Prescription Pattern of Tofacitinib for Alopecia Areata Among the Dermatologists in Saudi Arabia: A Cross-Sectional Study.

Introduction Alopecia areata (AA) is a complex autoimmune condition that causes nonscarring hair loss. In Saudi Arabia, AA accounts for 1-2% of new dermatological outpatient visits. It typically presents with sharply demarcated round patches of hair loss and may present at any age. Traditional medical therapies include corticosteroids and immunotherapy. Choosing the ideal treatment depends on multiple factors such as patient age, disease severity, efficacy, side effects, and remission rate. Recent medications that have been used for treating AA are Janus kinase inhibitors. Aim The aim of the study is to assess the awareness and attitude of dermatologists and their use of Tofacitinib in treating AA. Method A cross-sectional study was conducted in 2019 across 14 major cities in Saudi Arabia. A self-administered online questionnaire was specifically developed and used. Dermatologists from government hospitals and private clinics were included through non-probability convenience sampling. The collected data was entered into Microsoft Excel and analyzed using SPSS program version 24. Results In total, out of 546 Dermatologists across Saudi Arabia who responded to the questionnaire, 127 (23.2%) physicians prescribed Tofacitinib in their practice. Out of those who prescribed the drug for AA cases, 58 dermatologists (45.6%) prescribed Tofacitinib after the failure of steroid injections. Among the 127 dermatologists who have utilized Tofacitinib in their practice, 92 (72.4%) believe that Tofacitinib is effective in treating AA. Almost 200 (47.7%) Dermatologists who never prescribed Tofacitinib reported that the main reason was due to the unavailability of the drug in the clinic they were practicing. Conclusions To conclude, out of 546 dermatologists working in Saudi Arabia, 127 (23.2%) prescribe Tofacitinib to treat AA. Ninety-two (72.4%) of the participants reported the effectiveness of Tofacitinib. Two hundred (47.7%) dermatologists who never prescribe Tofacitinib reported that the main reason was due to the unavailability. However, this would raise the need for more research regarding JAK inhibitors generally and Tofacitinib specifically, focusing on the effectiveness versus the side effects of Tofacitinib.

Improvement of atopic dermatitis and alopecia universalis with dupilumab.

Dupilumab is an interleukin-4 receptor alpha antagonist that showed significant improvement of atopic dermatitis (AD). Many reports have shown significant resolution of alopecia areata, alopecia universalis and alopecia totalis after dupilumab treatment for AD. We present one of reported cases that showed improvement of underlying alopecia universalis treated with dupilumab.

Adherence of Saudi women with epilepsy to folic acid intake in the preconceptional period in two tertiary care hospitals in Riyadh: A cross sectional study.

Antiseizure medication have been associated with an increasing risk of congenital anomalies. Medical authorities recommend taking folic acid during the pre-conceptional period to reduce the risk of congenital malformations in the newborns of women with epilepsy (WWE). In this cross-sectional study, we aimed to measure the adherence of Saudi WWE to folic acid intake. We included WWE visiting outpatient epilepsy clinics in King Abdulaziz Medical City and King Fahad Medical City in Riyadh between September 2017 and August 2018. By consecutive non-probability sampling, we identified 85 patients who met the inclusion criteria of the study. The data were collected by a self-administrated questionnaire. We found that the mean age of the subjects was 33 ± 7.5 years. One third were university graduates. Eighty percent were aware of the role of folic acid in preventing congenital anomalies, and 63.9% were taking it during the preconceptional period. No association was found between educational level and adherence to folic acid intake. In conclusion, adherence to folic acid intake among Saudi WWE is not optimal. More efforts are needed to increase patient adherence to folic acid intake.

The Association Between Hair Loss and COVID-19: The Impact of Hair Loss After COVID-19 Infection on the Quality of Life Among Residents in Saudi Arabia.

