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Anonychia refers to the absence of nail plates owing to an autosomal dominant or recessive inheritance. Congenital anonychia is a rare condition that may be associated with other ectodermal or mesodermal malformations like epidermolysis bullosa, (deafness, onychodystrophy, osteodystrophy, and mental retardation) syndrome and Iso-Kikuchi syndrome. Here, we report 3 cases with anonychia congenita appearing in different generations of a single family in Kingdom of Saudi Arabia.

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BACKGROUND: Acne neonatorum (AN) is characterized by a facial eruption of inflammatory and noninflammatory acne lesions in a neonate. Hyperactivity of sebaceous glands, stimulated by neonatal androgens, is implicated in its pathogenesis. AIM: To elucidate the clinical profile of AN in eastern Saudi Arabia. METHODS: All patients diagnosed with AN in King Fahd Hospital of the University in Khobar, Saudi Arabia, during the year 2005 were evaluated clinically. RESULTS: AN was diagnosed in 26 patients (male/female ratio 1:1). The lesions included mainly facial comedones (30.8%); papules and pustules (15.3% each); and combination of papules, pustules, and cysts (53.4%). CONCLUSION: All patients recovered spontaneously. In 50% of the cases, one of the parents reported having had acne vulgaris during adolescence. Hereditary factors seem to play a significant role in our series.

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BACKGROUND: Herpes zoster (HZ), caused by varicella zoster virus (VZV), initially produces chicken-pox, then the virus lies dormant in the dorsal root ganglia. The virus can reactivate after many years and results in HZ along ganglion's distribution. Old age, trauma, stress, diabetes mellitus, and immune suppression are important risk factors for the reactivation. Herpes zoster is characterized by unilateral radicular pain and vesicular eruption that is generally limited to the dermatome innervated by the affected ganglion. In immunocompromised individuals, disseminated zoster may develop. The aims of therapy in HZ are to control pain or reduce its severity by the use of analgesics, reduce the duration and eruption of new lesions, and prevent complications, particularly postherpetic neuralgia (PHN) by appropriate antiviral therapy. METHODS: All cases of HZ seen in the dermatology clinic at King Fahd Hospital of the University (KFHU) from 1988 to 2006 were included in the study. Their diagnoses were based on the clinical presentation. The following parameters were collected and analyzed: age, sex, nationality, symptoms, dermatomal distribution, complications, coexisting diseases, and disease management. RESULTS: Of 22 749 new cases seen in the dermatology clinic over 18 years, 141 were HZ, with an occurrence of 0.62%. Male to female ratio was 2:1 and the age ranged from 14 months to 80 years. The thoracic dermatomes were the most commonly involved. The most frequent coexisting disease was diabetes mellitus, and the most common complication of HZ was PHN. Most patients with HZ ophthalmicus developed eye complications. CONCLUSION: The occurrence of HZ is 0.62% in patients reporting to the dermatology clinic of the hospital. Males are little more affected than females. The thoracic dermatomes are the most frequently involved. Diabetes mellitus is the most frequent coexisting disease. Postherpetic neuralgia is the most common complication of HZ.

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We are reporting a case of 23-year-old Saudi female with persistent chronic plaque psoriasis who was given subcutaneous Efalizumab 0.8 mg/kg/week for 14 weeks. During that period the patient developed multiple adverse reactions followed by severe rebound. The case is presented to highlight the importance of managing patients on Efalizumab carefully and closely.

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Malignant peripheral nerve sheath tumors (MPNSTs) are rare tumors derived from Schwann cells or pluripotent cells of the neural crest. In this report, we describe a 21-year-old Saudi woman who presented with an asymptomatic, solid, round, protruding tumor on the right upper back which was diagnosed as an MPNST with no stigmata of neurofibromatosis. It was completely excised with a wide surgical margin. The patient was followed up for 9 months with no evidence of recurrence.

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Familial cutaneous collagenoma is an inherited connective tissue nevus, which presents with asymptomatic symmetrically distributed skin nodules on the trunk or upper limbs. Here, we describe a case of a 12-year-old girl with collagenoma affecting the lower back.

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Mycosis Fungoides (MF) is a T-cell lymphoma initially presenting in the skin. Many clinical variants exist including follicular, vesicular, poikilodermic, hypo- and hyperpigmented, ichthyosiform and pigmented purpura-like lesions. We present an unusual variant in a case of poikilodermic MF.

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Vulvar basal cell carcinoma is a rare cutaneous neoplasm occurring mainly in white postmenopausal females. It can be misdiagnosed due to its nonspecific physical appearance. Here, we report a 59-year-old white female who had vulvar basal cell carcinoma misdiagnosed for 4 years.

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OBJECTIVES: The aim of this study was to determine the most frequent skin disorders in obese female schoolchildren in primary and intermediate schools in the Al-Khobar area, Eastern Saudi Arabia. METHODOLOGY: This was a cross-sectional study conducted in the Al-Khobar area. It involved 2239 female schoolchildren randomly selected from 30 regular public and private primary and preparatory schools. A multi-stage stratified random sampling technique with proportional allocation was used. Data was collected using clinical examination and anthropometric measurements. RESULT: THE SKIN DISEASES THAT WERE MOST COMMON IN OBESE SCHOOLCHILDREN WERE: dandruff, acne, xerosis, acanthosis nigricans, folliculitis, alopecia, stria distensae (stretch marks) and callosity. CONCLUSIONS AND RECOMMENDATIONS: obesity is associated with specific skin disorders. Health education programs on skin diseases and obesity should be provided to all schoolchildren, their families and teachers.

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BACKGROUND: Different types of lasers are used in the removal of undesirable hair by targeting the hair follicles, with the melanin pigment acting as the chromophore, and through the mechanism of selective photothermolysis. OBJECTIVES: This report documents an unusual increase in terminal hair growth after alexandrite laser hair removal in three female patients. CONCLUSION: Excessive hair growth after alexandrite laser hair removal must be listed as one of the complications resulting from the use of a laser with a fluence that is too low and can possibly be prevented if we use higher energy to fully destroy the hair follicles, with consideration given to the skin type and an effective cooling system.

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Hand dermatitis is a common chronic skin condition that has many clinical forms including contact, hyperkeratotic, frictional, nummular, atopic, pompholyx and chronic vesicular hand dermatitis. Topical steroids are the first line agents used. Here, we report the successful response to topical pimecrolimus 1% cream in a patient with steroid resistant chronic vesicular hand dermatitis.

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