Management of psoriasis in Africa and the Middle East: a review of current opinion, practice and opportunities for improvement.

Psoriasis is a common, chronic, systemic, inflammatory disease of the skin that is often associated with inflammatory musculoskeletal disease. Psoriasis impacts on affected individuals and on society at many levels, being associated with considerable economic burden and impaired quality of life. This article aims to provide dermatologists and their allied healthcare professionals, particularly those practicing in Africa and the Middle East, with a review of the current understanding of psoriasis, its treatment and impact, as a backdrop for further discussion of the management of psoriasis in these regions. Insight into the real-life, day-to-day challenges and unmet needs currently facing dermatologists in Africa and the Middle East is provided by the authors, most of whom are experienced dermatologists practicing in this region.

Etiology and outcome of thyrotoxicosis at a university hospital.

OBJECTIVE: To determine the causes, clinical manifestations, mode of treatment, and outcome of hyperthyroidism at King Abdulaziz University Hospital. METHODS: A retrospective study of all cases of thyrotoxicosis diagnosed at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia, in the period between January 1997 to January 1999, that received a minimum of one year treatment. RESULTS: A total of 203 patients were seen with female: male ratio of 3.8:1 and mean age of 35.49+/-10.86 years. Graves' disease was the underlying cause in 69% of cases, toxic multi nodular goiter in 29%, and toxic adenoma and sub acute thyroiditis in 1% each. Palpitations, tremor, weight loss and nervousness were the commonest presenting manifestations. Forty-five (45%) of patients were treated with antithyroid drugs, 36% with radioactive iodine and 18% underwent subtotal thyroidectomy. Post radiotherapy hypothyroidism developed in 37% of patients. CONCLUSION: Causes and clinical manifestations of thyrotoxicosis in our patients were comparable with those reported in the literature. There is under use of radioactive iodine therapy, and physicians should be encouraged to use this mode of therapy as its efficacy, safety and low cost made it the preferred definitive treatment in most patients with hyperthyroidism.