Abdulaziz Madani’s research while affiliated with King Saud University and other places

Background Hidradenitis suppurativa (HS) is a complex condition that is often misdiagnosed, and regional data on its clinical features and risk factors are limited. This study aimed to explore the clinical epidemiology and phenotypic characteristics of HS in the central region of Saudi Arabia. Materials and Methods A cross-sectional study was conducted on HS patients at King Khalid University Hospital (KKUH) in Riyadh from December 2020 to December 2021. Clinical, epidemiological, and comorbidity data were collected, and the severity of HS was categorized with the Hurley staging system. Statistical analysis was performed with SPSS, with the significance level set to p < 0.05. Results Of the patients, 54.8% were aged 15–30 years, 57.04% were female, and 95.56% were Saudi. Obesity was present in 48.89% of the patients, and 34.07% were smokers. The comorbid conditions included acne (10.37%), asthma (8.15%), mental disorders (2.22%), and endocrine or noncommunicable diseases (18.52%). Most patients (80.74%) had multiple affected sites. No significant associations were found between these factors and HS severity (p > 0.05). Conclusion In conclusion, HS primarily affects young, unmarried Saudi female patients, many of whom are smokers and have comorbid conditions such as asthma and skin disorders. Clinicians should carefully assess the risk profiles of patients, particularly those with smoking habits and comorbidities, and consider screening for HS in high-risk groups.

Early recognition of skin cancer reduces associated morbidity and improves survival. Most patients with suspicious skin lesions present to family medicine physicians. We aimed to evaluate the self-reported competency of family medicine residents in performing skin cancer examination (SCE) and assess the impact of different factors on their competency. All family medicine residents completed a previously validated questionnaire aimed at evaluating their skin cancer examination competency in this cross-sectional study. In total, 250 residents participated in this study. More than half of the residents never had a rotation in dermatology or received training under the supervision of a dermatologist. Approximately 70%, 72%, and 77% of residents had not observed SCE, received SCE training, and performed SCE, respectively. Although most residents were aware of the risk factors for skin cancer and the ABCD acronym for melanoma, only one out of ten residents screened their patients for these factors, enquired about changes in skin lesions, and personally practiced SCE. Only 16% of family medicine residents consider themselves competent in performing SCE. Training under the guidance of a dermatologist, SCE training, evaluating patients for cancer risk factors and any changes in moles, and SCE practice on personal level were associated with SCE competency. Multivariate analysis showed a significant association between the frequency of observing SCE and competency in performing SCE. Only 16% of family medicine residents considered themselves competent in performing SCE. The frequency of observation of SCE during residency was a significant predictor of self-reported competency in performing SCE.

Introduction Lichen sclerosus is a chronic inflammatory dermatological condition of unknown etiology, primarily impacting the genital epidermis in individuals of all genders, with a higher prevalence observed among postmenopausal women and prepubescent girls. Additionally, extragenital manifestations occur in approximately 20% of the patients diagnosed with genital lichen sclerosus. Notably, folliculocentric extragenital lichen sclerosus is rare and unusual, with only limited instances documented in existing literature. Case Description We report a 33 years old lady presented with multiple asymptomatic lesions on the dorsal feet for 1 year and similar lesions on the left hand for 4 months. On examination: folliculocentric, shiny, atrophic papules coalescing into reticulated plaques over the dorsum of both feet and few shiny, flat-topped, pink papules over the dorsum of the left hand. A skin biopsy was performed and confirmed the diagnosis of extragenital lichen sclerosus. Conclusion Acral folliculocentric extragenital lichen sclerosus is an unusual and rare clinical variant. Clinicopathologic correlation is necessary to establish the correct diagnosis. Contribution to the Literature Herein, we present an unusual presentation of extragenital lichen sclerosus, and we highlight the importance of considering it in the differential diagnosis of guttate acral skin lesions. We also review and summarize relevant cases from the literature in hope to aid physicians, especially dermatologists, to consider and swiftly reach the diagnosis and offer appropriate management. We also hope to bring about new insights and broaden future research efforts regarding lichen sclerosus especially and atrophic skin disease in general.

Purpose: There is limited information about the diagnosis and treatment of hidradenitis suppurativa (HS) in the Kingdom of Saudi Arabia (KSA). This Delphi consensus study was conducted to develop recommendations for the management of HS in the KSA.Methods: The expert panel including 12 dermatologists with extensive experience treating HS patients provided nine consensus statements and recommendations on diagnosis and assessment, management, comorbidities and multidisciplinary approach, and education. The experts also developed clinical questions pertaining to the management of HS and rolled out as a survey to 119 dermatologists practising in the KSA.Results: The topics covered included: referring physicians’ awareness of HS; referral criteria for HS; definition of moderate-to-severe HS; treatment goals; definition of treatment success; treatment and biologic initiation; comorbidities and multidisciplinary approach; patient education and awareness of HS. Full consensus (100%) from the expert dermatologists was received on all the topics except referring physicians’ awareness of HS, definition of treatment success, and treatment and biologic initiation. The survey results resonated with the expert opinion.Conclusion: As HS is a chronic disease with negative impact on quality-of-life, timely diagnosis and treatment, early identification of comorbid conditions and a multidisciplinary care approach are crucial for effective management of HS.

