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Cutaneous leishmaniasis incidence has been rising in the past couple of decades. Standard therapy often includes antileishmanial drugs; however, due to their low safety and toxicity threshold, alternative treatments are being investigated. The association between COVID-19 and cutaneous leishmaniasis remains unclear and exploring this connection may offer crucial insights into the pathophysiology of and treatment strategies for infected patients. In this article, we describe a case of a male patient with a history of cardiac and other comorbidities who presented with cutaneous leishmaniasis in the form of impetigo-like skin lesions after being infected with COVID-19. Due to the patient's poor cardiac profile, sodium stibogluconate was not used and an alternative therapeutic approach was employed. The patient was treated with oral terbinafine, cryotherapy on specific lesions, and a course of cephalexin. Following the course of treatment and subsequent follow-up, the patient exhibited complete resolution and healing of the lesions with scarring, and no active lesions or recurrence were observed. This case highlights the potential for alternative treatment strategies for cutaneous leishmaniasis in patients with comorbidities and emphasizes the importance of further research to better understand the link between COVID-19 and cutaneous leishmaniasis.
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Introduction Ankylosing spondylitis, now frequently referred to as spondyloarthritis (SpA), is a chronic inflammatory disease causing axial arthritis and inflammatory lower back pain resulting in the eventual impairment of spinal mobility. Moreover, its systemic complications include stiffness and inflexibility, restriction of lung capacity and function, eye inflammation, compression spinal fractures, and heart problems. Hence, early diagnosis and intervention play a key role in preventing acute complications and improving the quality of life. Objective We aimed to estimate the average duration of diagnosis, the average number of doctors visited, and the association between the specialty of the first physician and the length of SpA diagnosis delay. Methods A cross-sectional retrospective study was conducted from November 2019 to April 2020 with patients from King Khalid University Hospital, Riyadh, Saudi Arabia. The patients were 18 years and older and diagnosed with SpA. Call interviews were conducted and patients' medical charts were reviewed. The data were analyzed using the Statistical Package for Social Sciences statistical software, version 23 (IBM Corp., Armonk, NY). Result The total sample was 101 patients: 59 (58.4%) males and 42 (41.6%) females. The average duration from the onset of symptoms until seeking medical advice (lag 1) and from seeking medical advice until the definite diagnosis (lag 2) was 24.74 ± 48.13 and 16.16 ± 34.62 months, respectively. The average number of doctors visited between the first medical encounter and the final diagnosis was 3.56 ± 5.3. Patients who consulted rheumatologists as the first medical encounter showed less delay in diagnosis compared to patients who sought non-rheumatologists, such as orthopedists, emergency physicians, and general physicians (11.81 ± 33.35 months vs. 26.63 ± 44.28, 26.96 ± 44.88, and 44.33 ± 65.75 months, respectively). Conclusion Patients with SpA who were not seen by rheumatologists took a longer period till the final diagnosis than those who visited rheumatologists earlier in the course of the disease. Therefore, more studies are required to define the exact factors leading to the delay.
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Objective: The goal of this study is to assess the knowledge and attitude of dermatology patients regarding sunscreen use as recommended by the American Academy of Dermatology. Methods: This was an observational cross-sectional study at a university hospital in Riyadh. Participants were asked to complete a questionnaire to measure their knowledge and attitude regarding sunscreen use. Results were analyzed using a chi-square test. Results: Most participants heard about sunscreen (93.4%) and had indicated previous sunscreen use (72%). Sunscreen use was higher among women and participants with a postgraduate education. Sunscreen knowledge was higher among women, participants with non-photosensitive disorders, and participants with Fitzpatrick I, II, and III skin types. A total of 80% knew the worst time for sun exposure, but only 20.5% of the participants knew that sunscreen should be applied daily throughout the year, and 13.5% knew the correct minimum recommended SPF. A total of 34% were aware of the minimum time allowed for sunscreen application before sun exposure, and 20% were aware of the longest period allowed between reapplications. Only 4.5% knew the proper amount of sunscreen to cover the entire body. Conclusion: Our study revealed that most participants had heard of sunscreen, however their knowledge of the guidelines for sunscreen use was poor. Only 33% of the participants had received a recommendation for using sunscreen from their general practitioner or dermatologist. More comprehensive and directed efforts need to be made in counselling and educating these patients on proper sunscreen practice.
