ABSTRACT
Background and aim Studies have shown a significant relationship between psychological stress (PS) and health, and it is widely believed that factors such as stress and anxiety may not only be the result of certain diseases but can also cause and exacerbate some diseases. There is a lack of research on PS and its association with other skin conditions. Thus, this study aimed to examine the association of PS with skin symptoms using objective scales in the general population in the Kingdom of Saudi Arabia (KSA). Methods A cross-sectional study was carried out between February 6, 2023, and April 4, 2023. We administered an electronic questionnaire survey, consisting of Cohen's perceived stress scale and a self-reported skin complaint questionnaire, distributed via an online platform in the KSA. In all, 629 completed questionnaires were returned. Statistical analysis was conducted using RStudio. The results were presented as beta coefficients and their respective 95% confidence intervals (95% CIs). A p-value of <0.05 indicated statistical significance. Results The majority of the participants were female (71.7%, n=388), of Saudi nationality (93.2%, n=504), had a bachelor's degree (68.6%, n=371), were aged 18-29 years (58.8%, n=318), and were residing in the Western region (39.9%, n=216). Acne (26.8%, n=145) and eczema (12.8%, n=69) were the most commonly reported skin conditions. The stress level was low in 30.5% of the respondents (n=165), moderate in 64.9% of the respondents (n=351), and high in 4.6% of the respondents (n=25). The average skin symptom score was significantly predicted by the presence of psoriasis (p < 0.001), eczema (p < 0.001), acne (p < 0.001), rash (p < 0.001), and baldness (p = 0.041). Furthermore, the average skin symptoms scores were significantly higher among participants with high stress (median = 1.6, interquartile range (IQR) = 1.4, 1.8) than among those with moderate (median = 1.4, IQR = 1.2, 1.8) and low stress (median = 1.4, IQR = 1.1, 1.4, p < 0.001). Conclusion The general population of Saudi Arabia reported multiple skin symptoms associated with stress. PS can cause various common skin conditions including loss of hair, eczema, and acne. This study highlights the importance of assessing common skin problems in the general population in the KSA and their strong association with PS. Various skin conditions including loss of hair, eczema, and acne can be caused by PS. Dermatologists should be aware of the context of PS when assessing patients with these conditions.
ABSTRACT
Introduction Tattooing and piercing, which were uncommon in affluent countries, have recently spread throughout societies. Over the past two decades, young people have shown considerable excitement for the practice. This reported growth creates more difficulties because of the numerous operations performed without awareness of health and hygiene requirements. This study aims to assess the knowledge and attitudes of the general population toward the cutaneous complications of tattoos and piercings in Saudi Arabia. Methods This was a web-based descriptive cross-sectional study. An online questionnaire was developed by the study researchers, which included participants' demographic data, their knowledge of tattoos and piercings with associated health effects and possible infections, their attitude towards tattoos and piercings, and their practice and experienced complications regarding tattooing and body piercing. The final validated questionnaire was made publicly available via social media until no more new responses were obtained. Results Eight hundred and forty-eight individuals completed the study questionnaire. The ages of the participants varied from 18 to more than 55 years old, with a mean age of 25.2 ± 13.9 years, and (589 [69.5%]) were female. The most reported health effects and infections were bacterial infections in place of body modification (479 [56.5%]), purpura (380 [44.9%]), cutaneous abscesses (380 [44%]), melanoma (338 [39.9%]), hepatitis B virus (321 [37.9%]), HIV (311 [36.7%]), sepsis (306 [36.2%]), allergic contact dermatitis (296 [35%]), and hepatitis C virus (279 [33.1%]). In total, 336 (39.6%) had an overall good knowledge of tattooing and body piercing hazards, with higher knowledge among females with high education (p< 0.05). Conclusion This study revealed that one in three individuals knew about the health risks and infections associated with tattooing and body piercing. Higher awareness was found among females with high education levels. Of all the associated complications, procedure-related infections were the most common among participants.
ABSTRACT
Prurigo pigmentosa (PP) is an idiopathic cutaneous inflammatory disorder. Here we report a 50-year-old healthy male of Arabic descent who presented with a six-month history of very itchy persistent skin lesions on his back. Skin examination revealed multiple brownish non-scaly excoriated papules and patches in the midline of his lower back. The differential diagnosis includes lichen planus (LP), confluent and reticulated papillomatosis (CARP), and PP. Skin biopsy revealed acanthosis, spongiosis, and dyskeratotic keratinocytes in the epidermis. The dermis showed mild perivascular lymphocytic infiltrate. Based on the previous clinicopathological findings, the patient was diagnosed with PP. He was prescribed doxycycline 100 mg once daily (OD) for two months. Two months after treatment, all lesions disappeared completely. After one year at the follow-up, he presented with a recurrence of the same skin lesions at the same site. We restarted him on doxycycline treatment.
