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[Treatment of head lice with quassia tincture].
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Pyogenic versus pseudopyogenic granulomas.
Surgeons are confronted daily with a myriad of skin pathology. Pyogenic and pseudopyogenic granulomas are certainly among the differential diagnoses to many nonhealing dermal lesions. This article revisits two types of vascularized lesions that are perhaps part neoplastic and part inflammatory/reparative. The differences clinically between these two types of lesions are few. The classical form generally is found along mucosal surfaces and upper extremities. The pseudopyogenic granuloma is more often found on the scalp and ears. Confirmation in their diagnoses is based strictly on their histological criteria. The management of these two types of lesions is identical. Excisional biopsies for all nonhealing lesions are warranted to rule out lesions with an ominous progression.
The hair collar sign: marker for cranial dysraphism.
OBJECTIVE: To call attention to a cutaneous marker for neural tube closure defects of the scalp, the "hair collar" sign. This finding consists of a ring of long, dark, coarse hair surrounding a midline scalp nodule. METHODS AND RESULTS: Four children with small congenital scalp nodules and the hair collar sign were studied from the standpoint of clinical findings, radiologic scans, and histology of the excised nodules. All four had an overlying vascular stain in addition to the hair collar. Patients 1 and 2 were found to have encephaloceles, and one had heterotopic brain tissue. The fourth family refused surgery, but the clinical and radiologic findings were consistent with a diagnosis of atretic encephaloceles. One infant had agenesis of the corpus callosum and a Dandy-Walker malformation as associated findings. CONCLUSIONS: The "hair collar" sign should alert the pediatrician to the possibility of ectopic neural tissue in the scalp and/or underlying central nervous system malformations.
[Lichenoid eruption induced by gold salts. An autonomous eruption].
INTRODUCTION: We report a severe lichenoid drug eruption due to gold salts which relapsed 8 months after the cessation of chrysotherapy. CASE REPORT: A 56 year old man, 3 months after the beginning of a gold sodium propanol sulfonate therapy, developed a polymorphous eruption with violin papules on the trunk, eczematous lesions on the limbs and erosive stomatitis. Gold salts were definitively withdrawn. We saw the patient four months after gold therapy cessation: the eruption remained and diagnosis of severe drug cutaneo-mucous lichenoid eruption was done. We saw thereafter the patient again, 8 months after gold therapy cessation: the eruption had relapsed, more intense. DISCUSSION: We suggest that lichenoid eruption, first caused by gold salts, has become autonomous.
[Congenital atrichia with cysts].
INTRODUCTION: Congenital atrichia with papular lesions is a rare congenital ectodermic dysplasia. CASE REPORT: A male child had atrichia of the scalp and eyebrows from birth. The atrichia was associated with epidermic cystic lesions of the scalp. Biopsy showed cystic piler follicles within the derma surrounded with an inflammatory infiltration of multinucleated giant cells. DISCUSSION: In most reported cases, scalp hair is present at birth and then falls within the first three months of life. Follicular cysts appear later. This syndrome generally occurs sporadically and the mode of inheritance is unknown.
[Plica polonica].
The author summarizes the essentials and history of the plica polonica disease and describes some of his own experiences in diagnosis and treatment. It is remarkable, that the monographs of the internal medicine and the hungarian monographs of dermatology, with the exception of two, didn't even mention this phenomenon in this century. Besides, no original publications can be found in the hungarian medical literature about this topic. However we can find people with this syndrome in Hungary also at the present time. It can be connected with the increasing ageing and growing poverty in our country.
[Treatment of pediculosis capitis in children with permethrin 1% shampoo or lotion].
A clinical and entomological trial was carried out in 88 head louse (Pediculus humanus capitis) infested children treated with a single dose of 1% permethrin shampoo or lotion. The sex distribution was 47 males an 41 females with ages ranging between 5 and 14 year olds. In order to assess the efficiency of treatments, search for adult forms, nymphs and eggs (nits) of the parasite was performed in each of the children, before and after treatment (30 minutes, 7 days and 21 days). The entomological evaluations consisted in stereoscopic and microscopic examinations of a mean of 12 hair samples taken from the retroauricular and occipital regions of each of the children, the biological condition of eggs, viable (immature, mature), dead and empty, was recorded. The cure rates--both clinical and entomological--obtained were 91.5% for shampoo and 95.2% for lotion. No adverse reactions with the two formulations used were reported. In conclusion, 1% permethrin shampoo or lotion in an effective and safe treatment for pediculosis capitis.
