Pigmented Desmoplastic Trichilemmoma Arising in Nevus Sebaceous: A Potential Mimicker of Pigmented Basal Cell Carcinoma.

Introduction: Trichilemmomas are a form of benign adnexal neoplasm with differentiation toward the follicular outer sheath. Nevus sebaceous (NS) of Jadassohn is a congenital malformation characterized as a nonhereditary hamartoma of the adnexal structures of the skin, mainly the pilosebaceous unit. NS represents a fertile field for the development of secondary adnexal neoplasms, commonly benign but occasionally malignant. To our knowledge, one case of a pigmented desmoplastic trichilemmoma (DT) has been reported in the English literature. Case Presentation: We report a case of a 36-year-old male with pigmented DT that developed on long-standing congenital NS, mimicking pigmented basal cell carcinoma (BCC), which was successfully excised with 4-mm margins. Conclusion: Pigmented DT may mimic pigmented BCC on clinical and dermatoscopic examination; therefore, histological evaluation is always recommended to confirm the diagnosis.

The Prevalence and Level of Awareness of Medication Overuse Headache in Qassim Province, Saudi Arabia: A Cross-Sectional Study.

Introduction Medication overuse headache (MOH) is a secondary headache caused by regular overuse of medication(s) intended to relieve (notably, not prevent) the symptoms of a pre-existing primary headache (most commonly, migraine and tension headaches). MOH places a considerable burden on both patients and society. Understandably, the disorder is the subject of many cross-sectional studies worldwide. Research on MOH in Qassim province, Saudi Arabia, however, has not been conducted; therefore, the present study aims to identify the prevalence and level of awareness of MOH in Qassim province. Methods An observational cross-sectional study was conducted in Qassim province from July 1, 2021, to June 13, 2022. A modified electronic questionnaire was distributed through social media platforms. The questionnaire covers demographics, prevalence of MOH, and awareness of MOH. Prevalence was measured using a scoring system based on the criteria of the International Classification of Headache Disorders, third edition (ICHD-3) for diagnosing MOH. Results A total of 499 people completed the questionnaire, 286 (57.3%) of whom were female and 213 (42.7%) of whom were male. The majority of the participants were Saudi nationals (95.4%). The mean age of the participants was 35 years old (± 12.7 years). Out of the 499 participants, 451 (90.4%) reported that they had experienced headaches in their life. The prevalence of MOH among those who had reported headaches was 4%, compared with a level of awareness of MOH among all the participants of 18%. Conclusion According to our study, there is a high prevalence of MOH in Qassim province. This is also coupled with a high awareness of MOH.