Leprosy or “Hansen’s disease” is a contagious disease caused by mycobacterium leprae complex. In 2000, leprosy was eliminated as a cause of public health concern. Yet, cases still occur, especially in resource-limited countries such as India, Nepal, and Bangladesh. The reservoirs of M.leprae are the armadillos and red squirrels. Moreover, the primary mode of transmission is thought to be respiratory droplets. Risk factors include contact with active cases, especially with the lepromatous type of leprosy, exposure to armadillos, immunosuppression, and age.

Leprosy can be classified into a mild tuberculoid form and a more severe lepromatous form, with intermediate stages in-between. Signs include red or hypopigmented skin patches and loss of sensation in the same skin patches. The lepromatous form presents with more generalized symptoms with erythematous skin nodules, thickening of earlobes, and loss of body hair. Complications include painful neuropathy, corneal ulceration, and abrasion. Late diagnosis and incomplete treatment of leprosy are associated with an increased burden of the disease, deformities, and stigma. The diagnosis is based on clinical presentation supported by the presence of acid-fast bacilli on full-thickness skin biopsy from the most active skin lesion. PCR for M. leprae DNA can also be used for diagnosis.

Leprosy is treated with multi-drug therapy (rifampicin, dapsone, and clofazimine). The duration ranges from 6 months for tuberculoid form and 12 months for lepromatous form. Drug resistance has been reported in some countries in which second-line drugs can be used, such as clarithromycin, minocycline, and fluoroquinolones.

Skin lesions usually start to resolve after few months to years if the patient is compliant with the drug regimen. Although rare, leprosy might relapse mostly 5 to 10 years after stopping the treatment. In areas with a high prevalence of leprosy, a single dose of BCG vaccine can give 50 percent protection. For contacts with active cases of leprosy, chemoprophylaxis with single-dose rifampicin can be given for adults and children more than two years.

 

Written by: Dr. Tammam Alanazi, Dermatology resident.

References:
1- WHO Guidelines for the Diagnosis, Treatment, and Prevention of Leprosy
2- UptoDate

 

 

 

Dermatomyositis is a rare disease that causes muscle inflammation and skin rash.

It can occur at any age, but it most often affects adults over the age of 50, the exact cause is not known but is thought to be an autoimmune disorders, with genetic predisposition and environmental factors that might play a role.

 

symptoms are caused by swelling and inflammation in the blood vessels that supply the skin and muscle scan appear suddenly or develop gradually over time most commonly a violet-colored or dusky red rash develops on the face and eyelids(heliotrope rash), knuckles (guttron’s sign), elbows, knees, chest and back(shawl sign). The rash can be itchy and painful.Muscle changes usually develops after the rash ,muscles are stiff and tender which make it difficult to do things like brushing hair ,walking upstairs and lifting legs.

 

Dermatomyositis might cause other conditions including Raynaud’s phenomenonwhen  fingersturn pale when exposed to cold temperature,cardiovascular diseases, lung diseases and increased likelihood of developing cancer.

 

Diagnosis of dermatomyositis is based on person’s medical history and a physical exam, also by ordering blood tests to look for autoantibodies. muscle biopsy, Electromyography, and imaging screening for underlying cancer.

 

There’s no cure for dermatomyositis, but treatment aim is to improveskin rash and muscle strength and functionwith medications like corticosteroid and steroid sparing agents, also general measures including sun protection and regular exercises.

 

 

Written by:

Yasmeen Alanazi, Dermatology resident, King Fahad Medical City.

 

References:

bad.org.uk

dermnetnz.org

 

Introduction: 

According to the American Academy of Dermatology Association, May is Skin Cancer Awareness Month, and May 28 is National Sunscreen Day, by the early 20-century sunscreen started to manufacture and by the mid-1970s that sunscreens gained a degree of consumer acceptance, which help and prevent a variety of dermatological conditions. 

