Tertiary Dermatology Research Articles

Dose Escalation of Adalimumab in Patients with Hidradenitis Suppurativa: A Retrospective Case Series.

Adalimumab is a central treatment for moderate-to-severe hidradenitis suppurativa (HS). However, half of patients treated with adalimumab for HS do not achieve a clinically significant response. Data on non-immunological factors correlating clinical response and adalimumab blood concentration are scarce. To determine whether increasing adalimumab dose to 80 mg weekly can improve the clinical outcome of patients unresponsive to adalimumab 40 mg weekly. To identify parameters influencing disease activity and those modifying serum adalimumab concentration. This is a retrospective case series from a tertiary dermatology clinic, comprising 40 patients with moderate-to-severe HS with suboptimal response to the FDA-approved dose of adalimumab. All patients had a measurement of blood adalimumab concentration. Depending on their dosage, some patients had their adalimumab dose increased to 80 mg weekly while others stayed at 40 mg dose weekly. Chi-squared and ANOVA tests were used for data analysis. 43.8% of patients who increased to a weekly dose of 80 mg clinically improved at their follow-up, compared with 33.3% of those who stayed at a weekly dose of 40 mg. The dose increase led to a statistically significant increase in serum concentration of adalimumab (P < .001). Higher serum adalimumab concentration is associated with lower disease activity (P = .043). Normal-weight patients had significantly higher concentrations than overweight patients (P = .011). An increase in the weekly dose of adalimumab led to a nonstatistically significant improvement in clinical response but led to a statistically significant increase in serum concentration.

P85 Genital psoriasis in Asians: impact on quality of life and sexual health

Abstract Genital involvement and sexual dysfunction are common amongst patients with psoriasis; however, most patients do not discuss their genital rashes or sexual health with their doctor. The aim of this study was to evaluate the impact of genital psoriasis on quality of life (QoL) and sexual health in adult Asian psoriasis patients with genital psoriasis, an entity that is poorly understood, under-recognized and undertreated. We performed an observational study on adult Asian psoriasis patients attending psoriasis subspecialty clinics at a tertiary dermatology centre over 1 year. Participants underwent clinical examination of the whole-body surface, with particular attention to the genitalia, and questionnaires to evaluate QoL and psychosexual health were administered. Patients received a small renumeration for their participation. The study received no commercial funding. A total of 62 patients participated. Most participants were male (82.3%) and Chinese (59.7%) with a mean age of 41.7 years [standard deviation (SD) 12.5]. The commonest site involved was the suprapubis (61.3%). Perianal, glutaeal cleft and perineum involvement were more common amongst females (P &amp;lt; 0.05). The mean psoriasis area and severity index (PASI) score was 7.0 (SD 4.3) with a mean Dermatology Life Quality Index (DLQI) score of 9.8 (SD 6.7), indicating moderately impaired QoL. Higher PASI scores were associated with increasing QoL impairment on DLQI (P = 0.021). Males in whom genital psoriasis prevented sexual intercourse or diminished their libido reported more sexual dysfunction. Females reported greater severity in terms of symptomatic burden and feelings of embarrassment (P = 0.038) yet were less likely to be on treatment (37.5 vs. 45.0%). Perceived efficacy of treatment was low and younger patients fared poorer on the Patient Health Questionnaire-9 depression questionnaire (P = 0.047). Genital involvement may be a key contributor to the lower QoL compared with psoriasis patients without genital involvement. Although patients desire more efficacious treatment, they may be reluctant to discuss their genital rashes or sexual health when not prompted leading to under-recognition and under-treatment, particularly amongst female patients. More studies need to be performed with age and gender-matched control groups using validated QoL and sexual health questionnaires for genital psoriasis. Nonetheless, clinicians should proactively evaluate for and treat genital psoriasis, as disease control has been shown to restore both QoL and sexual function.