[Quinquad's folliculitis decalvans and tufted hair].
We observed a case of folliculitis decalvans involving the beard and the scalp with a tufted hair folliculitis aspect in the occipital region. The presence of two clinical presentations in the same patient has not been reported in the literature. This would suggest that the two entities could be morphological aspects of the same pathological process which might cause either atrophy with loss or the annexes or tufted hair folliculitis depending upon the depts and destructive capacity of the inflammatory process.
[Perifolliculitis capitis abscedens and suffidiens. Efficacy of isotretinoin].
Perifolliculitis capitis abscedens et suffodiens is a rare, chronic and suppurative scalp disease. The treatment of this condition is difficult. CASE REPORT. We report a case successfully treated with isotretinoin at the dose of 2/3 mg/kg/day during eight month. DISCUSSION. The main difficulty is the maintenance of remission after drug withdrawal, so, duration of treatment has to be defined. A eight month's therapy seems to constitute the minimum duration in this pathology. A second course of isotretinoin is still possible if relapse occurs. CONCLUSION. A long course of isotretinoin can be considered as the most effective treatment in perifolliculitis capitis abscedens et suffodiens.
[Tufted folliculitis of the scalp].
INTRODUCTION: Tufted hair folliculitis is a localized scarring bacterial folliculitis due to Staphylococcus aureus. We present two cases. OBSERVATIONS: Both patients were in their thirties. The first had had an inflammatory sclerous lesion of the vertex for three years, and the second an alopecial scarring lesion. Clinically there were tufts of hair within or around the lesions. Staphylococcus aureus was found in biopsy samples which showed hairs or composed follicles. Prolonged treatment with oral antibiotics led to progressive limitation of the lesions. DISCUSSION: Tufted hair folliculitis is a characteristic folliculitis of the scalp showing scar formation and the presence of Staphylococcus aureus. The review of the literature raises the question of the role of local immunity and the nature of the hair tufts: primary anomaly or secondary to Staphylococcus infection? The therapeutic attitude is not well defined but prolonged treatment with oral antibiotics can stabilize the lesions.
[Resistance of lice to insecticides: a serious public health problem].
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Alopecia: diagnosis and management.
Hair loss is a common problem that may affect both males and females in all age groups. Although androgenetic alopecia (common baldness) is the most frequently occurring type of hair loss, hair loss can result from a variety of local and systemic conditions. A detailed history, complete physical examination and directed use of laboratory tests are indicated in making the diagnosis. Specialized tests such as "hair pluck" and scalp biopsy may also be required. Treatment is focused on removing the cause of secondary hair loss, patient education and specific interventions for individual types of alopecia. All treatment strategies should address the significant cosmetic and psychologic impact of hair loss.
The difficult scalp and skull wound.
Scalp and skull defects can be very difficult to reconstruct. Whereas small defects may require only primary closure, skin graft, or small rotation flaps, large defects involving full-thickness scalp can be much more problematic. These large defects may require free-tissue transfer for adequate soft-tissue coverage. The calvaria also may require reconstruction. If the underlying bone is not infected, it can be left in situ and covered with well-vascularized tissue. The bone should be removed only if it is infected. Calvarial reconstruction should then be delayed for 3 to 6 months. If the tissue has been irradiated, only selected defects are appropriate for coverage with local scalp flaps because adjacent tissues may have underlying damage. With a methodic, accurate assessment of the defect, successful reconstruction can be expected.
[Cutaneous ectoparasitosis: pediculosis. Epidemiology, diagnosis, treatment].
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Pediculosis capitis among urban school children in Ilorin, Nigeria.
A survey of 6882 primary school children living in Ilorin, Nigeria revealed that 3.7% of the children were infested with Pediculus humanus capitis. Infestation rate among the children in the Islamic community was 4.1%, whereas in the Christian area, the infestation rate was 3%. Girls had a higher infestation rate (5.6%) than boys (2.1%). The highest infestation rate (28.4%) was observed among girls of low socioeconomic class, followed by their male counterparts (11.2%). Factors associated with the onset of pediculosis included overcrowding, long hair, family size, age, living in a sordid environment, and personal hygiene. Strategies for the effective control of pediculosis are discussed.
Recognition and treatment of pediculosis (head lice) in the emergency department.
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