Background. Large epidemiological studies on patterns of skin diseases in Saudi Arabia are scarce. Therefore, this systematic review and meta-analysis was conducted to gather available epidemiologic data describing the pattern of skin diseases in different geographical areas in Saudi Arabia. Methods. A comprehensive literature search of articles was conducted in PubMed, SCOPUS, and Web of Science through October 2019. We included all published cross-sectional studies that provided data on relevant incidence or prevalence of skin disease in Saudi Arabia. The risk of bias within the included cross-sectional studies was assessed using the Hoy tool for the prevalence studies. All statistical analysis was performed using the Comprehensive Meta-analysis software. Results. The present meta-analysis included 14 studies that reported the frequency of the skin disease patterns in different regions in Saudi Arabia with a total sample size of 30436 patients with an overall low risk of bias. The diseases of skin appendages and dermatitis were the most commonly reported skin diseases in Saudi Arabia (24.8% (95% CI, 24.3–25.3) and 24% (95% CI, 23.6%–24.6%), respectively). Skin infection represented about 18.5% (95% CI, 18.1%–19%), while the papulosquamous disorders represented 5.3% (95% CI, 5%–5.6%) of the skin diseases in Saudi Arabia. Skin cancers were pooled from only two studies. Basal cell carcinoma and squamous cell carcinoma were the most common malignant neoplasm in Saudi Arabia (51.4% and 22.5% of the malignant neoplasm, respectively), while malignant melanoma represents only 3.8% of the malignant skin cancer. Conclusion. Adnexal disorders and dermatitis are the most common skin disease in Saudi Arabia, followed by skin infection and pigmentary disorders. While skin cancer is more frequent than other countries, awareness campaigns should be initiated to increase knowledge about the harmful effect of long-term sun exposure.

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Background: Kaposi sarcoma (KS) is a cutaneous endothelial vascular proliferation with four subtypes: iatrogenic, acquired immune deficiency syndrome (AIDS) related, African, and classic. Familial cases of KS are rare, with 72 cases reported to date, and all were described with the classic variant. The occurrence of classic KS in the Jewish population is well documented, and most of the familial classic KS cases were also reported in Jewish families.Objective: We briefly present the history, biopsies, laboratory data, diagnosis, and treatment of localized lower limb classic KS in two siblings of Jewish Eastern European ethnic descent with their response to different therapy modalities. One of our cases had the second longest reported period of follow-up for familial classic KS of 40 years.Contexte: Le sarcome de Kaposi (SK) consiste en une prolifé ration de cellules endothé liales vasculaires cutané es, et il se divise en quatre types: iatrogè ne, lié au syndrome de l'immunodé ficience acquise (SIDA), africain, et classique. Les cas familiaux du SK sont rares; seuls 72 cas ont é té signalé s jusqu'à maintenant, et tous é taient du type classique. La pré sence de la forme classique du SK dans la population juive est bien documenté e, et la plupart des cas de la forme classique familiale de la maladie ont é galement é té signalé s au sein de familles juives.Objectif: Nous faisons é tat, dans le pré sent article, d'une forme classique et locale du SK touchant les membres infé rieurs, chez deux frè res d'ascendance juive et d'origine europé enne orientale; seront traité s les ré sultats de la prise en charge de la maladie: anamnè se, biopsies, examens de laboratoire, diagnostic, traitement, ainsi que leur ré action à diffé rentes formes de traitement. L'un d'eux a mê me fait l'objet de la deuxiè me pé riode de suivi en importance quant à la duré e, soit 40 ans, en ce qui concerne la forme classique familiale du SK.

The objective of the article is to summarize the current evidence regarding the association between angiotensin-converting enzyme insertion/deletion (ACE I/D) gene polymorphism and vitiligo disease. Methods A computerized search was performed through four electronic databases (PubMed, Scopus, Cochrane Central Register of Controlled Trials [CENTRAL], and Web of Science) with the relevant keywords. Included studies comprised of papers examining the association of ACE gene polymorphisms with vitiligo. Data were pooled as an odds ratio (OR) in random-and fixed-effect models using the Mantel-Haenszel (M-H) method. Review Manager 5.3 software (clicktime.com, Inc., San Francisco, US) was utilized in the meta-analysis. Results Ten studies (n=2,740) matching the inclusion criteria were included in the systematic review and meta-analysis. Results showed no significant difference between individuals carrying deletion/deletion (D/D) genotype and individuals with deletion/insertion (D/I) + insertion/insertion (I/I) genotypes in terms of vitiligo risk (odds ratio [OR]=1.13, 95% confidence interval [CI]: 0.78 to 1.64, p=0.53). However, vitiligo risk was higher in the individuals carrying the I/D genotype when compared with individuals with D/D + I/I genotypes (OR=1.29, 95% CI: 1.10 to 1.52, p=0.001). Moreover, the increased risk was observed in individuals carrying D/D when compared with I/I (OR=1.67, 95% CI: 1.33 to 2.09, p<0.0001). D allele was associated with significant risk when compared with the I allele (OR=1.29, 95% CI: 1.15 to 1.45, p<0.0001).

Background: Atopic dermatitis (AD) is a long-term, pruritic, recurrent, systemic, inflammatory skin disorder. In the Middle East region, the burden of AD is understudied, and there is a dearth of AD guideline documents for practitioners. Methods: An expert panel meeting, encompassing 12 dermatologists from the Kingdom of Saudi Arabia (KSA), was congregated to develop evidence-and experience-based consensus recommendations for AD management, especially in adults in KSA. They completed a questionnaire with seven clinical statements, and a consensus was defined when the responses of ≥75% of participants coincided. Results: The expert recommendations were as follows: American Association of Dermatology guidelines are to be followed for defining AD; Eczema Area and Severity Index or SCORing atopic dermatitis index may be used to quantify the disease severity; Dermatology Life Quality Index may be used to determine the impact of AD on patients' quality of life; Atopic Dermatitis Control Tool may be used to assess long-term disease control in AD patients; and the European guidelines are to be followed for the management of AD. In AD patients who are inadequately controlled with topical or systemic therapies, the preferred systemic agent for use either alone or in combination with topical treatments is dupilumab, cyclosporine, methotrexate, phototherapy, or other available systemic treatments that may include mycophenolate mofetil or oral corticosteroids. Conclusion: These expert recommendations assist physicians by providing a reference framework for optimal care of adult AD patients.