Search

Multiple, hard, flesh-to-pink papules, plaques, and nodules, often seen on the extensor surfaces of the limbs, are characteristic of prurigo nodularis, a persistent skin condition. The itchy lesions may strike people of any age. It often occurs in tandem with another condition that causes constant itching, such atopic dermatitis or another dermatosis. The clinical symptoms are the primary indicators. However, there may be numerous instances when lichen simplex chronic us and hypertrophic lichen planus are indistinguishable from a clinical standpoint. Therefore, it is crucial to confirm the diagnosis by dermoscopy and histology. Many other therapy strategies are being used, including those using powerful antipruritics, immunomodulators, and neuromodulators. After a diagnosis has been made, treatment might take a long time, thus patient education and counseling are crucial to ensuring they stick with the plan. A subset of chronic prurigo, prurigo nodularis (PN) manifests as hyperkeratotic, very itchy papules and nodules that are often seen in a symmetrical pattern. PN develops with persistent pruritus in the setting of a wide variety of dermatological, systemic, neurological, or mental disorders. Although the specific pathophysiology of PN is not well understood, chronic scratching may be a primary cause. Topical steroids, capsaicin, calcineurin inhibitors, ultraviolet (UV) treatment, systemic injection of gabapentinoids, -opioid receptor antagonists, antidepressants, and immunosuppressants are the current gold standard in treating PN. Clinical trials are being conducted on cutting-edge therapeutic modalities such blockers of neurokinin-1, opioid, and interleukin-31 receptors.

Background and objectivesThe prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infections has been steadily increasing. These infections are considered to be either hospital-acquired MRSA (HA-MRSA) or community-acquired MRSA (CA-MRSA). Children are at higher risk of infection than adults. HA-MRSA has been reported to have more serious outcomes than CA-MRSA. However, there are not enough studies in Saudi Arabia to study the characteristics of HA-MRSA in children. We aim to describe the characteristics of HA-MRSA infection, including risk factors, culture site, clinical manifestations, complications, and outcomes among pediatric patients in a tertiary care hospital in Riyadh, Saudi Arabia.Design and settingsThis is a retrospective chart review study. It was conducted in King Abdulaziz medical city in Riyadh.Patients and methodsThe study included all patients 14 years of age or younger who were culture-positive from any site in the body during the period from January 1, 2009 to December 31, 2011. The time of culture compared to admission time was used to differentiate between CA-MRSA (within 72 h of admission) and HA-MRSA (more than 72 h after admission). The final sample size was 39 patients.ResultsWe found HA-MRSA to be more common in males and those with risk factors such as previous surgery and previous hospitalization. Patients had a high Pediatric intensive care unit (PICU) admission rate and were commonly septic with positive blood cultures. Seventy-four percent of patients fully recovered, 10% recovered with complications and 15% died.ConclusionHA-MRSA is an infection that can cause serious complications and a high rate of PICU admissions. Clinical manifestations such as shock are associated with higher mortality and morbidity rates. Special care should be given to those admitted to PICU, as they have high rates of mortality and morbidity.

Background and objectives The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infections has been steadily increasing. These infections are considered to be either hospital-acquired MRSA (HA-MRSA) or community-acquired MRSA (CA-MRSA). Children are at higher risk of infection than adults. HA-MRSA has been reported to have more serious outcomes than CA-MRSA. However, there are not enough studies in Saudi Arabia to study the characteristics of HA-MRSA in children. We aim to describe the characteristics of HA-MRSA infection, including risk factors, culture site, clinical manifestations, complications, and outcomes among pediatric patients in a tertiary care hospital in Riyadh, Saudi Arabia. Design and settings This is a retrospective chart review study. It was conducted in King Abdulaziz medical city in Riyadh. Patients and methods The study included all patients 14 years of age or younger who were culture-positive from any site in the body during the period from January 1, 2009 to December 31, 2011. The time of culture compared to admission time was used to differentiate between CA-MRSA (within 72 h of admission) and HA-MRSA (more than 72 h after admission). The final sample size was 39 patients. Results We found HA-MRSA to be more common in males and those with risk factors such as previous surgery and previous hospitalization. Patients had a high Pediatric intensive care unit (PICU) admission rate and were commonly septic with positive blood cultures. Seventy-four percent of patients fully recovered, 10% recovered with complications and 15% died. Conclusion HA-MRSA is an infection that can cause serious complications and a high rate of PICU admissions. Clinical manifestations such as shock are associated with higher mortality and morbidity rates. Special care should be given to those admitted to PICU, as they have high rates of mortality and morbidity.