132 Ensuring the Safe Prescribing of Azathioprine: A Retrospective Audit in a Tertiary Dermatology Setting in the UK

132 Ensuring the Safe Prescribing of Azathioprine: A Retrospective Audit in a Tertiary Dermatology Setting in the UK

Adherence to melanoma screening and surveillance skin check schedules tailored to personal risk.

Population-wide skin cancer screening is not currently recommended in most countries. Instead, most clinical guidelines incorporate risk-based recommendations for skin checks, despite limited evidence around implementation and adherence to recommendations in practice. We aimed to determine adherence to personal risk-tailored melanoma skin check schedules and explore reasons influencing adherence. Patients (with/without a previous melanoma) attending tertiary dermatology clinics at the Melanoma Institute Australia, Sydney, Australia, were invited to complete a melanoma risk assessment questionnaire via iPad and provided with personal risk information alongside a risk-tailored skin check schedule. Data were collected from the risk tool, clinician-recorded data on schedule deviations, and appointment booking system. Post-consultation, we conducted semi-structured interviews with patients and clinic staff. We used a convergent segregated mixed methods approach for analysis. Interviews were audio recorded, transcribed and data were analysed thematically. Participant data were analysed from clinic records (n = 247) and interviews (n = 29 patients, 11 staff). Overall, there was 62% adherence to risk-tailored skin check schedules. In cases of non-adherence, skin checks tended to occur more frequently than recommended. Decisions to deviate were similarly influenced by patients (44%) and clinicians (56%). Themes driving non-adherence among patients included anxiety and wanting autonomy around decision-making, and among clinicians included concerns around specific lesions and risk estimate accuracy. There was moderate adherence to a clinical service program of personal risk-tailored skin check recommendations. Further adherence may be gained by incorporating strategies to identify and assist patients with high levels of anxiety and supporting clinicians to communicate risk-based recommendations with patients.

Eating Disorder Risk Factors and the Impact of Obesity in Patients With Psoriasis.

Current evidence indicates that obesity may initiate psoriasis or worsen existing disease. Various factors contribute to the development of obesity, including eating disorders (EDs). The aim of this study was to screen for and identify factors associated with EDs in patients with psoriasis and their impact on the development of obesity in this population. Demographic information including body mass index (BMI), Eating Attitude Test (EAT-26), Dermatology Life Quality Index (DLQI), Attitude Scale for Healthy Nutrition (ASHN), and Depression Anxiety Stress Scale 21 (DASS-21) scores were statistically analyzed for 82 participants with psoriasis at a tertiary dermatology clinic. It is important to manage obesity and other comorbidities of psoriasis in addition to treating its cutaneous manifestations, which may require a biopsychosocial approach.

Real-world data on the efficacy and safety of hedgehog pathway inhibitors in patients with basal cell carcinoma: Experience of a tertiary Australian centre.

Basal cell carcinomas (BCCs) are the most common cancers worldwide. Although most BCCs are amenable to local treatment, there are limited therapeutic options for surgically unresectable locally advanced and metastatic BCCs. Activation of the sonic hedgehog signalling pathway plays a significant role in the development of most BCCs. Hedgehog pathway inhibitors (HPIs) can be used to inhibit this pathway. Efficacy and safety data on HPI use in Australia is scarce. This study aims to present the effectiveness and safety of HPI at a tertiary dermatology referral centre. We conducted a retrospective analysis of the clinical charts of all patients with BCC treated with an HPI at a tertiary Dermatology referral centre in New South Wales, Australia from 1 January 2016 to 1 July 2023. Twenty-three patients with BCCs were treated with an HPI; 11 locally advanced, 8 multiple, 3 basal cell naevus syndrome and 1 metastatic. All patients were of Caucasian background, with a median age of 56. Across 41 treatment cycles, the median treatment duration was 4 months. The overall response rate (ORR) was 20/23 (87%) and complete response (CR) rate was 9/23 (39%); patients treated with sonidegib achieved an ORR of 11/12 (92%) and CR of 4/12 (33%), and vismodegib-treated patients achieved an ORR of 9/11 (82%) and CR of 5/11 (45%). Patients who responded to HPI treatment also responded to a subsequent HPI rechallenge. Common treatment emergent adverse events (TEAEs) included muscle spasms, dysgeusia and alopecia. Dysgeusia was more frequent with vismodegib than sonidegib (p = 0.0001). There was no evidence to suggest a difference in other TEAEs between the two HPIs. Four treatment cycles were stopped due to grade 3 muscle spasm. In our cohort of 23 patients being treated with HPI, the ORR was 87% and CR was 39%. All patients who experienced TEAEs and had a drug holiday successfully responded to HPI rechallenge.TEAEs, particularly muscle spasms, are common reasons for treatment cessation. Clinicians should implement strategies to mitigate TEAE to improve drug survivability.

