The Association Between Hair Loss and COVID-19: The Impact of Hair Loss After COVID-19 Infection on the Quality of Life Among Residents in Saudi Arabia.

Background Coronavirus disease 2019 (COVID-19) is an infectious disease that is associated with many health conditions, including, but not limited to, dermatological diseases. Some patients suffer from hair loss after becoming infected with severe acute respiratory syndrome coronavirus 2. Acute telogen effluvium (TE) is a non-scarring hair loss that usually occurs three months after a stressful event and can last up to six months, and it can be associated with post-COVID-19 infections. This study aims to explore the prevalence of hair loss among recovered COVID-19 patients in Saudi Arabia and determine the contributing factors. Furthermore, we aimed to measure the impact of hair loss after COVID-19 on their quality of life. Methodology An observational, cross-sectional study was conducted from September to December 2021 in Saudi Arabia. A questionnaire was used to assess hair loss after being infected with COVID-19. Furthermore, quality of life was assessed using the Dermatology Life Quality Index (DLQI) questionnaire. Participants were recruited by sharing the questionnaire on social media platforms (Twitter, Telegram, and WhatsApp). The data were analyzed using SPSS version 23 (IBM Corp., Armonk, NY, USA). Frequency and percentages were used to display categorical variables, while minimum, maximum, mean, and standard deviation were used to present continuous variables. The categorical variables were compared using a chi-square test, and the statistical significance cut-off was set at p < 0.05. Results A total of 806 participants were included in the study, of whom 52.7% experienced hair loss after COVID-19 infection. Age, gender, high temperature during, and the presence of hair loss prior to infection were significantly associated with the incidence of TE. The severity of life affection based on DLQI showed that 91.4% of the participants did not have severe life affection, while 8.6% had their lives severely affected. Conclusions This study revealed subjective hair loss that was significantly associated with high temperature, being female, and having a history of previous hair loss. Further studies using objective assessments are suggested for reaching more precise conclusions.

A case of nail psoriasis improved with treatment by risankizumab.

Nail psoriasis causes significant aesthetic and functional disabilities. The treatment of nail psoriasis is essential to improve the health outcomes and quality of life among patients. Pain associated with intralesional injections, inadequate penetration into the nail and underlying tissue, poor adherence to therapy, limited efficacy and recurrent relapses are among the many challenging issues with topical therapy. While conventional systemic therapies are still useful and often appropriate for some patients, current evidence indicates that highly selective agents including anti-tumor necrosis factor-alpha, anti-interleukin (IL)-17 and anti-IL-12/23 antibodies that are primarily available for plaque psoriasis and psoriatic arthritis have also demonstrated long-term efficacy in the treatment of nail psoriasis. We report a case of nail psoriasis improved with treatment by risankizumab.

Prevalence of Helicobacter pylori Infection Among Rosacea and Chronic Spontaneous Urticaria Patients in a Tertiary Hospital in Riyadh, Saudi Arabia.

BACKGROUND: The multifactorial nature of rosacea and chronic spontaneous urticaria (CSU) pathogenesis complicates the achievement of satisfactory treatment outcomes. 13C urea breath test (UBT) has been identified as an accurate, non-invasive, and quick procedure to detect the presence of Helicobacter pylori (H. pylori) with high sensitivity and specificity. OBJECTIVE: In this study, we aim to assess the correlation between H. pylori infection and rosacea and CSU patients. METHODS: A cross-sectional, observational study was conducted on patients with rosacea and CSU in the dermatology clinic at King Khalid University Hospital in Riyadh, Saudi Arabia. History and physical examination were performed by a dermatologist. H. pylori 13C-UBT detection was performed in all subjects. RESULTS: In total, 114 patients were included in this current study, with 41 rosacea and 73 urticaria patients. The vast majority of our subjects were females (96.5%). The mean (±SD) age was 42.3 (±12.7). More than half (58.8%) of the examined samples were positive for 13C-UBT; however, positive results were significantly higher in the rosacea patients (73.2%) compared to the urticaria group (50.7%), with a p-value of 0.019. CONCLUSION: Our findings underline the significant association of H. pylori with rosacea and CSU regardless of the presence or absence of gastrointestinal symptoms. We thus recommend the inclusion of H. pylori testing in the routine workup of CSU and rosacea patients.

Clinicopathological concordance in the diagnosis of skin diseases: a retrospective analysis of 5000 histopathology reports.

BACKGROUND: The accuracy of clinical diagnoses of skin diseases has not been researched in Saudi Arabia. OBJECTIVES: Assess concordance between the histopathological and clinical diagnosis in skin diseases. DESIGN: Retrospective. SETTING: Academic tertiary care center. METHODS: Demographic, clinical and pathological data were collected from the medical record for the period 1997-2013. MAIN OUTCOME MEASURES: Concordance between the pathological and clinical diagnosis. SAMPLE SIZE: 4268 cases. RESULTS: Of 4268 biopsies, 2440 (58.1%) were females. The mean age (SD) of patients was 36.9 (17.8) years. The three most common locations from which skin biopsies were retrieved in descending order were the lower extremity (1123; 29.1%), head, neck, scalp and hair (1033; 26.7%) and trunk (853; 22.1%). Overall concordance was 75.9% (partial concordance 47.6%, full concordance 28.3%). Biopsies from the oral mucosa and lips had the lowest concordance (overall 58.5%, full 26.4%) at P=.004. Overall concordance was highest for the following three diagnoses: malignant neoplasms, 88%; vesiculobullous diseases 87%; urticarias, erythemas, and purpuras 87%. CONCLUSION: There is considerable variability in concordance among different histopathological diagnoses. The full concordance between the clinical diagnosis and the pathological diagnosis is low. This is a reflection of the fact that the biopsies were obtained only in cases where the clinical diagnosis was a dilemma. LIMITATIONS: Single center, retrospective, incomplete medical records, low percentage of biopsies were assessed by dermatopathologists. CONFLICT OF INTEREST: None.