Sneddon syndrome, also known as livedo reticularis with cerebrovascular accidents, is a rare but chronic condition that affects blood vessels in the skin and brain. This syndrome is characterized by a net-like appearance on the skin, known as livedo reticularis, which occurs due to the constriction of blood vessels. In addition to skin manifestations, Sneddon syndrome is often associated with repeated neurological events, such as strokes or transient ischemic attacks. These neurological symptoms can vary in severity and can lead to various complications. Upon admission to the stroke unit, a 28-year-old female was found to have bilateral livedo reticularis affecting the soles and the dorsal sides of the hands. Patient evaluation is done through medical history, physical examination, routine laboratory tests, and other diagnostic procedures.

BACKGROUND The introduction of biological treatments has revolutionized the management of moderate-to-severe psoriasis. Multiple clinical trials have established the efficacy of biological agents in the treatment of moderate-to-severe psoriasis. Nevertheless, there are no clear indications for optimal monitoring intervals during treatment. OBJECTIVES Collect and analyze laboratory evaluation data from patients receiving biological therapy to provide a better understanding of the need for laboratory investigations before and during treatment with biological agents, and to analyze adverse events and other factors. DESIGN Retrospective cohort SETTINGS Tertiary care center in Riyadh, Saudi Arabia. PATIENTS AND METHODS Data were collected from the electronic medical records of patients attending the dermatology, rheumatology, and gastroenterology clinics from June 2014 to June 2019. The laboratory parameters of patients who have received one of the TNF-alpha inhibitors (adalimumab, etanercept, or infliximab) were collected starting at baseline and up to at least one year from treatment initiation. MAIN OUTCOME MEASURES The time points at which patients developed significantly abnormal laboratory results during treatment with one of the TNF-alpha inhibitors. SAMPLE SIZE 250 patients RESULTS Most patients were treated with adalimumab (38.4%); a similar proportion (38%) with infliximab, whereas only 23.6% were treated with etanercept. The majority of the significant abnormal laboratory results occurred at baseline, 3–6 and 9–12 months. Most abnormalities were among patients using infliximab, followed by etanercept, and then adalimumab. The median number of laboratory abnormalities for dermatology patients was significantly lower than that for gastroenterology patients ( P <.001), and for rheumatology patients ( P =.002). CONCLUSIONS Because dermatology patients showed a lower median number of laboratory abnormalities than patients treated by other specialties in our study, we believe that dermatology patients require less frequent laboratory monitoring. Therefore, we recommend laboratory evaluation at baseline, after 3–6 months, 1 year from the beginning of treatment, and annually thereafter for patients using TNF-alpha inhibitor agents. However, more frequent testing might be warranted according to patient comorbidities, concomitant medications, and physician judgment. LIMITATIONS Single center and retrospective design. CONFLICT OF INTEREST None.

Lamellar ichthyosis (LI) is a rare autosomal cornification disorder, with most cases due to a mutation in the transglutaminase-1 (TGM1) gene on chromosome 14. Patients with LI usually present with a collodion membrane and mild erythroderma at birth, with the collodion membranes shedding within the first weeks of life and being replaced by a generalized scale. Typically, LI is managed with oral retinoids, emollients, and keratolytic agents, eg, lactic acid. We report an LI case associated with atopic dermatitis and asthma that showed a marked improvement with dupilumab treatment. This finding is highly significant as it may represent a breakthrough in the treatment of LI, thus more research is needed to investigate the potential benefits of dupilumab for the treatment of ichthyosis, such as the effects observed in our patient.

Background: The coronavirus vaccine was developed to help overcome the COVID-19 crisis. This study aimed to identify the cutaneous side effects secondary to Pfizer-BioNTech and Oxford-AstraZeneca COVID-19 vaccines in the general population of Saudi Arabia and to list the risk factors for the development of cutaneous side effects. Methods: This cross-sectional study was conducted in 2021, Self-administered surveys were distributed electronically through social media, and telephonic interviews were conducted with a sample size of 1000 participants. Data analysis was performed using Statistical Package for the Social Sciences. Results: A total of 1021 patients (229 male and 722 female) aged 12 years or older were included. While 833 participants were medically free, 188 had chronic illnesses. While 802 participants were not taking any medications, 219 were taking medications regularly. Oxford-Astra Zeneca and Pfizer BioNTech vaccines were administered to 319 and 702 participants, respectively. One-hundred and twenty-five participants previously had COVID-19 infection and 407 were exposed to a PCR positive case of COVID. Six hundred and fifty-nine patients (64.5%) reported experiencing injection site reactions: 606 (59.4%) had injection site pain, 168 (16.5%) had injection site swelling, and 107 (10.5%) had injection site redness. Only 51 patients (5%) experienced cutaneous side effects after injection CONCLUSION: A significant association was found between chronic illnesses and cutaneous side effects post-vaccine (9% vs. 4.1%; p value=0.005). Patients on medications showed a higher rate of symptoms (8.2% vs. 4.1%; p value= 0.005). Age, gender, vaccine types, and history of COVID-19 infection were not significantly associated with cutaneous side effects post-vaccine. This article is protected by copyright. All rights reserved.