Remote cutaneous confocal microscopy: A multicentric prospective study evaluating diagnostic accuracy for melanoma and keratinocyte carcinoma in tertiary settings

Cutaneous confocal microscopy (CCM) facilitates invivo visualization of skin at a cellular level. Use of a "store and forward" approach for remote-CCM interpretation (remote-CCM) across multiple sites has not been tested and may increase access to noninvasive diagnosis. To test the diagnostic accuracy and safety of remote-CCM. We prospectively recruited lesions selected for biopsy for skin malignancy across 5 Australian tertiary dermatology centers. CCM, clinical and dermatoscopy images were acquired prebiopsy and accessed by a cloud-based platform for interpretation by CCM readers. CCM diagnosis was compared with histopathology results. Among the 201 lesions included, melanoma was the most common malignancy (34/72, 47.2%). Of the 89 lesions (44.8%) potentially "saved" from biopsy, 80 (90%) were truly benign lesions and 9 (10.1%) were missed malignant lesions of melanoma in situ (n=7) and squamous cell carcinoma (SCC) (n=2). No invasive melanomas were missed. Sensitivity of remote-CCM for detection of malignancy was 89% (95% CI, 79%-95%) and specificity was 64% (95% CI, 55%-73%). The study recruited from high-risk populations and excluded lesions that were not biopsied. Remote-CCM has comparable accuracy to bedside CCM and safely reduces unnecessary biopsies. Potential SCCs are not appropriate for remote-CCM. Follow-up of borderline melanocytic lesions is recommended.

Laser hair removal complications and the associated risk factors at a tertiary dermatology center: a case-control study.

Laser hair removal (LHR) has been established as a safe and efficient method for eliminating unwanted hair. This study aimed to investigate the frequency of LHR complications and assess the contributing factors. During one year, 16,900 patients undergoing LHR therapy were evaluated for complications. For each case, two external controls were selected (matched based on age, sex, Fitzpatrick skin type (FST) III-IV, and the treated anatomical region). To assess the impact of anatomical region on complication occurrence, each patient was used as their internal control if another area was treated during the same session. GEE analysis was used for statistical analysis.The incidence of LHR complications was calculated to be 0.69%. The most common complications were petechia, purpura, and ecchymosis (31.66%) followed by pigmentation changes (20.0%). LHR complications were most commonly observed in the lower limbs (32.0%), face and neck (23.3%), and genitalia and thighs (22.3%), respectively. Possible risk factors were younger age (OR = 0.74, P-value ≤ 0.001), operating LHR in the head and neck (OR = 5.8, P-value = 0.022), utilization of the alexandrite laser (OR = 2.32, P-value = 0.011), and fluence in the Alexandrite laser (OR = 3.47, P-value = 0.003).Overall,the results of this study indicate that LHR is generally a safe method for removing unwanted hair. However, factors such as younger age, treatment of the facial area, and use of the alexandrite laser especially with higher fluence levels in patients with FST III-IV were identified as potential risk factors.

Minimally Invasive Plasma Device Management of Multiple Benign Skin Cancers Associated with Rare Genodermatoses-Case Series and Review of the Therapeutic Methods.

