by the Pk2 157del2 mutation

Naxos disease is a rare hereditary disorder characterized by palmoplantar keratoderma, woolly hair and cardiomyopathy. This study aims to determine whether Naxos disease in a Saudi Arab family is caused by the Pk2157del2 mutation that was identified in Greek families from Naxos Island where the disease had originally been described. This study was undertaken at King Fahad Hospital of the University, Al-Khobar, and the Medical University of Hannover, in the spring of 2003. Naxos disease has been encountered in a 2-year-old girl and her 30-year-old aunt of a Saudi Arab family. Deoxyribonucleic acid samples of this family were analyzed by polymerase chain-reaction [PCR] amplification of the respective region of the plakoglobin gene, and direct nucleotide sequencing of the PCR-products. Segregation analysis was performed employing the newly detected IVS11+22G/A polymorphism. Molecular genetic analysis of the DNA sample of the child diagnosed with Naxos disease showed absence of the Pk2157del2 mutation. In addition, the segregation analysis revealed heterozygosity for IVS11+22G/A in the affected girl. Absence of the Pk2157del2 frameshift in the affected child proved that Naxos disease in this Saudi Arab family is not caused by the same mutation that was identified in the Greek families. Furthermore, heterozygosity for the IVS11+22G/A polymorphism provided evidence for exclusion of the plakoglobin gene in this consanguineous family

Erythrokeratoderma variabilis

Erythrokeratoderma variabilis is a rare autosomal dominant genodermatosis of variable expressivity. In this report, we describe the clinical features and microscopic findings in one of our patients born to unaffected parents. We also briefly review the literature on this disorder

Seborrhoeic dermatitis in Saudi Arabia

Seborrhoeic dermatitis [SD] is a common chronic form of eczema that affects all age groups. The exact pathogenic mechanism is uncertain, but the lipophilic yeast pityrosporum ovale is believed to play a role. The data on SD from the Middle East are sparse. This study was undertaken to fill this gap in our knowledge. A three year retrospective and a four month prospective studies were carried out to assess demographic, and clinical features of SD, precipitating factors and associated diseases. Setting: King Fahad Hospital of the University, Al-Khobar, Saudi Arabia. Incidence of SD was 5.9% of all new dermatological referrals. It was age related, 30% in infants, 7% in children, and 63% in adults, no sex predilection, and was seen mostly in winter. Most commonly affected sites were the scalp and face and the predominant clinical lesions were the dry loose scaly and erythematous types. Important associated conditions included acne vulgaris, diffuse hair fall, diabetes mellitus and obesity. Ambient temperature changes were more important contributing factors to SD than sun exposure. SD is not uncommon in Saudi Arabia, especially in winter. It occurs more frequently in adults than infants in whom distribution is different. This suggests different pathogenetic mechanism. Ambient temperature changes affect SD and probably not the solar radiation in our desert environment. Further studies are needed to elucidate the aetiology