A syndromic rash in patients attending methadone clinics in New South Wales.
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Diagnosis, Differential↗
Biomedical subjects
Rodney D Sinclair
Publications and source records attributed to Rodney D Sinclair.
Prevalence of male and female pattern hair loss in Maryborough.
Maryborough, in central Victoria has an approximate population of 8000 and census data is well matched for Australia overall. Australia has compulsory voting and registration on the electoral roll. To determine the age-related prevalence of balding among men and women in Maryborough we conducted a postal survey of 5000 men and women aged 20 or older, and 427 were invited to attend for examination. Additional data was collected on dandruff, presence of gray hair. Supplementary questionnaires were sent to 340 children aged 5-9, attending a coeducational primary school. 1456 adults (34.1%) responded to the questionnaire. 396 attended for examination. The prevalence of androgenetic alopecia (AGA) increased with advancing age. 98.6% of men had bitemporal recession and severity was significantly associated with vertex and mid-frontal hair loss (p <0.01) but not age (p = 0.06). In all, 64.4% of women had bitemporal hair loss, and similar to men there was a significant association with mid-frontal hair loss (p =0.042) but not age (p =0.467). One hundred and forty children with completed questionnaires were examined. All 72 females and 68 males were assessed as stage 1 on the mid-line part and with no bitemporal recession (frequency stage 1 = 100%, 95% CI (confidence interval) 97.4%-100%). A significant but weak positive association existed between presence of gray hair and history of dandruff (p<0.01). The prevalence of mid-frontal hair loss increases with age and affects 57% of women and 73.5% of men aged 80 and over.
Adult↗
Simple modification to the punch biopsy technique to minimize handling and crush artefact.
A number of techniques have been described to retrieve the tissue core after punch biopsy. We describe a simple modification to the punch-biopsy technique that minimizes instrumentation, handling and the subsequent risk of crush artefact. Our technique is simple, quick and economical and essentially involves rotation of the punch through 90 degrees then lateral extraction with a degree of upward traction, which usually leaves the tissue core deposited beside the skin defect. At this point it can be easily grasped with a square of gauze or detached if required using scissors or a scalpel blade.
Biopsy↗
Preventing pressure ulcers with the Australian Medical Sheepskin: an open-label randomised controlled trial.
OBJECTIVE: To estimate the effectiveness of a new high-performance Australian medical sheepskin (meeting Australian Standard 4480.1-1998) in preventing pressure ulcers in a general hospital population at low to moderate risk of these ulcers. DESIGN: Open-label randomised controlled clinical trial. SETTING: A large metropolitan teaching hospital in Melbourne, Victoria, in 2000. PARTICIPANTS: 441 patients aged over 18 years admitted between 12 June and 30 November 2000, with expected length of stay over 2 days and assessed as at low to moderate risk of developing pressure ulcers. INTERVENTION: Patients were randomly allocated to receive a sheepskin mattress overlay for the duration of their hospital stay (218 patients) or usual treatment, as determined by ward staff (referent group, 223 patients). MAIN OUTCOME MEASURES: Incidence rate and cumulative incidence of pressure ulcers, assessed daily throughout hospital stay. RESULTS: 58 patients developed pressure ulcers (sheepskin group, 21; referent group, 37). Cumulative incidence risk was 9.6% in the sheepskin group (95% CI, 6.1%-14.3%) versus 16.6% in the referent group (95% CI, 12.0%-22.1%). Patients in the sheepskin group developed new pressure ulcers at a rate less than half that of referent patients (rate ratio, 0.42; 95% CI, 0.26-0.67). CONCLUSIONS: The Australian Medical Sheepskin is effective in reducing the incidence of pressure ulcers in general hospital inpatients at low to moderate risk of these ulcers.
Adolescent↗
A gene for pili annulati maps to the telomeric region of chromosome 12q.
Pili annulati (PA) is a rare hair shaft disorder characterized by discrete banding of hairs. We studied two families with PA in which the disorder segregated in an autosomal dominant fashion. All family members were clinically examined and hair samples were examined under the light microscope. In family G, of 19 individuals examined, ten were affected, over three generations. In family B, there were three affected individuals of seven examined over three generations. A genome-wide scan of family G revealed a maximum logarithm of odds (LOD) of linkage score of 3.89 at marker D12S1723 at the telomeric region of chromosome 12q. From one critical recombinant in family G, the locus was narrowed down to a 9.2 cM region between D12S367 and the end of chromosome 12q. In family B linkage at the telomeric region of chromosome 12q also revealed a maximum LOD score of 0.89 at marker D12S1723. A combined LOD score, assuming no locus heterogeneity between the families was 4.78. Frizzled 10, which is located within the region, was sequenced but we were unable to detect a mutation causing PA. This study, for the first time, identifies a genetic locus for PA.
Chromosome Mapping↗
Short anagen hair with persistent synchronized pattern of scalp hair growth.
