Retention hyperkeratosis over surgical scar: case report and review of literature.

Background: Retention hyperkeratosis (RHK) is benign and commonly seen skin condition in dermatology clinics. Hyperkeratosis refers to the increased thickness of the outermost layer of skin stratum corneum. RHK occurs when there is abnormality of routine desquamation that can be associated with poor hygiene. There are various types of hyperkeratosis, and could be divided according to their etiology. Although RHK is commonly recognized by dermatologists it is rarely reported. To the best of our knowledge, this is the first reported case of RHK over surgical scar. Case Description: A 63-year-old male presented to our dermatology clinic with severe RHK over a midline sternotomy scar post-coronary artery bypass grafting (post-CABG) in which he developed over the past 8 years. Our patient's history was significant in avoiding touching the surgical area as he feared disturbing the healing process of his surgical wound We discussed in details as further examination and investigations took a place on clinic-base during his management. Conclusions: Since RHK is associated with poor hygiene as we have seen in our patient's case, it could be prevented by providing the patient instructions regarding his wound care and general hygiene postoperatively and management of hyperkeratosis differs depending on type, severity, and chronicity. Our case represents a rare extreme manifestation related to the fear of our patient cleaning surgical wounds.

The circadian preference to operate electively among surgeons: A cross-sectional study.

Background: The circadian rhythm is unique to each individual. The time of the day when an individual is most productive is determined by several factors associated with circadian rhythm. Some evidence suggests that late-night surgeries are associated with a better prognosis and a lower rate of complications than those performed at other times of the day. However, the impact of surgeons' preferred operating time on patients remains unclear. Objective: The present study is the first to examine at what time of the day surgeons prefer to operate. Methods: This cross-sectional, questionnaire-based study involved 15 items designed to interrogate surgeons' preferred time of day to operate. The questionnaire was distributed electronically to the consultants of different surgical specialties after explaining the purpose of the study and obtaining their consent to participate. Results: A total of 226 surgeons participated in this study, of which 192 (85%) were men. Most (25.2%) consultants were general surgeons. The weekly workload for most (66.4%) surgeons was 41-60 h. The surgeons indicated their preference to operate in the early (11.9%) or late morning (71.2%), early (15.0%) and late (1.3%) afternoon, and evening (0.4%). The key determinant of their preference was the availability of hospital resources (36.3%). Men and women tended to prefer operating in the early morning and afternoon and late afternoon, respectively. Conclusions: In the present study, most surgeons preferred to operate between 8 am and 12 noon (late morning), and their preference was determined by the availability of hospital resources.

Public Awareness of Breast Implant-associated Anaplastic Large Cell Lymphoma in Saudi Arabia.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) was first reported in 1997. Since then, the number of reported cases has been increasing, and patients' knowledge and perceptions about this condition are unclear. This study aimed to evaluate the public knowledge and perceptions toward BIA-ALCL and its association with cosmetic/reconstructive breast implants in Saudi Arabia. METHODS: In this cross-sectional, online survey-based study, women aged 18-60 years in Saudi Arabia were the target population on social media platforms. Questions included data on demographics, experience of implants, and knowledge and concerns regarding BIA-ALCL. RESULTS: A total of 543 women participated in this study, with a mean age of 34 years. Only 1.9% had breast implants due to cosmetic or reconstructive reasons, whereas 9.8% expressed their desire of having implants in the future. More than half (57.3%) of the respondents had never heard of BIA-ALCL in comparison with 21.7% who had an established background. After reading the highlights on BIA-ALCL, 60% of the women with breast implants still wanted to keep their implants and 42.5% of the ones who desired breast implants would still aim to have them. Almost all the sample stated that BIA-ALCL should be included in the written consent. CONCLUSIONS: Nearly half of Saudi women have not heard of BIA-ALCL, and report that it is an important part of the surgical consultation and informed consent. Our role as plastic surgeons is to raise the awareness of BIA-ALCL through social media and health care settings to maximize the safety of women with breast implants.

Perception of Cosmetic Procedures among Saudis during COVID-19 Pandemic.

BACKGROUND: A novel coronavirus disease (COVID-19) was first reported in December 2019 in Wuhan, China. The fast spread of the virus has led to a significant reduction in the numbers of elective procedures especially cosmetic interventions. Although many measures have been carried out to offload the health care system, it is unclear whether these changes had an effect on general population perception toward undergoing cosmetic procedures. The aim of this study was to assess the perception of Saudis toward undergoing a cosmetic surgery during the COVID-19 pandemic. METHOD: An online survey consisting of two parts was used, with a series of questions about cosmetic procedures, in general, and cosmetic procedures during the COVID-19 pandemic, in particular. The survey included Saudis (age 18 to 60 years) with access to social media. RESULTS: A total of 563 respondents participated in this survey. The vast majority were women (86.9%) and were between 18 and 24 years old (38.7%). Some 27.4% considered a cosmetic procedure during the COVID-19 pandemic; however, only 11.9% underwent any. In the majority of the participants (86%), the pandemic did not change their minds about having a cosmetic procedure. About 49.7% agreed that fear of contracting the virus would be a factor for not undergoing a cosmetic procedure during the pandemic. CONCLUSIONS: Clear differences in the engagement and perception of cosmetic procedures during the COVID-19 pandemic exist among Saudis. More studies are needed to explore the effects of pandemics on aesthetic practice and to find ways to perform elective procedures in a safe way.