BackgroundIsotretinoin has been used to treat moderate to severe acne. It is well known that isotretinoin can cause an elevation in liver enzymes, triglycerides, and cholesterol. Laboratory monitoring is indicated while patients are on isotretinoin, but the frequency of laboratory monitoring is very variable among physicians who prescribe it. Study objectivesThis study aimed to determine the frequency of laboratory abnormalities of triglycerides, cholesterol, and liver aminotransferases in acne patients treated with oral isotretinoin in order to assess the need for frequent laboratory monitoring while on isotretinoin and to study the association between body weight and laboratory abnormalities. MethodsA retrospective chart review has been conducted using data extracted from electronic medical records of the

Background. Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are life-threatening conditions caused by drug reactions. There are multiple causative drugs and different risk factors associated with SJS/TEN. Objectives. To study the epidemiology of SJS/TEN and associated mortality rate in Qassim region, Saudi Arabia. Methodology. A retrospective chart review of all patients with the diagnosis of SJS/TEN who were admitted to King Fahad Specialist Hospital (KFSH) in Qassim region, Saudi Arabia, for the period between Jan 2014 to Jan 2019. The Careware information health system is used at KFSH, and patients were identified searching the diagnosis SJS/TEN. Results. Total of 10 patients with diagnosis of SJS/TEN were admitted to KFSH for the period from Jan 2014 to Jan 2019. Antibiotics were the culprit in 5 out of 10 patients. 9 out of 10 patients survived with good outcome. One patient with the diagnosis of TEN died, given extensive skin involvement complicated by sepsis. Conclusion. Despite the limitation of this study given small sample size, this is the first study of its kind that discusses the epidemiology of SJS/TEN in Saudi Arabia. We found the estimated incidence rate of SJS/TEN in Qassim region to be 7.6 cases per million person-years. Antibiotics and antiepileptics were the culprits in 8 out of 10 patients.

Key Clinical MessagePorokeratotic eccrine ostial and dermal duct nevus (PEODDN) is a rare eccrine hamartoma, with treatment generally being unsatisfactory. The unique features of PEODDN presented include bilateral and facial lesions, and extensive body involvement. Management with CO2 laser was successful, and follow‐up will be necessary to monitor for recurrent lesions.

Background: Persulfate is an oxidizing agent used for multiple purposes, including bleaching hair, bleaching flour, and as pool/spa water disinfectant. Objective: To identify the prevalence and clinical characteristics of patients allergic to ammonium persulfate (APS) among patients who underwent patch testing in our clinic. Methods: A retrospective chart review of 2138 patients who underwent patch testing at Brigham and Women's hospital in Boston between July 2015 to November 2019. All patients were tested to our standard series including APS 2.5% petrolatum. Given the irritant nature of APS, we included for analysis only patients with 2+ or 3+ reactions. Results: Among 2138 patients, 61 (2.85%) had 2+ or 3+ reactions to APS. In this study, 72% were female. 75% had an atopic diathesis; 56% had 2+ reactions, and 44% had 3+ reactions. Clinical relevance was definite in 11%, probable in 10%, and unknown/possible in 79%. In patients with definite clinical relevance, 6/7 had occupational allergic contact dermatitis: 4 hairdressers, 1 hair salon cleaner, and 1 aquarium worker; 1/7 was bleaching her hair. Conclusion: Prevalence of 2+ or 3+ APS reactions in this single-center study was higher than that reported by the North American Contact Dermatitis Group, 2015–2016, (0.75% vs. 2.85% in our study). APS is an important occupational allergen, and clinicians should be aware of this when treating patients with exposure to APS.