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At least 235 records · Page 13Linked to original sources
PubMed1999

Secondary expansion of a replanted scalp salvaged by an intrinsic arteriovenous shunt.

1. Although scalping injuries reported in most large series rarely involve young children, partial scalp replantation, even in a 2-year-old boy after a dog-bite avulsion, should also be warranted. However, technical difficulties because of the diminutive vasculature can be expected. 2. Unconventional methods for reestablishing inflow or outflow for the replanted scalp may become the only practical alternative and must not be overlooked. In this case, an arteriovenous shunt between the frontal branch of the superficial temporal artery within the amputated part itself to a more distal scalp vein at the superior edge of the fragment allowed high-output flow to maintain patency after recurrent thromboses of the conventional superficial temporal arterial anastomosis. This fistula was assumed to be the major contributor to nutrient flow of the remaining scalp, as the parietal branch was truncated along the margin of the avulsion. 3. Delayed tissue expansion is also an option. In this case, delayed expansion of the replanted scalp that survived allowed elimination of the skin grafts needed to cover areas where necrosis ensued, restoration of the anterior hairline, and resulted in a more normal appearance.

Animals↗
PubMed2005

Artificial dermis as an alternative for coverage of complex scalp defects following excision of malignant tumors.

BACKGROUND: Artificial dermis has been used successfully for coverage of full-thickness wounds with a well-vascularized surgical bed. However, the use of artificial dermis in the reconstruction of partial- and full-thickness scalp defects has not been well documented. METHODS: Seven patients (six men and one woman; mean age, 70 +/- 14 years) with partial-thickness (three patients) and full-thickness (four patients) soft-tissue defects of the scalp (mean defect area, 97 +/- 58 cm) following resection of recurrent malignant tumors and/or previous failed reconstructions underwent staged scalp reconstruction with a bilaminate skin substitute (Integra). After adequate debridement of scalp wounds, including burring the outer table of the calvaria down to bleeding bone for full-thickness defects, Integra was scored and applied unexpanded. A split-thickness skin graft (0.011 +/- 0.0 inch in thickness) was placed on the operative site at postoperative day 36 +/- 15 after removal of the silicone layer of the artificial dermis. Two patients required repeated applications of artificial dermis to compensate for contour deficits before skin grafting. RESULTS: Clinically, all reconstructed areas showed well-vascularized neodermis before skin grafting. There was a 100 percent take of the skin grafts, with no infections or other complications noted. All reconstructive procedures were performed in less than 3 hours of combined operative time, with the last stage performed on an outpatient basis. CONCLUSIONS: Artificial dermis can be used successfully for reconstruction of complex scalp defects following oncologic resection, offering minimal donor-site morbidity, expedient operative time, and when needed, temporary quality closure until final pathologic results are known. Integra skin may offer another option for definitive management of extensive full-thickness scalp defects.

Aged↗
PubMed2005

The lack of significant changes in scalp hair follicle density with advancing age.

BACKGROUND: Age-related reduction in hair is seen in the axillary and pubic regions as well as the scalp; however, it has not been investigated qualitatively on the scalp. Horizontally sectioned scalp biopsy is an ideal tool to investigate the impact of advancing age on scalp hair follicle density and morphology. OBJECTIVES: To examine the effect of age and follicle miniaturization on total hair count in 1666 horizontally sectioned mid-scalp biopsies from 928 women aged between 13 and 84 years with hair loss. METHODS SETTING: Specialist hair loss referral clinic in a teaching hospital. DESIGN: Analysis of data set. Methods: All scalp biopsies were 4 mm in diameter and taken from the crown. Miniaturization was assessed by calculating the ratio of terminal to vellus-like hairs (T/V) at the mid-isthmus level and considered significant if the ratio was < or = 4 : 1. Fibrosis was documented when present. Linear regression was used to examine the association between total hair count, age and miniaturization. RESULTS: The average number of hair follicles per biopsy was 39.6 (SD +/- 10.8). A highly significant negative association (P < 0.0001) was found between age and total follicle number, although the predictive value of age in total hair count was found to be small [root error mean square (R2) < 2%]. Controlling for T/V < or = 4 : 1, the association was weakened, but remained significant. The relationship unconfounded by T/V < or = 4 : 1 shows that for every additional year of ageing, 0.077 total hair follicles (0.22%) are lost per biopsy. CONCLUSIONS: Age and follicular miniaturization were found to be extremely weak predictors of total hair count in women with hair loss.

Adolescent↗
PubMed2006

Evaluation of androgens in the scalp hair and plasma of patients with male-pattern baldness before and after finasteride administration.