How to have optimal sun protection 

To have good sunscreen: 

Broad-spectrum sunscreen= UVA + UVB protection 

Water resistance = maintenance of SPF after 40 or 80 minutes in water. 

SPF ≥ 15 or 30 recommended. 

Re-apply1-2 hours during outdoor activates 

Other measures: 

Staying in the shade especially from 10 AM – 2 PM 

Wide brim hats 

Sunglasses 

Protective clothing 

Types of sunscreens: Chemical	Physical
works like a sponge on the surface of your skin, absorbing the sun’s rays.	works like a shield on the surface of your skin, deflecting the sun’s rays.
Optimal if you have sensitive skin	Easier to rub in the skin without leaving residue
Example: zinc oxide, titanium dioxide	oxybenzone, avobenzone, and ecamsule

 Concentrations as are utilized in SPF testing is: 2 mg/cm2 to achieve 2 mg/cm2 of density: 

1 teaspoon of sunscreen to the face/head/neck 

1 teaspoon to each upper extremity 

2 teaspoons to the front and back torso 

2 teaspoons to each lower extremity 

Benefits of sunscreen: 

Reduce the onset of Photoaging 

Photo immune Suppression 

Non-melanoma Skin cancer 

Photosensitivity Disorders 

 

Written by: Abdullah Nasser Al-Omair, Dermatology Resident

Reference: UpToDate

 

 

  Vitamin D is a fat-soluble hormone found in the body that serves many purposes, most famously bone formation. Although vitamin D is most important for bone health, it also plays a key role in many of the body’s other functions including but not limited to; antimicrobial, antiproliferative, anti comedogenic, and antioxidative processes. Vitamin D is gained through diet, supplements, and exposure to sunlight. In regards to dermatologic diseases, and more specifically in the treatment of acne vulgaris, the antimicrobial properties of vitamin D have been an interesting area of research in recent years.

 

  It has been established that acne vulgaris patients were more likely to have deficient vitamin D levels than controls. Variable associations have been made between the severity of acne lesions and deficient vitamin D levels, although some studies have shown improvement in inflammatory acne lesions when patients were given vitamin D supplementation. This improvement is restricted to inflammatory lesions, while non-inflammatory lesions showed no improvement. This could be due to vitamin D’s antimicrobial properties, as inflammation caused by propionibacterium acnes is significant to the pathogenesis of acne vulgaris. Another association between vitamin D levels and acne vulgaris is linked to sebaceous gland activity, in which it was found that lower levels of vitamin D stimulate lipogenesis in sebaceous glands. The increased lipogenesis promotes inflammatory lesions in acne vulgaris.

 

 These findings open the door to the possibility of using topical vitamin D analogues in the treatment of acne, as well as screening acne vulgaris patients for Vitamin D deficiency. As of today, using vitamin D in the treatment of acne is grade B recommendation with IIb level of evidence.

 

 

 

 

Written by: Hadeel Awartani, Medical Student

 

 

Resources:

1-Amal Ahmed Mohamed, Eman Mohamed Salah Ahmed, Rasha T.A. Abdel-Aziz, Halaa H. Eldeeb Abdallah, Hadeel El-Hanafi, Ghada Hussein, Maggie M. Abbassi & Radwa El Borolossy (2020) The impact of active vitamin D administration on the clinical outcomes of acne vulgaris, Journal of Dermatological Treatment, DOI: 10.1080/09546634.2019.1708852

2-Navarro-Triviño FJ, Arias-Santiago S, Gilaberte-Calzada Y. Vitamin D and the Skin: A Review for Dermatologists [Internet]. Actas Dermo-Sifiliográficas (English Edition). Elsevier Doyma; 2019 [cited 2021Apr23]. Available from: https://www.sciencedirect.com/science/article/pii/S157821901930112X

3-Mostafa WZ, Hegazy RA. Vitamin D and the skin: Focus on a complex relationship: A review [Internet]. Journal of advanced research. Elsevier; 2015 [cited 2021Apr23]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642156/