Unlike other mammals that molt hair seasonally, human beings have scalp hair follicles that exhibit an asynchronized pattern of cycling, with the growth and subsequent shedding of each hair being independent of others around it. This mosaic cycling behavior is established early and continues throughout life. We describe a boy who continues to have a synchronized pattern of hair growth and shedding, and a short anagen duration at 4 years of age. He appears to never have established the expected asynchronized pattern of hair growth.
Child, Preschool↗
Progressive patterned scalp hypotrichosis, with wiry hair, onycholysis, and intermittently associated cleft lip and palate: clinical and genetic distinction from Marie Unna.
Marie Unna hereditary hypotrichosis has been described in over a dozen families since 1924. Features include scant or no eyebrows at birth, the development of firm wiry hair in the first few years of life followed by a progressive patterned scalp alopecia in the second or third decade. This is associated with generalized hypotrichosis of the body and the condition is nonsyndromic. We have identified a novel form of autosomal dominant ectodermal dysplasia that resembles Marie Unna hereditary hypotrichosis in a family of 23 members over four generations. Affected individuals have patterned hair loss and associated hair shaft dystrophy similar to that seen in Marie Unna hereditary hypotrichosis. It differs from Marie Unna hereditary hypotrichosis by an absence of signs of affectation at birth, relative sparing of body hair, distal onycholysis, and intermittent cosegregation with autosomal dominant cleft lip and palate. Linkage studies to the known Marie Unna locus at 8p21 near the Hairless gene were performed. Linkage analysis using markers D8S298, D8S560, D8S258, and D8S282 revealed significant exclusion of this locus (Z = -2.0 or lower) at theta = 0.1. This demonstrates that this novel ectodermal dysplasia is both phenotypically and genetically distinct from Marie Unna hereditary hypotrichosis.
Adolescent↗
Shortness of breath: an uncommon side-effect of cyproterone acetate in the treatment of androgenetic alopecia.
Cyproterone acetate is indicated for treatment of acne, hirsutism, seborrhea, and androgenetic alopecia in females. In general this medication is well tolerated in standard doses. Shortness of breath has been previously reported in men with prostatic carcinoma, receiving high-dose (200 mg/day) treatment with cyproterone acetate. We report a 66-year-old lady taking 50 mg/day of cyproterone acetate for biopsy proven androgenetic alopecia, who developed this unusual complication of shortness of breath. To our knowledge it has not been previously reported in women undergoing treatment for androgenization.
Aged↗
Sensitization to saw palmetto and minoxidil in separate topical extemporaneous treatments for androgenetic alopecia.
We report a 24-year-old woman with androgenetic alopecia who became sensitized to topical minoxidil following use of an extemporaneous preparation of minoxidil 4% with retinoic acid in a propylene glycol base. She subsequently also became sensitized to saw palmetto (Serenoa repens), a topical herbal extract commonly promoted for the treatment of hair loss.
Administration, Topical↗
C-5 propyne-modified oligonucleotides penetrate the epidermis in psoriatic and not normal human skin after topical application.
We have previously shown that antisense oligonucleotides effectively reduced insulin-like growth factor I receptor expression in human psoriatic skin grafted on to nude mice when injected intradermally. We therefore investigated the penetration of C-5 propyne modified antisense oligonucleotides into human normal and psoriatic skin after topical administration. Oligonucleotide (37.5 microg; 250 microM) was applied in aqueous solution or 5% methylcellulose gel for 24 h, prior to live confocal microscopy and fluorescence microscopy of fixed sections. We found that oligonucleotide could penetrate through the stratum corneum of psoriatic but not normal human skin over large regions of the epidermis. The oligonucleotide was localized to the nucleus of large parakeratotic cells in the psoriatic skin as well as smaller basal and suprabasal keratinocytes. In normal human skin, oligonucleotide was confined to the stratum corneum, with little or no oligonucleotide apparent in the viable epidermis. Electrophoresis of oligonucleotide recovered from treated psoriatic and normal skin revealed that the oligonucleotide remained intact over the 24 h period. In summary, we found that C-5 propyne modified antisense oligonucleotides could reach the target cells (in this case basal keratinocytes) after topical administration to psoriatic but not normal skin.
Administration, Topical↗
Chronic telogen effluvium in a man.
Chronic telogen effluvium is a recently described condition, in which there is persistent excessive hair shedding. Hairs are replaced as quickly as they shed, so patients never become bald. This condition is found primarily in women. We describe chronic telogen effluvium in a man; the diagnosis may have only become obvious because of his long hair.
Adult↗
Treatment of Bowen's disease of the penis with imiquimod.
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Aminoquinolines↗
Persistent depigmented regrowth after alopecia areata.
We report a case of persistent depigmented hair regrowth from the site of a patch of alopecia areata. It is well known that hair may regrow unpigmented from a site of alopecia areata; however, it was previously thought that this was temporary, lasting no longer than the first hair cycle.
Adolescent↗
Disorders of hair in infants and children other than alopecia.
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Adolescent↗