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Objectives: To assess teledermatology (TD) perception among dermatologists in the Kingdom of Saudi Arabia during the COVID-19 pandemic and to identify the most common advantages and disadvantages of TD. Methods: We conducted a cross-sectional survey-based study to address Saudi dermatologist perceptions of TD from July 2020 to December 2020, during Covid-19 pandemic. Results: Out of 664 emails sent, 107 complete responses were returned. Approximately 40.2% used TD through phone calls, followed by those who used a virtual clinic (32.7%). Also, the best way to use TD, according to respondents, was for triage before inpatient and outpatient visits. When we compared the use of TD in the outpatient and inpatient settings, outpatient responses always had more positive attitudes than inpatients. The most important benefit of TD is to reduce the risk of pandemic infections (69%). More than half of the participants sometimes used TD for diagnosis (n=63, 58.9%) and management (n=59, 55.1%), and 69 (64.5%) considered using it in the future. Conclusion: Our survey-based study indicates that TD is an important part in the future dermatology because our participants agreed that TD decreases cost, increases access to dermatology care, and reduces the risk of pandemic infections. And it is necessary to establish an infrastructure for TD that protects patient’s privacy and ensures accurate diagnosis.

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. It can affect all age groups, but it is relatively rare in children.1 Clinical manifestations can vary substantially depending on multiple factors, such as the patient's age and the different organs involved. Infants and children younger than 4 years of age usually present with the triad of cutaneous eruption, uveitis, and arthritis, without classic pulmonary disease.1, 2 Cutaneous sarcoidosis is rare and can manifest with different clinical presentations but rarely with livedo reticularis–like eruption.3, 4, 5 However, older children have a classic presentation resembling that of adults, which includes involvement of the lungs and lymph nodes predominantly.6 It can also be accompanied by generalized constitutional symptoms, such as fever, fatigue, malaise, and weight loss. The diagnosis of sarcoidosis is mainly established by confirming a typical noncaseating granuloma on a tissue biopsy specimen and excluding other granulomatous diseases clinically, microbiologically, and histologically. Other causes of granulomatous disease include infections, such as tuberculosis, autoimmune diseases (eg, Sjogren syndrome and Behcet disease), neoplasms (eg, lymphoma), and other diseases.7, 8, 9 There is no significant difference between childhood sarcoidosis and the adult type, although most children have a better prognosis.1 We describe a unique clinical variant of cutaneous sarcoidosis manifesting as livedo reticularis–like eruption in a pediatric patient with a history of intermittent joint pain, cranial nerve involvement, and uveitis for 1 year.

Introduction. Alopecia areata (AA) is a common autoimmune disorder of hair follicles characterized by patches on nonscarring hair loss. Reports of prevalence and clinical characteristic of AA in Saudi Arabia are limited. The aim of our study is to describe the prevalence and clinical characteristics of Saudi patients with AA. Materials and Methods. A retrospective cross-sectional study was conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia. All patients diagnosed with AA between January 2016 and December 2017 were included. Data included patient demographics, type of AA, disease duration, family history of AA, and comorbid autoimmune diseases. Results. A total of 216 patients with AA were included. The overall prevalence of AA was approximately 2.3%. The mean disease duration at the time of presentation was 2 months while the mean age of onset was 25.61 years. The most common type of AA in both adult and pediatric groups was the patchy type involving the scalp. Comorbid diseases were found in 32.41% of patients. Common associated conditions included hypothyroidism, diabetes mellitus, and atopic diseases. Conclusion. The overall prevalence of AA among a population of Saudi patients is 2.3%. AA prevalence is higher in pediatrics than adults. Common comorbid conditions include hypothyroidism, diabetes mellitus, and atopic diseases.

Mycobacterium marinum is an atypical mycobacterium that causes a skin infection known as fish tank granuloma or swimming pool granuloma affecting people who are exposed to aquatic environments. In general, it is managed medically with antimicrobials and variable treatment protocols. Here, we report a Saudi gentleman who acquired this infection in Thailand and was misdiagnosed as cutaneous leishmaniasis. After establishing the correct diagnosis, treatment with minocycline and trimethoprim-sulfamethoxazole resulted in rapid healing.

Background: Office-based surgery is commonly practiced in different specialties for a variety of procedures. During these procedures, the health care worker (HCW) is exposed to a large number of pathogens that can be bloodborne, including the hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). These pathogens can be transmitted through needlesticks or sharp injuries to intact skin or by backsplash of contaminated body fluids onto mucous membranes or injured skin. Objectives and Conclusions: This article reviews the published techniques designed to protect the HCW from such hazards. These techniques are classified into preoperative, intraoperative, and postoperative. Preoperative measures include general protective measures, organization of the surgical field, and consideration of alternative treatments in high-risk patients. Intraoperative techniques deal with safe handling and transferring of sharp instruments, working without using sharps, and protection from backspray injuries. Postoperative measures address proper disposal of used sharps.