Background: Non-melanocytic benign skin tumours encompass a diverse group of lesions, classified based on their cellular origin, such as epidermal, vascular, fibrous, neural, muscle, and adnexal tumours. Though they often reveal solitary lesions, multiple skin tumours focus on genodermatoses. Each syndrome exhibits distinct clinical characteristics and potential complications, including cutaneous and extra-cutaneous malignancies, some of which are potentially life-threatening. Diagnosing genetic syndromes is complex and requires numerous histopathological and immunohistochemistry tests due to similarities between the adnexal tumours and basal cell carcinoma upon pathology. Methods: To illustrate the clinical practice, we conducted a retrospective case study that included eleven patients with genodermatoses referred to a tertiary dermatology clinic from September 2018 to April 2024. We have also conducted a research study on available treatment modalities in this setting. Results: Five patients with excellent aesthetic results were treated using a recently approved FDA plasma device. After searching SCOPUS and PubMed database records, we assessed 96 original articles to present current knowledge regarding the dermato-surgical approach. Conclusions: Multiple skin tumours, especially on the face, may significantly affect patients' quality of life and have psychological consequences. An appropriate treatment selection tailored to the patient's needs should be provided. There is no standardised treatment for multiple benign tumours in genodermatoses, and selected methods with varying efficacy are employed. We presented the utility of a new plasma device in these settings.

PS01 (P075) A retrospective review of isotretinoin treatment-related psychosexual health side-effects in a tertiary dermatology clinic

PS01 (P075) A retrospective review of isotretinoin treatment-related psychosexual health side-effects in a tertiary dermatology clinic

P075 A retrospective review of isotretinoin treatment-related psychosexual health side-effects in a tertiary dermatology clinic

P075 A retrospective review of isotretinoin treatment-related psychosexual health side-effects in a tertiary dermatology clinic

Potassium dichromate sensitivity presenting as tefillin dermatitis: A retrospective cohort study.

Tefillin are a religious article worn by Jewish men during daily prayer. Tefillin dermatitis secondary to potassium dichromate sensitivity is recognised, but data remain sparse. To investigate the prevalence and clinical characteristics of tefillin dermatitis. Patients who underwent patch testing with the European baseline series in a tertiary dermatology clinic in 2009-2023 and were diagnosed with tefillin dermatitis were identified by file review and their clinical data recorded. Of 1679 consecutive male patients tested, 25 (1.49%) were diagnosed with tefillin dermatitis, accounting for 15.34% of all potassium-dichromate-positive patients (163/1679). Mean pre-symptomatic duration of tefillin use was 38 ± 16.9 years, and mean follow-up time, 3.1 ± 2.9 years. Patients presented with an eczematous rash on body areas in direct contact with the leather box or straps of the tefillin. An id reaction was noted in 32%, and sensitivity to other leather accessories, in 44%. Fourteen patients (56%) switched to chromate-free tefillin: symptoms resolved completely in 11 (79%) and partially in 2. Retrospective cohort design. This is the largest study to date of tefillin dermatitis caused by sensitivity to potassium dichromate used in leather production. Prognosis after switching to chromate-free tefillin was good-to-excellent. Tefillin dermatitis may be more prevalent than previously thought.

Vulval dermatoses: A review of referrals to dermatology.

We undertook a retrospective observational review of patients referred to a tertiary dermatology department with vulval complaints over 12 months. The most common provisional diagnoses made by the referrer and final dermatology diagnoses were lichen sclerosus (54% and 38%), dermatitis (12.7% and 16.5%) and psoriasis (5.1% and 6.3%). Referrers may benefit from further education about skin diseases of the vulva, topical steroids for vulval complaints and the importance of clinical photography.

A Prospective, Monocentric Case-Control Study on Uncontrolled Psoriasis as Independent Risk Factor for a Hypercoagulable State.

