Prevalence of Self-Medication Among Patients With Common Dermatological Diseases in Saudi Arabia.

Introduction  Self-medication is defined as the use of a medication or product to treat, alleviate, or prevent a condition or symptom of an illness or to promote health. Self-management is increasingly used for dermatological diseases, especially chronic inflammatory skin diseases. Hence, it is crucial to be aware of its prevalence and the leading factors of its usage. Therefore, this study aims to estimate the prevalence of self-treatment for dermatological diseases and to determine possible factors associated with its practice.  Methodology  This is a cross-sectional online-based questionnaire study that was conducted in King Fahad Armed Forces Hospital in Jeddah, Saudi Arabia. In this study, we included all first-visit and follow-up patients diagnosed with vitiligo, eczema, alopecia areata, and psoriasis. Data analysis was conducted using JMP Statistical Discovery Software, version 15 (JMP Statistical Discovery LLC, Cary, NC).  Results  Of the 203 patients who participated in this study, 91 (44.8%) had vitiligo. Moreover, topical corticosteroids were the most commonly used medications in self-treatment and included mometasone and hydrocortisone, which were used by 143 (41.3%) and 50 (14.5%) patients, respectively. Thirty patients (16.2%) improved with self-treatment, whereas 52 (28.1%) had no improvement. In addition, the most common reason for self-treatment was having mild symptoms of the disease in 97 patients (30.1%).  Conclusion  This study revealed that the prevalence of self-treatment among various dermatological diseases was 53.2%. Topical corticosteroids were the most commonly used conventional medicines, whereas the most common alternative medications used were honey and henna. We found that the most common reason for self-treatment was mildness of the dermatological disease. Family and friends were the most common sources of information.

The efficacy of Topical Clascoterone versus systematic spironolactone for treatment of acne vulgaris: A systematic review and network meta-analysis.

OBJECTIVES: This study aimed to evaluate the effectiveness of topical clascoterone (TC) compared to oral spironolactone for acne vulgaris treatment. METHODS: A computerized search through PubMed/MEDLINE, SCOPUS, and the Cochrane Library was conducted to find relevant papers. We used the "netmeta" and "meta" packages for network meta-analysis (NMA) in RStudio 1.2.5019 (2009-2019 RStudio, Inc.) to conduct all of our statistical tests. RESULTS: Seven articles (n = 2,006 patients) were included. The fixed-effect size showed that TC 1% bis in die (BID) showed potential effectiveness in reducing the inflammatory and non-inflammatory lesion count compared to placebo (Standardized mean difference, SMD = -0.27, 95% CI: -0.36 to -0.17) and (SMD = -0.31, 95% CI: -0.41 to -0.22), respectively. The random-effect size showed that TC 1% BID was significantly associated with a 12-week treatment success compared to placebo (Odds ratio, OR = 2.44, 95% CI: 1.12 to 5.30). Spironolactone 200 mg was associated with a significant reduction in total lesion count (SMD = -4.46, 95% CI: -5.60 to -3.32). CONCLUSION: TC appears to reduce both inflammatory and non-inflammatory lesion count and may lead to treatment success. Spironolactone at 200 mg showed potential effectiveness in terms of total lesion count reduction. These results suggest that both TC and Spironolactone could be beneficial in treating patients with acne vulgaris.

Pleomorphic Fibroma Presenting as a Nodular Lesion in the Left Shoulder: A Case Report.

Pleomorphic fibroma is an uncommon benign cutaneous tumor that often presents as a single asymptomatic skin-colored lesion with indefinite clinical diagnostic features. Here, we report a case of a 47-year-old female diagnosed with pleomorphic fibroma of the skin in the left shoulder and discuss the importance of immunohistochemistry and special features in histopathology to distinguish some of the differentials.

The Role of Systemic and Topical Beta-Blockers in Dermatology: A Systematic Review.

