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The prevalence of atopic dermatitis (AD), spanning across from childhood through adolescence is increasing in the Middle East region. Poor Quality of Life (QoL), excessive healthcare expenditure, loss of school and workdays are considered to be the significant burden of AD. Although, QoL data is available for children affected by AD in Saudi Arabia, there is limited data for adolescents and adults. Moreover, data on healthcare resource utilization (HCRU) in Saudi Arabia is lacking. The purpose of this review was to evaluate the association between AD severity and AD-related QoL and HCRU in adolescents and adults in Saudi Arabia. It also aimed to identify the gaps in literature on AD in the above two patient populations in Saudi Arabia and provide recommendations for better management of QoL and HCRU- related issues. Extensive literature search was carried out through various search engines, such as PubMed, MEDLINE, Web of Science, and Google Scholar using different keywords. This review highlighted the lack of literature from Saudi Arabia with respect to the effect of AD on QoL and HCRU in adult and adolescent populations. The gaps in data regarding patient perception, physician knowledge, family and caregiver burden, and QoL for better AD management related HRQoL and HCRU in Saudi Arabia were also identified and recommendations to bridge these gaps were provided.

Abdullah Alakeel,1 Afaf Al Sheikh,2,3 Ali A Alraddadi,4– 6 Khalid Mohammed Alattas,7 Maha Aldayel,8 Mohammed Abdulaziz Alajlan,9 Mohammed Al-Haddab,1 Mohammad Almohideb,3,10 Mohamed Fatani,11 Issam R Hamadah,12 Ruaa Alharithy,13,14 Yousef Binamer,15,16 Kim Papp,17 Ahmed Elaraby18 1Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Division of Dermatology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 3Department of Dermatology, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 4Department of Dermatology, Ministry of National Guard-Health Affairs, Jeddah, Saudi Arabia; 5King Abdullah International Research Center, Jeddah, Saudi Arabia; 6King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; 7King Fahad Central Hospital, Jazan, Saudi Arabia; 8Dammam Medical Complex, Dammam, Saudi Arabia; 9Dermatology Section MSD, King Fahad Medical City, Riyadh, Saudi Arabia; 10King Abdulaziz Medical City, Riyadh, Saudi Arabia; 11Hera General Hospital, Makkah, Saudi Arabia; 12King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 13Security Forces Hospital, Riyadh, Saudi Arabia; 14Princess Nourah University, Riyadh, Saudi Arabia; 15Department of Dermatology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 16Department of Dermatology, Alfaisal University, Riyadh, Saudi Arabia; 17Probity Medical Research Inc. and K. Papp Clinical Research Inc., Waterloo, ON, Canada; 18Bachelor of pharmacy, Cairo University, Giza, EgyptCorrespondence: Issam R Hamadah, Email ihamadah@kfshrc.edu.sa; issamhamadah@gmail.comBackground: Atopic dermatitis (AD) is a long-term, pruritic, recurrent, systemic, inflammatory skin disorder. In the Middle East region, the burden of AD is understudied, and there is a dearth of AD guideline documents for practitioners.Methods: An expert panel meeting, encompassing 12 dermatologists from the Kingdom of Saudi Arabia (KSA), was congregated to develop evidence- and experience-based consensus recommendations for AD management, especially in adults in KSA. They completed a questionnaire with seven clinical statements, and a consensus was defined when the responses of ≥ 75% of participants coincided.Results: The expert recommendations were as follows: American Association of Dermatology guidelines are to be followed for defining AD; Eczema Area and Severity Index or SCORing atopic dermatitis index may be used to quantify the disease severity; Dermatology Life Quality Index may be used to determine the impact of AD on patients’ quality of life; Atopic Dermatitis Control Tool may be used to assess long-term disease control in AD patients; and the European guidelines are to be followed for the management of AD. In AD patients who are inadequately controlled with topical or systemic therapies, the preferred systemic agent for use either alone or in combination with topical treatments is dupilumab, cyclosporine, methotrexate, phototherapy, or other available systemic treatments that may include mycophenolate mofetil or oral corticosteroids.Conclusion: These expert recommendations assist physicians by providing a reference framework for optimal care of adult AD patients.Keywords: atopic dermatitis, Dermatology Life Quality Index, Eczema Area and Severity Index, SCORing atopic dermatitis

Hidradenitis suppurativa (HS) rarely affects pediatric patients. The literature on pediatric HS patients is scarce. This is a cross-sectional study based on case note review or interviews and clinical examination of 140 pediatric patients undergoing secondary or tertiary level care. Patients were predominantly female (75.5%, n = 105) with a median age of 16. 39% reported 1st-degree relative with HS. Median BMI percentile was 88, and 11% were smokers (n = 15). Median modified Sartorius score was 8.5. Notable comorbidities found were acne (32.8%, n = 45), hirsutism (19.3%, n = 27), and pilonidal cysts (16.4%, n = 23). Resorcinol (n = 27) and clindamycin (n = 25) were the most frequently used topical treatments. Patients were treated with tetracycline (n = 32), or oral clindamycin and rifampicin in combination (n = 29). Surgical excision was performed in 18 patients, deroofing in five and incision in seven patients. Obesity seemed to be prominent in the pediatric population and correlated to parent BMI, suggesting a potential for preventive measures for the family. Disease management appeared to be similar to that of adult HS, bearing in mind that the younger the patient, the milder the disease in majority of cases., info:eu-repo/semantics/published

Background: According to World Health Organization (WHO) in 2012, an estimated 1.5 million deaths were a direct outcome to diabetes and another 2.2 million deaths were attributively related to high blood glucose in a global population. As a consequence, researches confirmed that diabetics have a shorter life expectancy than non-diabetic individuals and this extravagant mortality is predominantly due to diabetic complications. Methods: We have conducted a descriptive cross-sectional study on Makkah Region population, Saudi Arabia. All Saudi patients diagnosed with DM, regardless the type, and living in Makkah regions were included in this study. The total sample obtained was 299 patients. A self-administered questionnaire, about knowledge of diabetes mellitus complications, was filled by participants. Results: Participants were classified into five categories according to age. Male and female groups percent was (39.1%) and (60.9%) respectively. Nearly two thirds of participants have the disease for more than five years (63.2%), and nearly two thirds were compliant to their medications (62.5%). Three quarters of participants (76.9%) had positive family history of diabetes mellitus. (26.1%) of participants had only one family member with diabetes mellitus, (16.7%) had two members, and (14.7%) had five members or more with diabetes mellitus.Conclusion: To develop effective patient education and improve patients’ diabetic control and own complications, educational strategies are needed so as they may help diabetic patients to improve self-knowledge and recognition of early signs and symptoms of DM complications, and this will prevent further deterioration, which will improve life quality and increase life expectancy for those patients.

The immunomodulatory effect of vitamin D is well known, and some previous studies have found a potential association between vitamin D deficiency and psoriasis. If this is the case, correction of vitamin D levels could provide a simple, cost-effective treatment method for psoriasis patients. The aim of this case-control study was to confirm whether there was such an association. We also investigated several potential risk factors of psoriasis. We recruited 68 consecutive psoriasis outpatients at three hospitals in Saudi Arabia, as well as 68 control patients with dermatological conditions, and compared serum 25-hydroxycalciferol levels. However, we found no significant differences in vitamin D levels between the two groups. This finding supports similar negative findings of some previous studies, but further studies are needed to resolve this matter.