Chronic inflammatory diseases, including psoriasis, are associated with development of venous thromboembolism (VTE). The clot lysis profile (CLP) provides information on both the clotting tendency and fibrinolysis activity. We hypothesized that CLP in uncontrolled psoriasis patients is disturbed towards more clotting/less lysis compared to healthy controls (HC) and that successful psoriasis treatment could normalize the CLP. In this project, we aim to compare the CLP in patients with uncontrolled psoriasis with age- and sex-matched HC and investigate the effect of anti-inflammatory treatment on CLP. Patients with uncontrolled psoriasis [psoriasis area severity index (PASI) or body surface area (BSA) > 10] (n = 87) and HC (n = 87) were recruited at a tertiary dermatology department. Samples from patients were obtained before treatment and when disease control was obtained (PASI < 3). Amplitude, area under the curve (AUC) and 50% clot lysis time were determined. At baseline, psoriasis patients had higher median amplitude and AUC compared with HC (p < 0.0001). After correction for possible confounders (BMI, smoking behavior, psoriatic arthritis, arterial hypertension, diabetes and coronary artery disease), the increased amplitude in psoriasis patients compared to HC remained significant. Successful anti-inflammatory treatment resulted in a significant decrease in amplitude (p = 0.0365). This is the first prospective study comparing the CLP of psoriasis patients with that of HC. A significant increase in both amplitude and area under the curve, indicative of a hypercoagulable CLP, was observed in psoriasis patients compared to HC. After successful anti-inflammatory treatment, amplitude significantly decreased.

Lymphatic expression of the proliferation marker Ki67 is linked to sentinel node positivity, recurrence and mortality in primary cutaneous melanoma.

Lymphangiogenesis is a precursor to lymphovascular invasion, and may therefore signal a higher risk of metastasis and mortality in primary cutaneous melanoma. This retrospective longitudinal study aimed to evaluate whether emergent lymphangiogenesis, as measured through co-expression of endothelial proteins with the proliferation marker Ki67, was associated with poorer prognosis in a cohort of patients with single primary cutaneous melanoma. We screened all patients with a single locally invasive primary cutaneous melanoma who received sentinel lymph node biopsy at a tertiary dermatology centre in Brisbane, Australia between 1994 and 2007. Primary melanoma sections were stained via Opal multiplex immunofluorescence, and categorized according to the presence of Ki67 within either CD31+ or D2-40+ endothelial cells. Multivariate Cox regression modelling was used to evaluate associations between endothelial Ki67 positivity and clinical outcomes, with adjustment for age, sex, Breslow depth, ulceration, and anatomical location. Overall, 264 patients were available for analysis, with a median follow-up duration of 7.1 years. The presence of D2-40+ /Ki67+ co-expression was associated with greater melanoma-specific mortality (adjusted hazard ratio [HR]: 2.03; 95% confidence interval [CI]: 1.33-3.10; p = 0.001) and recurrence (adjusted HR: 1.70; 95% CI: 1.33-3.10; p = 0.001) relative to absence. CD31+ /Ki67+ co-expression was not prognostic in this cohort. Lymphatic proliferation, as measured through D2-40+ /Ki67+ co-expression, predicted greater melanoma-specific mortality and recurrence in this cohort of primary cutaneous melanoma.

Spectrum of offending drugs and cutaneous adverse drug reactions requiring hospitalisation in a tertiary South African hospital in TB/HIV endemic setting.