INTRODUCTION: Beta-blockers are proven to be safe and cost-effective agents in treating multiple dermatological conditions, which is why they are considered as an interesting and good alternative therapeutic agent by dermatologists. To our knowledge, there has been no comprehensive systematic review to date summarizing the role of both systemic and topical beta-blockers in dermatology. METHODS: In this systematic review, we aim to review recent and relevant published literature in order to provide a comprehensive evidence-based summary to inform dermatologists. RESULTS: An electronic-based literature search was carried out during October-December 2021 in the databases PubMed (MEDLINE), SCOPUS (EMBASE), and Cochrane Library. Furthermore, bibliographic sources were also reviewed for the selected articles. We followed The Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 (PRISMA) guidelines. We reviewed published literature about the role of beta-blockers in dermatology for the time period (January 2016 to December 2021). CONCLUSIONS: A total of 126 publications were retrieved from different databases, of which 59 studies were finally included in our review after excluding non-eligible literature in accordance with our inclusion and exclusion criteria. The included articles consisted of meta-analyses, systematic reviews, clinical trials, retrospective and prospective cohort studies, case-control studies, case series, and case reports. In general, data in reviewed literature showed that both systemic and topical beta-blockers were reliable and safe therapeutic options in treating different dermatoses. Their effect has been studied as a mono-therapy, also as an adjuvant therapy combined with other current disease-specific therapeutic modalities such as lasers, radiation, chemotherapy, corticosteroids, or other beta-blockers options. Local and systemic adverse effects were mainly minor and non-significant.

Influence of narrowband ultraviolet B phototherapy on serum folate level in skin of color females: A cross-sectional study.

Narrowband ultraviolet B (NB-UVB) (311-312 nm) is widely used for dermatological conditions with a favorable side-effect profile during pregnancy. Recently published data showed that NB-UVB might decrease serum folate level in Fitzpatrick skin phenotype I-III, especially at higher doses; this may predispose newborns to neural tube defects. Objective: To compare serum folate levels of skin of color females treated with NB-UVB and healthy females of childbearing age, as well as to note whether subsequent complications have been observed, if any. Methods: Multicenter, cross-sectional study of 30 females (N = 30): 15 female patients undergoing NB-UVB phototherapy as well as 15 age-, gender-, and skin phenotype-matched healthy volunteers who were enrolled into the study after excluding factors known to alter serum folate concentration. NB-UVB exposures were performed 2-3 times a week for at least 8-12 weeks (mean cumulative NB-UVB dose ± standard deviation [SD] was 55 ± 79 J/cm2). Results: Mean serum folate ± SD in NB-UVB exposed and healthy controls were 10.3 ± 4 and 8.3 ± 3 ng/mL, respectively. This was not a statistically significant difference between the 2 groups (P = .14). Limitations: Small sample size (N = 30) and a cross-sectional study type. Conclusion: Cumulative NB-UVB exposure is not associated with a statistically significant difference in serum folate level (P > .05) in skin of color females of childbearing age in comparison to age-, gender-, and skin phenotype-matched healthy females, even with the relatively higher cumulative doses (mean ± SD was 55 ± 79 J/cm2) that have been shown to reduce serum folate level in lighter skin phenotypes.

Reed's Syndrome: A Case of Multiple Cutaneous Leiomyomas Treated with Liquid Nitrogen Cryotherapy.

Reed's syndrome is an autosomal dominant genetic disorder. Affected individuals are at increased risk of developing benign smooth muscle tumors in the skin and uterus. In this article, we report a case of a 52-year-old female who presented to our dermatology clinic complaining of painful skin lesions on her right arm, left forearm and trunk. The patient had a past medical history of uterine leiomyomatosis for which she underwent hysterectomy 17 years ago. The patient's family history revealed that her mother, 2 sisters and 2 maternal aunts also had uterine leiomyomas. The diagnosis of Reed's syndrome was confirmed by histopathologic examination of the patient's dermal lesion in conjunction with her surgical and family histories. Five years after the initial presentation, the patient underwent treatment with liquid nitrogen cryotherapy for the dermal leiomyomas. After the treatment, marked improvement was noticed with regard to the pain and size of the skin lesions.