4-Study links vitamin D deficiency with acne [Internet]. Dermatology Times. [cited 2021Apr23]. Available from: https://www.dermatologytimes.com/view/study-links-vitamin-d-deficiency-with-acne

5-Vitamin D for Acne: Benefits, Uses, & Effects of Vitamin D Deficiency [Internet]. Healthline. 2021 [cited 23 April 2021]. Available from: https://www.healthline.com/health/vitamin-d-for-acne

 

 

  Dermaplaning is a simple non-invasive outpatient procedure which has gained popularity through social media platforms as an easy way to achieve a smoother skin complexion, remove unwanted hair on the face and prevent acne vulgaris. Although this procedure has only recently become well-known, it has been performed by dermatologists and licensed aestheticians for many years.

 

  Dermaplaning exfoliates the face by using a small scalpel blade to remove dead skin cells from the upper epidermis and facial hair. The removal of this superficial layer of skin offers the cosmetic benefit of achieving a more radiant and even texture complexion, as well as minimizing fine wrinkles and reducing the appearance of acne scars. As with any exfoliating procedure, dermaplaning allows deeper penetration of skin products such as moisturizers and serums which may contribute to the improved appearance of skin post-procedure. This is why dermaplaning may be of great benefit in patients with hyperproliferative disorders such as eczema or psoriasis, as removal of the cellular debris would allow proper penetration of hydrating treatments.

 

  Although dermaplaning is considered a low-risk procedure, it does not come without side effects such as skin hypersensitivity directly after or infection in rare cases. It is advised to apply protective sunscreen to reduce the risk of hyperpigmentation of the new skin layer and apply soothing agents to reduce inflammation.

 

  Despite the renewed public interest, patients should take into consideration the possible risks of dermaplaning especially if they plan to do it themselves. Improper tools or technique may result in injury or infection, and it is best to consult your dermatologist before self-performing this procedure.

 

 

Written by: Hadeel Awartani, Medical Student

 

 

Resources:

1- Dermabrasion and Dermaplaning  https://www.hopkinsmedicine.org/health/wellness-and-prevention/dermabrasion-and-dermaplaning

2- Townsend R (2017) The Use of Advance Dermaplaning in Clinical Skin Care and Treatment. Clin Dermatol Res J 2:2. doi: 10.4172/2576-1439.1000117

3- Dermaplaning: Efficacy, Side Effects, and More https://www.healthline.com/health/beauty-skin-care/dermaplaning

4- Pryor L, Gordon CR, Swanson EW, Reish RG, Horton-Beeman K, Cohen SR. Dermaplaning, topical oxygen, and photodynamic therapy: a systematic review of the literature. Aesthetic Plast Surg. 2011 Dec;35(6):1151-9. doi: 10.1007/s00266-011-9730-z. Epub 2011 May 2. PMID: 21533984.

 

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been initially defined as a disease of the respiratory tract; however, with the increasing number of patients and announcing that the virus became a pandemic, new systemic clinical manifestations are observed, including dermatological manifestations. However, the identification and characteristics of these manifestations are still controversial. This review article aims to evaluate the medical literature and explore the dermatological clinical manifestations in patients with SARS-CoV-2.

 

 

Dermatological lesions are frequent in patients with SARS-CoV-2, especially erythema, urticaria, and varicella-like rash. Differential diagnosis should be thoroughly considered before deciding that the present rash is related to SARS-CoV-2 infections. Till present, the rash is not correlated to the severity of SARS-CoV-2 infection, which needs to be confirmed with studies with a more robust design and larger sample sizes. These findings should be considered by clinicians working with patients with SARS-CoV-2 in order not to misdiagnose the occurrence of dermatological lesions, which may delay therapy or increase the risk of complications.

 

 

Written by: Abdulelah Khalaf Nasser Almutairi, MBBS

 

Reference:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7402433