The prevalence of SFI was twofold greater in females than males. Children were most commonly affected by tinea capitis, whereas adults generally suffered from tinea pedis. The frequency of onychomycosis was nearly three times higher in adults. This study clearly shows that SFIs are of concern in both genders and in all age groups.

Correspondence Familial mucosal lichen planus in three successive generationsLichen planus (LP) in families is uncommon. The prevalence of familial LP in a large series has been reported to be 1.5%. 1 Since 1970, there have been 10 case reports/studies describing familial LP in 28 families. These case reports of familial LP occurring in two or more members of one family have described cutaneous or a combination of cutaneous and mucosal lesions. [2][3][4][5][6][7][8] The present case report describes a woman, her son, and grandson with mucosal LP and no cutaneous lesions. To my knowledge, a familial occurrence of mucosal LP in three successive generations has not been reported previously.A 65-year-old woman (Case 1) presented with complaints of soreness of the mouth of 10 years' duration. She experienced discomfort and a burning sensation on consuming hot and spicy food. On examination, she had a violaceous plaque of 2.0 × 1.5 cm in size in the middle of the right half of the tongue (Fig. 1). She did not have cutaneous, nail, or scalp lesions. A clinical diagnosis of LP was confirmed on histopathology of the lesion, which showed characteristic parakeratosis, basal cell vacuolar degeneration, and a dense upper dermal infiltrate comprising predominantly lymphocytes. One year later, the 32-year-old son (Case 2) of Case 1 presented with a moderately itchy, violaceous papule on the glans penis of 6 months' duration and multiple painful violaceous lesions on the buccal mucosa bilaterally. Around the same time, the 11-year-old grandson (Case 3) of Case 1 and the son of Case 2 presented with an erythematous, painful lesion with a violaceous hue, measuring 1.0 × 1.5 cm in size, on the right half of the tongue (Fig. 1) of 2 months' duration. Histopathology from the lesions was consistent with a clinical diagnosis of LP in Cases 2 and 3. All three patients were treated with topical betamethasone dipropionate 0.05% in gel formulation for a duration of 3-6 months. This treatment resulted in the resolution of the lesions with postinflammatory hyperpigmentation in all three cases. Other members of the family were also clinically examined, but none were found to have mucosal or cutaneous lesions of LP.The pedigree (Fig. 2) of this family suggests an autosomal dominant transmission, as mucosal LP manifested in one female and two males over three successive generations with each affected individual having an affected parent. In the earlier case reports of familial LP, only two generations were affected, and hence the pattern of inheritance could not be ascertained. The etiopathogenesis of LP remains obscure. Immunologic, infective, and genetic etiologies have been suggested. Copeman et al . 2 found an association of human leukocyte antigen (HLA)-B7 in familial cases, but not in patients with sporadic LP; however, no significant associations were found between HLA and LP in other studies. 8,9 A single case report described LP concurrently in monozygotic twin sisters, supporting a possible genetic predisposition. 10 The present ...

Background/Aim. Apolipoprotein E (APOE) gene variants have been reported to influence psoriasis risk. However, data is limited to a few ethnicities and no similar study has been performed in middle eastern populations. We investigated this association in Saudi psoriasis patients. Methods. Saudi subjects (294) were genotyped for APOE gene using APOE StripAssay kit. Results. The frequencies of alleles ε2, ε4, and genotypes ε3/ε4 and ε3/ε2 were significantly higher in psoriasis patients compared with those in controls. The frequency of ε3 allele and ε3/ε3 genotype was significantly lower in patients. Other genotypes, ε2/ε4, ε2/ε2, and ε4/ε4, were absent in both groups. The serum cholesterol, triglycerides, and LDL levels were significantly higher in psoriasis patients contrary to HDL level. Patients with APOE ε4 had significantly higher levels of total cholesterol and LDL cholesterol, whereas those with the ε2 had higher HDL cholesterol, and triglycerides. Conclusion. APOE alleles ε2, ε4, and genotypes ε2/ε3 and ε4/ε3 are associated with psoriasis and can be a risk factor while allele ε3 and genotype ε3/ε3 may be protective for psoriasis in Saudis. Results of lipid profile support that psoriasis is one of the independent risk factors for hyperlipidemia and emphasize the need of screening cardiovascular diseases in psoriatic patients.

The promoter region of human Interleukin −10 gene is highly polymorphic and has been associated with numerous autoimmune diseases. Recent studies have linked vitiligo with defective autoimmune system. This study is aimed to explore a possible association between IL-10 gene polymorphism and vitiligo in Saudi population. This case control study consisted of 184 Saudi subjects including 83 vitiligo patients (40 males, 43 females mean age 27.85 ± 12.43 years) and 101 matched controls. Genomic DNA was extracted from the blood samples of healthy controls and Vitiligo patients visiting out patient clinic of Department of Dermatology, Riyadh Armed Forces Hospital, using QIA ampR DNA mini kit (Qiagen CA, USA). Interleukin-10 gene was amplified by polymerase chain reaction (PCR) using Arms primers to detect any polymorphism involved at positions −592, −819 and −1082.The frequencies of GG genotype at −1082, and CC genotype at positions −592 and 819 were significantly higher in vitiligo patients compared to healthy subjects suggesting that GG and CC genotypes might be susceptible to vitiligo in Saudis. On the other hand genotypes −1082 GA, −819 CT, and −592 CA of IL-10 were more prevalent in healthy controls suggesting protective effects of GA, CT and CA genotypes against vitiligo. This study indicates that the IL-10 gene may play a significant role in the etiology of vitiligo among Saudis.

HLA complex is composed of several closely linked loci, each containing several alleles, yielding a high expression of polymorphism. Vitiligo, a commonly acquired dermatological disorder, has been associated with different HLA antigens in different ethnic groups. In this study, HLA classes I (HLA-A, B, and C) and II (HLA-DR, DQ) antigens/alleles were analyzed in a group of 80 Saudi subjects consisting of vitiligo patients (40) and matched controls (40). The frequency of antigens of various HLA loci was tested using two-stage microcytotoxicity assays, while the frequency of alleles of HLA-DR was screened by polymerase chain reaction/sequence specific primers (PCR/SSP) method. The frequencies of HLA-B7, B15, Bw6, Cw6, Cw7, and DRB4*010101 were found to be significantly higher in vitiligo patients compared to controls [P = 0.029, 0.015, 0.033, 0.009, 0.043, and 0.015, respectively, with relative risk (RR) > or = 3, etiologic fraction (EF) > or = 0.4]. On the other hand, HLA-A9, B5, DQ1, and DRB3*010101 were significantly decreased in vitiligo patients compared to healthy Saudis [P = 0.008, 0.004, 0.028, and 0.04, respectively, with RR < 1 and preventive fraction (PF) < 0.5]. Among the patients, the highest allele frequency was noted for DRB4*010101(70%), while in controls it was for DRB3*010101 (72.5%). These results for antigens and allele frequency of various HLA Loci in vitiligo patients and control subjects suggested that HLA-B7, Bw6, Cw6, Cw7, and DRB4*010101 could be susceptible to vitiligo, while HLA-A9, B5, DQ1, and DRB3*010101 might be negatively associated with the development of vitiligo in Saudis.