Awareness, acceptance, and perspective of women for reconstruction post Mastectomy.

OBJECTIVE: To assess the level of awareness and acceptance among women for breast reconstruction surgery after mastectomy. METHODS: The observational cross-sectional study was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia, from November 2014 to April 2015, and comprised women aged 19-65 years with breast masses and women with high risk for breast cancer who were offered therapeutic mastectomy. The subjects were interviewed using a structured and validated questionnaire. Data was analyzed using SPSS 21. RESULTS: Of the 224 individuals approached, 209(93.3%) participated. Of them, 106(50.7%) considered having reconstruction and 97(46.4%) had read or heard about it. The most influencing factor for reconstruction was improving their psychological status 84(40.2%) and the most common reason for refusal was old age 26(12.4%). Patients who were 40 years or younger were more willing to undergo reconstruction (p=0.001). CONCLUSIONS: Patients with knowledge about breast reconstruction were more willing to accept the procedure. Increasing the awareness will increase acceptance of breast reconstruction..

Nonmelanoma skin cancer in Saudi Arabia: single center experience.

BACKGROUND: Skin cancer is the most common cancer worldwide; one in every three diagnosed malignancies is a skin cancer. However, skin cancer is rarely reported in Saudi Arabia so we conducted this study to highlight these underreported neoplasms. OBJECTIVES: Determine the prevalence and patterns of basal cell carcinoma (BCC) and primary squamous cell carcinoma (SCC), the most common types of nonmelanoma skin cancer (NMSC) with respect to age, sex, and anatomic location and to identify potentially associated risk factors. DESIGN: Retrospective, descriptive medical record review. SETTING: A tertiary care centre. PATIENTS AND METHODS: We did a retrospective chart review of all patients diagnosed with basal cell carcinoma and primary squamous cell carcinoma between 2003-2016. MAIN OUTCOME MEASURES: Prevalence and pattern of BCC and SCC with respect to age, sex, and anatomic location. RESULTS: Of 593 cases reviewed, 279 had NMSC. Most (95%) were diagnosed with BCC or SCC or both in a few cases. The mean age at diagnosis was 59 (19.5) years. Sixty-two percent of the patients were males. However, 24.3% (n=68) of skin cancers occurred in patients younger than 50 years. The frequency of BCC and SCC was 50.2% and 44.8%, respectively. The head and neck was the most common location (79.6%). In patients younger than 50 years, xeroderma pigmentosum and previously treated solid malignancies were the major factors. CONCLUSIONS: BCC and SCC are uncommon but not rare. However, skin cancers are underreported in our population. NMSC in individuals younger than 50 years of age requires more careful evaluation of possible risk factors. LIMITATIONS: Retrospective in a single tertiary care setting.

The outcome of cochlear implantation among children with genetic syndromes.

OBJECTIVE: To assess the outcome and efficacy of cochlear implantation in children with genetic syndromes. METHOD: Study design: case-control study. SETTING: A cochlear implantation tertiary referral center. PATIENTS: All pediatric cochlear implantation recipients with Waardenburg syndrome, Usher syndrome, Dandy-Walker syndrome, or albinism. A control group was appropriately matched to the syndromic group with regard to age at implantation and duration of device use. INTERVENTION: Cochlear implantation. MAIN OUTCOME MEASURES: Subjects' auditory abilities, speech intelligibility, and pure tone thresholds were compared between the syndromic and non-syndromic group. RESULTS: A total of 25 subjects (13 syndromic and 12 non-syndromic) participated in the study. Neither auditory ability nor speech intelligibility scores differed significantly by group. The final PTA of both the groups showed normal-to-mild hearing loss: 26 dB HL in the syndromic group and 23 dB HL for the control group. CONCLUSIONS: Cochlear implant recipients with genetic syndromes achieved similar levels auditory perception and speech intelligibility as their peers with a genetic syndrome. The presence of any of the genetic syndromes described herein should not be a contraindication to cochlear implant provision, as it would have a positive impact on the patients' sensory perception and lifestyle.

Loco-Regional Control With Complete Resection and Tongue Reconstruction on the Malignant Melanoma in the Tongue.

Primary malignant melanoma in the tongue is very uncommon disease that is considered low in comparison to cutaneous melanoma. In this report, the authors described a case of the hemitongue reconstruction with fasciocutaneous free flap on the patient who suffered from the malignant melanoma primarily originating from the base of the tongue that was treated with surgery and radiotherapy but developed a lung metastasis. A 76-year-old man was referred to the otorhinolaryngology clinic after complaining of a painful mass present for 3 months on the right side of the tongue. A punch biopsy was revealed atypical cells with pigmentation that is consistent with malignant melanoma. After wide excision and bilateral neck dissection performed, hemipartial tongue reconstruction was done using a radial forearm free flap. The patient had an uneventful recovery and received a course of radiotherapy along with follow-up examinations for 3 years. The authors report this rare patient for providing the other surgeons with the useful information regarding the management of the malignant melanoma on the tongue with free flap reconstruction which turned out to be successful in loco-regional control.