Physicians should be vigilant for COVID‐19 vaccine side effects and investigate any associated cutaneous manifestations. This will ultimately facilitate better understanding and recognition of various skin reactions related to the vaccine.

Background: Burnout is a multidimensional syndrome declared recently as an occupational phenomenon in the International Classification of Diseases, recognizing burnout as a serious public health issue of national proportions. Objective: To determine burnout prevalence in Saudi dermatology residency and identify contributing factors. Methods: Validated measure of burnout (Maslach Burnout Inventory-human services survey), alongside the possible risk factors of burnout, was distributed to all dermatology board training programs in all centers with Saudi Board Dermatology Training Program in the Western, Eastern, and Southern Region in Saudi Arabia. Results: A total of 70 respondents completed the questionnaire. High Emotional Exhaustion (EE) was present in (47.1%) , low personal accomplishment (PA) was present in (65.7%) , and high depersonalization (DP) was the least prevalent across all burnout dimensions (24.3%) of dermatology residents. Overall burnout was present in (21.4%) of the dermatology residents. Multivariate analysis showed that the odds of EE were significantly lower in males than females (OR = 0.2, P = 0.016) and the higher number of patients seen per clinic (OR = 1.09, P = 0.032) was associated with higher odds of having high risk of EE while higher satisfaction with work life balance was associated with lower odds of high risk of EE (OR = 0.47, P = 0.005). Higher number of study hours/week was associated with lower odds of low PA (OR = 0.95, P = 0.02). Similarly, higher satisfaction with career was associated with lower odds of low PA (OR = 0.35, P = 0.042). Multivariate analysis showed that only exercise (OR = 0.21, P = 0.05) and satisfaction with work/life balance (OR = 0.42, P = 0.008) were associated with lower risk of burnout. Conclusion: Our study adds to the literature the burnout rates in dermatology residents in Saudi Arabia, in addition to possible risk factors that can predict burnout. These findings can be applied in the improvement of training programs to reduce the burnout rate among residents.

Minoxidil is a widely utilized medication for various hair conditions, such as androgenic alopecia. The current literature lacks an original study that reports the possibility of this medication causing a well-noticed side effect, hair discoloration, among the treated patients. We conducted an observational study utilizing two face-validated questionnaires that experts, in dermatology, revised to assess the possibility of Minoxidil in inducing hair discoloration. This study was done in Saudi Arabia, and the data collection spanned October and November 2022. The first questionnaire was targeting the population, while the second was targeting practicing dermatologists. In survey 1, of 453 included patients, 56.7% of the participants were between the ages of 18-24, most of whom were females. Interestingly, 26% (n=118) noticed greying of hair and 14.8% (n=67) noticed other hair color changes. The hair discoloration was more prevalently noticed among the groups who used Minoxidil for a longer duration and among those with a family history of hair greying, with a p-value of 0.0001 for each group. Survey 2 was targeting dermatologists and was answered by 57 participants. Almost 60% of the physicians have ten years or more experience in Dermatology. 42.1% of the dermatologists noticed greying of hair on their patients after using Minoxidil. 17.5% of the physicians think Minoxidil caused hair greying. This observational study analyzed the data of more than 400 patients to assess the possibility of Minoxidil inducing hair discoloration; based on the data presented, we hypothesize that Minoxidil could be classified as a drug that potentially induces hair discoloration with more extended periods of usage and among those who have familial history of hair greying. Further confirmatory data are warranted to support such statement.

Prurigo nodularis (PN) is a chronic skin disease that manifests with severe itchy, firm, hyperkeratotic nodules distributed on the trunk and the extremities symmetrically. Here, we report a unique presentation of PN. A 26-year-old male presented with multiple itchy nodules over the hands and feet sparing the trunk, which were confirmed histologically as PN. This is the first reported case of PN with exclusive acral distribution.

Background: Drug-induced hyperpigmentation (DIH) represents a significant subset of acquired pigmentation disorders and poses diagnostic challenges due to delayed onset and polypharmacy. This systematic review and meta-analysis aimed to identify medications significantly associated with DIH and evaluate their reported incidence. Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, and Cochrane Library for studies published between 2002 and June 2024. Eligible studies reported DIH as an outcome with incidence or descriptive data. Pooled proportions were calculated using a random-effects model, and heterogeneity was assessed via the I ² statistic. Results: Twenty-two studies met the inclusion criteria. The overall pooled incidence of DIH was 36.7% (95% CI: 0.291–0.444). Subgroup analyses revealed the highest incidences with tyrosine kinase inhibitors (89.2%) and MC4R agonists (71.4%), followed by antibiotics (52.0%), antineoplastic agents (35.5%), and antimalarials (29.0%). Commonly implicated agents included minocycline, hydroxychloroquine, and hydroxyurea. Conclusion: DIH is a prevalent adverse drug reaction with considerable variation in incidence across drug classes. Recognition of high-risk medications is essential for prompt diagnosis and clinical management. Systematic review registration: The study protocol was pre-registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42024529250).

Background and Clinical Significance: Blistering distal dactylitis is a localized infection of the distal phalanx, most commonly affecting children and adolescents and typically caused by group A β-hemolytic Streptococcus. Infections due to atypical organisms are rare. Involvement of atypical organisms such as Acinetobacter lwoffii is extremely rare; Case Presentation: We report an 18-month-old boy presenting with hemorrhagic crustation over bilateral big toes for 2 weeks; wound culture swab revealed Acinetobacter lwoffii. Patient was managed with 5 mL of trimethoprim–sulfamethoxazole twice daily for a week; Conclusions: This case highlights the rare involvement of Acinetobacter lwoffii in blistering distal dactylitis and emphasizes the importance of culture-guided diagnosis and treatment.