Bullous striae distensae in a nephrotic syndrome patient: First case report from the Middle East of a rare presentation and review of the literature.

Striae distensae is a common cutaneous phenomenon that begins as reddish linear atrophic plaques (striae rubra) that over time progress to silvery-white coloration (stria alba). Striae distensae in rare occasions becomes edematous, ulcerative, emphysematous, or urticated. Bullous striae distensae is a sequela of conditions causing interstitial edema along with systemic glucocorticoids use. To our knowledge, only eight cases of bullous striae distensae have been reported in the literature. Herein, we report a 17-year-old female, known case of nephrotic syndrome, presented to our clinic with abdominal fluid-fill cutaneous lesions only for 5 days. She had used systemic glucocorticoids for more than a decade before she was labeled as steroid resistant nephrotic syndrome. Cushingoid body habitus were observed during physical examination, in addition to translucent bullae overlying her previously known stretch marks. Punch biopsy of the lesions revealed dermal edema with thinned collagen bundles. Based on these clinicopathological findings, a diagnosis of bullous striae distensae was made. Awareness of this rare complication and unusual clinical presentation is fundamental to avoid unnecessary and excessive interventions whether investigatory or therapeutic in order to provide appropriate management of the underlying condition.

The Influence of Social Media on the Treatment of Acne in Saudi Arabia.

Objectives The purpose of this study was to examine the effects of social media on acne treatment among the Saudi Arabian population. Methods This was a cross-sectional survey-based study conducted from January 2021 to August 2021. A self-administered survey was distributed through social media to different regions of Saudi Arabia. The survey obtained participants' sociodemographic information and details on whether people used social media for advice on acne treatment. It also asked whether they noticed any change in their acne based on social media recommendations. Results Of the 5,539 respondents, 4,227 experienced acne, of which 1,793 were influenced by social media. Most respondents were women. The majority of social media users were between 18 and 25 years old and chose social media as their first approach for acne advice. The most commonly used platform was Instagram (34%). The most frequent social media recommendation chosen was to increase water intake. Many noticed a slight change in their acne (64%), and 14.9% had side effects. There was a significant association between the use of social media for advice and gender (p-value < 0.001), education level (p-value = 0.002), and severity of acne (p-value < 0.001). Conclusion Social media has an influence on acne treatment, with many advice not recommended by established guidelines. These findings imply that dermatologists should pinpoint inaccuracies resulting from advice found on social media.

The Assessment of Dermatology Clinical Research in Saudi Arabia.

OBJECTIVES: To determine the level of evidence in dermatology research over the last five years and to assess the frequency of publication in different journals in the field of dermatology in the kingdom of Saudi Arabia, western region. METHODS: All published research were reviewed during the period of 2015 till 2020 using online research database through PubMed, Embase, and Google Scholar. A list of all Saudi dermatologists who are registered by the Saudi Commission for Health Specialties as consultants, and who worked in public institutions at Jeddah and Makkah was retrieved. The Oxford Level of Evidence Scale was utilized to determine the level of evidence of these studies. Descriptive statistics were used to determine the frequency of different study types and levels of evidence. RESULTS: A total of 125 articles were published in 62 different national and international journals. Majority of the published studies were level IV (76%). Case reports were the most common type of published research (56%) and meta-analysis studies accounted for (6.4%). Thirty-two articles were produced by academic institutions, compared to 68 published articles from governmental institutions, and 22 from military hospitals. CONCLUSION: Only a small percentage of publications in Saudi Arabia are considered high level clinical research. The number of publications during the past five years was high compared to the previous years and case reports constituted the majority. Authors should be encouraged to conduct higher-level studies to enhance patient care.

Skin metastasis from squamous cell carcinoma of the cervix to the lower extremities: Case report and review of the literature.

Squamous cell carcinoma of cervix commonly metastasizes to the lymph nodes of the pelvis and skin metastasis is a rare presentation even in the late stages of cervical cancer. We report here the first case of cervical cancer with skin metastasis in Saudi Arabia in a 69-year-old female that preceded the diagnosis of cervical carcinoma. Microscopic examination of the skin lesion revealed poorly differentiated squamous cell carcinoma. The patient was in stage IVB based on the International Federation of Gynecology and Obstetrics (FIGO) staging system. Due to her late presentation and advanced stage, the decision was to place the patient on palliative therapy. Later, the patient passed away due to the progression of her disease. The case reported in this paper emphasizes the need for a complete clinical assessment to rule out metastatic disease from cases with known cervical cancer and include skin examination in their follow-up.