Cutaneous immune-mediated adverse drug reactions are more prevalent in people with human immunodeficiency virus (PWH). Severe cutaneous adverse drug reactions (SCAR) are a life-threatening subset of cutaneous adverse drug reactions (CADRs) and a significant public health issue in settings endemic for human immunodeficiency virus and tuberculosis. However, limited data are available on CADR requiring hospitalisation in African settings. The aim of this study is to describe the epidemiology, offending drugs and outcomes of CADRs requiring admission to a South African tertiary dermatology service. Retrospective folder review was conducted on all CADRs requiring hospitalisation at Nelson Mandela Academic Hospital in Mthatha, Eastern Cape, South Africa between 30 July 2015 and 15 December 2022. This data was compared to prospective inclusion of CADR admissions between 03 March 2021 and 09 April 2024 as part of the Immune-Mediated Adverse Drug Reactions (IMARI) Registry and Biorepository and AFRISCAR consortium. Where possible, phenotype and drug causality assessment was performed through RegiSCAR, or Naranjo and/or ALDEN scoring respectively. CADR admissions included 122 cases: 89 and 33 in the retrospective and prospective cohorts respectively. The commonest SCAR phenotype was Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) at 59.8% (73/122), although other validated SCAR phenotypes included drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP) and generalized fixed bullous drug eruption (GBFDE). Cutaneous presentations included typical and atypical SCAR features against a background Fitzpatrick skin tones of type IV and above. Amongst the retrospective cohort 16.9% (15/89) of phenotypes were unclassifiable due to lack of photographs. The overall median (IQR) age was 38 (25-50) years, 50.8% (62/122) were male and 60.7% (74/122) were PWH [median (IQR) CD4T-cell count of 267 (76-470) cells/mm3]. The commonest offending drugs included cotrimoxazole in 24.6% (30/122); and anti-retroviral therapy (ART) in 13.9% (17/122). No offending drug could be identified in 24.7% (22/89) of the retrospective cohort. The median (IQR) length of hospital stay for validated SCAR was 13 (8-21) days for the retrospective cohort and 19 (13-28) days for the prospective cohort (p = 0.03). The median (IQR) length of hospital stay for non-SCAR was 9 (5-13) days for the retrospective cohort and 11 (9-16) days for the prospective cohort. Typical and atypical presentations of SCAR were represented in this vulnerable South African cohort of predominantly PWH. SJS/TEN was the commonest phenotype, and cotrimoxazole the most frequent offending drug. This data emphasises the need for prospective data collection across a diverse African population for valid SCAR phenotyping and drug causality assessment.

The prevalence of skin diseases among the elderly patients applying a tertiary dermatology outpatient clinic: A retrospective analysis of 2400 patients

Introduction: As the population ages, particular health issues affect this susceptible age group. The aim of this study was to evaluate the incidence, frequency, age, gender, and season-of-year distribution of dermatological disorders among geriatric patients. Materials and Method: This was a retrospective, descriptive study. Skin diseases were categorized into 12 different groups and analyzed according to the age groups, gender, and season of the application. Results: The study included 2431 patients (1203 were female and 1228 were male). The mean age of the patients was 74.02±7.07(65-100) years. For 23.1% of these patients, the problems were acute, and for 76.9%, they were chronic. The ratio of patients with one, two, and more than three complaints was 81.0%, 13.9%, and 5.1%, respectively. The most frequent diagnoses were pruritus (n=424, 17.4%); eczematous dermatitis (n=395, 16.2%); fungal infections (n=372, 15.3%); premalign and malign skin disorders (n=247, 10.2%); bacterial infections (n=147, 6%); viral infections (n=118, 4.9%); papulosquamous diseases (n=95, 3.9%); urticaria and adverse drug reactions (n=96, 3.9%); benign skin tumors (n=79, 3.2%); acneiform disorders (n=40, 1.6%); and vesiculobullous disorders (n=22, 0.9%). Conclusion: The majority of skin diseases among the elderly are not life-threatening, and they are preventable. Knowing the prevalence and distribution of skin diseases seen in the elderly can help prevent these disorders and develop policies for better management of elderly-related health issues. Keywords: Aged; Skin Diseases; Preventive Medicine; Skin Aging.

Herpes Zoster after COVID-19 Infection or Vaccination: A Prospective Cohort Study in a Tertiary Dermatology Clinic.