Background Coronavirus disease 2019 (COVID-19) is an infectious disease that is associated with many health conditions, including, but not limited to, dermatological diseases. Some patients suffer from hair loss after becoming infected with severe acute respiratory syndrome coronavirus 2. Acute telogen effluvium (TE) is a non-scarring hair loss that usually occurs three months after a stressful event and can last up to six months, and it can be associated with post-COVID-19 infections. This study aims to explore the prevalence of hair loss among recovered COVID-19 patients in Saudi Arabia and determine the contributing factors. Furthermore, we aimed to measure the impact of hair loss after COVID-19 on their quality of life. Methodology An observational, cross-sectional study was conducted from September to December 2021 in Saudi Arabia. A questionnaire was used to assess hair loss after being infected with COVID-19. Furthermore, quality of life was assessed using the Dermatology Life Quality Index (DLQI) questionnaire. Participants were recruited by sharing the questionnaire on social media platforms (Twitter, Telegram, and WhatsApp). The data were analyzed using SPSS version 23 (IBM Corp., Armonk, NY, USA). Frequency and percentages were used to display categorical variables, while minimum, maximum, mean, and standard deviation were used to present continuous variables. The categorical variables were compared using a chi-square test, and the statistical significance cut-off was set at p < 0.05. Results A total of 806 participants were included in the study, of whom 52.7% experienced hair loss after COVID-19 infection. Age, gender, high temperature during, and the presence of hair loss prior to infection were significantly associated with the incidence of TE. The severity of life affection based on DLQI showed that 91.4% of the participants did not have severe life affection, while 8.6% had their lives severely affected. Conclusions This study revealed subjective hair loss that was significantly associated with high temperature, being female, and having a history of previous hair loss. Further studies using objective assessments are suggested for reaching more precise conclusions.

Genetic Profile of Epidermolysis Bullosa Cases in King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Epidermolysis bullosa (EB) is a rare heterogeneous genetic mechanobullous skin disorder that is characterized by increased skin fragility leading to blistering following minor trauma. EB may be inherited as an autosomal dominant or an autosomal recessive disorder and can be classified into dystrophic EB (DEB), junctional EB (JEB), and EB simplex (EBS). A total of 28 Saudi patients with EB were included in this observational, retrospective chart-review study. A consecutive non-probability sampling technique was used to approach all affected patients. Molecular analysis was done to test the patients' genomic DNA using a custom-designed AmpliSeq panel of suspected genes. All disease-causing variants were checked against available public databases. Twelve patients (42.9%) were found to have DEB, 6 patients (21.4%) with JEB, and 10 patients (35.7%) with EBS. The molecular genetic results revealed detections of 24 various homozygous genetic variations in the genes associated with EB, of which 14 were novel mutations. The most frequent variations were detected in COL7A1 in 12 cases (42.9%), followed by LAMB3 in 5 cases (17.9%), TGM5 in 4 cases (14.3%), and other genes. Furthermore, the majority (87.5%) of EB cases were confirmed to have homozygous mutations, and few were documented with positive consanguinity history. Only 3 cases (12.5%) were found to be autosomal dominant displaying heterozygous mutations. This is the first study to establish the EB genetic profile in Saudi Arabia where DEB is the most frequent type. A total of 14 novel mutations were identified that had not been previously reported. Consanguineous marriage is clearly recognized in the Saudi population; therefore, we propose a nationwide EB program that would help extend the spectrum of the genetic profile and help in the diagnosis and better understanding of this disease.

Pollen molecular biology: Applications in the forensic palynology and future prospects: A review.

Palynology, which is the study of pollen and spores in an archaeological or geological context, has become a well-established research tool leading to many significant scientific developments. The term palynomorph includes pollen of spermatophytes, spores of fungi, ferns, and bryophytes, as well as other organic-walled microfossils, such as dinoflagellates and acritarches. Advances in plant genomics have had a high impact on the field of forensic botany. Forensic palynology has also been used and applied more recently to criminal investigation in a meaningful way. However, the use of pollen DNA profiling in forensic investigations has yet to be applied. There were earlier uses of dust traces in some forensic analyses that considered pollen as a type of botanical dust debris. Pollen grains can be studied for comparative morphological data, clues to unexpected aspects relating to breeding systems, pollination biology and hybridization. This can provide a better understanding of the entire biology of the group under investigation. Forensic palynology refers to the use of pollen and other spores when it is used as evidence in legal cases to resolve criminal issues by proving or disproving relationships between people and crime scenes. This overview describes the various contributions and the significance of palynology, its applications, different recent approaches and how it could be further employed in solving criminal investigations.