BACKGROUND: The accuracy of clinical diagnoses of skin diseases has not been researched in Saudi Arabia.OBJECTIVES: Assess concordance between the histopathological and clinical diagnosis in skin diseases.DESIGN: Retrospective.SETTING: Academic tertiary care center.METHODS: Demographic, clinical and pathological data were collected from the medical record for the period 1997-2013.MAIN OUTCOME MEASURES: Concordance between the pathological and clinical diagnosis.SAMPLE SIZE: 4268 cases.RESULTS: Of 4268 biopsies, 2440 (58.1%) were females. The mean age (SD) of patients was 36.9 (17.8) years. The three most common locations from which skin biopsies were retrieved in descending order were the lower extremity (1123; 29.1%), head, neck, scalp and hair (1033; 26.7%) and trunk (853; 22.1%). Overall concordance was 75.9% (partial concordance 47.6%, full concordance 28.3%). Biopsies from the oral mucosa and lips had the lowest concordance (overall 58.5%, full 26.4%) at P=.004. Overall concordance was highest for the following three diagnoses: malignant neoplasms, 88%; vesiculobullous diseases 87%; urticarias, erythemas, and purpuras 87%.CONCLUSION: There is considerable variability in concordance among different histopathological diagnoses. The full concordance between the clinical diagnosis and the pathological diagnosis is low. This is a reflection of the fact that the biopsies were obtained only in cases where the clinical diagnosis was a dilemma.LIMITATIONS: Single center, retrospective, incomplete medical records, low percentage of biopsies were assessed by dermatopathologists.CONFLICT OF INTEREST: None.

Background In recent years, there was a rise in ocular injuries secondary to cosmetic laser‐assisted hair removal. Purpose To assess the level of adherence to optical safety guidelines during laser‐assisted hair removal performed by nurses or physicians in private practice. Methods A cross‐sectional study was conducted at thirty‐one private laser‐assisted hair removal clinics. An electronic random number generator using a cluster random sampling technique was used to select the clinics. The Alexlazr™ (Candela Corp.) device operator's manual checklist was modified to collect data from laser device operators and patients by surveying the laser rooms, interviewing the patients, and observing the treatments. Results Ninety‐four patients treated by different service providers were included from 31 private centers. All treatment sessions were delivered by trained nurses. Only 9.5% had acceptable adherence to optical safety guidelines during hair removal treatment, while the majority (90.5%) of service providers were poorly adherent. None of the providers achieved excellent adherence to optical safety guidelines. The item with the least adherence was the lack of non‐reflective floors inside laser rooms in 72.3% of centers. All service providers were familiar with the laser system controls and emergency shutdown (100% adherence). Conclusion There is a significant deficiency in the safety precautions at laser‐assisted hair removal centers that can result in devastating ophthalmic injuries. Companies providing laser‐assisted hair removal machines should be involved in aiding these centers to implement safety procedures.

Isotretinoin is one of the most effective drugs for the treatment of all forms of acne vulgaris. It has been suspected of causing alterations in lipids and liver enzymes. The aim of this retrospective study was to determine the prevalence of laboratory changes among 371 patients with acne receiving isotretinoin therapy. Each patient's medical records were evaluated to determine baseline alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol, and triglycerides (TGs) compared to levels recorded at 2 later readings following initiation of treatment with oral isotretinoin. Results indicated that isotretinoin can be administered with minimal concern regarding changes in serum transaminase and lipid profiles. Nevertheless, physicians should be cautious when administering isotretinoin in patients with a history of abnormal findings.