Herpes zoster (HZ) has been observed to occur after COVID-19 infection and vaccination; however, knowledge regarding the demographic data, clinical presentations, and treatment outcomes of HZ is limited. To compare the demographic data, clinical manifestations, treatments, and outcomes of patients with and without HZ within 14 days of COVID-19 infection or vaccination. This prospective cohort study involving patients diagnosed with cutaneous HZ was conducted at a dermatology clinic from October 2021 to January 2023. Among a total of 232 patients with HZ, the median age was 62.0 years and 59.1% were female. HZ developed in 23 (9.9%) and four (1.7%) patients after COVID-19 vaccination and infection, respectively. The mean duration from vaccination and the median duration from infection to HZ onset were 5.7 and 8.5 days, respectively. The proportion of female patients was significantly higher in the group of patients with COVID-19 vaccination or infection than in those without such a history (P = 0.035). Patients who developed HZ following the recent COVID-19 infection had a median age of 42.5 years, which was lower than that of the other groups. Dissemination occurred in 8.7% of the patients after COVID-19 vaccination. HZ recurrence was reported in five cases, of which 80% had been vaccinated or infected with COVID-19 during the previous 21 days. All patients had similar durations of antiviral treatment, crust-off time, and duration of neuralgia. HZ after COVID-19 vaccination is more frequently observed in females, while HZ after COVID-19 infection tends to occur in younger patients. Disseminated HZ is more common in patients recently vaccinated against COVID-19. COVID-19 vaccination or infection may trigger recurrent HZ infection.

Evaluation of Misbeliefs, Myths and Knowledge About Nevi and Skin Cancer in Dermatology Patients

Aim: This study aimed to evaluate the misbeliefs and myths about nevus and skin cancer, knowledge about melanoma, and compare the results between the sexes, education levels, and age groups in the Turkish population. Methods: The study was conducted between August 2020 and November 2021 in a tertiary dermatology outpatient clinic. Data were collected through a self-administered questionnaire. The questions were about demographic data, awareness and beliefs about nevus features, beliefs about nevus and skin cancer relation, and melanoma knowledge. Results: A total of 517 patients, 69.1% (n=357) females and 30.9% (n=160) males were included. Of the participants, 15.3% (n=79) had heard of melanoma, 84.7% (n=438) had not. 16.2% (n=84) of the patients responded that excising nevi causes a risk of skin cancer. 50.5% of the patients answered that nevi turn into skin cancer. 44.3% of the patients considered as traumatized nevus turns into skin cancer. These beliefs were more common in females and varied according to different stages of age and education levels. Conclusion: Nevus and skin cancer continue to carry misbeliefs and myths which are significant problems in public health because they cause difficulties in the treatment and management of skin cancer. Accurate knowledge through education programs is necessary for debunking myths. Keywords: nevi, nevus, skin cancer, melanoma

Clinicopathological Pattern of Nonmelanoma Skin Cancer in Kuwait: A Retrospective Study

Objective: One in every three diagnosed malignancies is skin cancer, making it the most prevalent type of cancer in the world. As skin cancer is not commonly reported in Kuwait, this study was conducted to analyze the clinicopathological characteristics of nonmelanoma skin cancers (NMSC), primarily basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), during the last 13 years in a tertiary dermatology center in Kuwait. Materials and Methods: Data were searched for patients with NMSC, primarily BCC and SCC, from 2010 to 2022. A retrospective review was conducted and descriptive data analysis was performed. Results: Of 7,645 cases, a total of 146 patients had NMSC. The patient’s average age was 64.9 years. 123 cases (84.2%) had BCC, whereas 23 (15.8%) had SCC. Most of the tumors were seen on the face (35.6%), scalp (20.8%), and nose (17.8%), followed by the back (6.2%), trunk (5.5%), and ear (5.5%). Well-differentiated Cutaneous SCCs were detected in 82.6% of cases. Ulceration was observed in (21.9%) of tumors. The nodular BCC subtype was observed in 50.4% of patients. Conclusion: BCC is the most common type of NMSC detected in Kuwait, with the scalp and face being the most common sites of involvement. Any suspicious lesions should be biopsied to rule out skin malignancy.