BACKGROUND: Finasteride, a competitive inhibitor of the enzyme 5alpha-reductase II, is widely used as a medical treatment for patients with male-pattern baldness (MPB), which is affected by the distribution of androgenic steroids. It is also notable that the androgenic effect in MPB is different for each region of the head. OBJECTIVES: To study the effect of the drug finasteride, we quantified androgenic steroids in the vertex and occipital scalp hair and in the plasma of patients with MPB. METHODS: The patients with MPB, aged 23-52 years, were treated with finasteride 1 mg daily for 5 months. The hair and plasma samples were hydrolysed, extracted with n-pentane, and derivatized with MSTFA:NH4I:DTE (1000:4:5, v/w/w). We analysed the concentrations of dihydrotestosterone (DHT) and testosterone (T) in the hair and plasma using gas chromatography-mass spectrometry (GC-MS). RESULTS: In the hair, the ratio of DHT/T was decreased in the vertex scalp hair after the individual received finasteride (P < 0.005). However, we found no significant difference in the ratio of DHT/T in the occipital scalp hair before and after individuals received finasteride. Like the results in the vertex scalp hair, the ratio of DHT/T in the plasma was remarkably decreased after finasteride administration (P < 0.001). CONCLUSIONS: This study supports the effect of finasteride in patients with MPB by examining the decreased level of DHT/T in scalp hair and in plasma. Thus, in view of the androgenic effect in the different hair regions, the vertex scalp hair plays a more important role for patients with MPB treated with finasteride than does the occipital hair.

5-alpha Reductase Inhibitors↗
PubMed1984

Variability of fetal scalp blood flow during labour: continuous transcutaneous measurement by the laser Doppler technique.

Variability of fetal scalp blood flow was measured in 15 patients in labour. Using the continuous transcutaneous laser Doppler technique adapted for fetal intrapartum measurements, it was possible to obtain recordings from a cervical dilatation of 3 cm until delivery. The general trend of fetal scalp blood flow showed a decrease in the majority of the patients during the first and the second stages of labour, with a fall of more than 50% of the initial value at the end of the first stage in seven. During the second stage the decrease in flow was generally less pronounced, although in one fetus scalp blood flow fell to 18% of the initial level by the end of the second stage. Of all the uterine contractions recorded, 57% were accompanied by a transient decrease in blood flow, often by 40-50%, but a temporary increase in scalp blood flow was found in 25% of contractions. Caput succedaneum formation was associated with a more pronounced transient decrease in local scalp blood flow during contractions. It is concluded that during labour a considerable reduction in fetal scalp blood flow occurs. It follows that the reliability of fetal transcutaneous blood gas monitoring techniques, which need a substantial increase in local capillary blood flow, seems highly questionable.

Doppler Effect↗
PubMed1996

Randomised evaluation of a prototype suction fetal scalp electrode.

OBJECTIVE: To compare the performance and acceptability of a prototype suction fetal scalp electrode with that of a double helix spiral electrode. SETTING: An urban academic hospital in Johannesburg, South Africa. DESIGN: Randomised, by means of sealed opaque envelopes opened consecutively. PARTICIPANTS: One hundred women in active labour with an indication for direct fetal heart rate monitoring. INTERVENTION: Application of a fetal scalp electrode to the presenting part. OUTCOME MEASURES: Performance of the electrodes with respect to application success, detachment, quality of the tracings, scalp trauma and women's preferences. RESULTS: Application of the suction electrode was unsuccessful in 15/50 (30%) compared to 1/50 (2%) with the spiral electrode. Detachment rates were similar. There were more tracings of average quality with the suction electrode (nine versus four). There were three instances of scalp bleeding at delivery with the spiral electrode. The suction electrode was preferred by more women and its application caused somewhat less discomfort. CONCLUSIONS: The lower rate of successful application with the suction electrode needs to be weighed against the advantage of avoiding fetal scalp penetration. In particular, women's concerns about pain or harm to the baby from needle electrodes, the theoretical risk of viral transmission, and the risk of serious scalp infection must be considered. These factors favour the use of a suction electrode when direct fetal heart rate monitoring is required. Needle electrodes should be considered when suction electrode application is unsuccessful. Correction of practical problems experienced with the prototype suction electrodes used in this study may result in improved success rates.

Adolescent↗
PubMed1996

Is intrapartum vibratory acoustic stimulation a valid alternative to fetal scalp pH determination?

OBJECTIVES: To determine the association between fetal heart rate accelerations, whether spontaneous or induced by vibratory acoustic stimulation, and subsequent scalp pH values in presence of a suspicious intrapartum fetal heart rate tracing, and thereby assess the ability of accelerations to predict a concurrent normal fetal scalp blood pH. DESIGN: Prospective observational study of 253 labours involving 421 pH samples. SETTING: Tertiary care university hospital of Genoeva. INTERVENTION: Vibratory acoustic stimulation through the maternal abdominal wall for five seconds prior to fetal blood sampling. MAIN OUTCOME MEASURES: Spontaneous fetal heart rate reactivity (accelerations) in the 10 min preceding vibratory acoustic stimulation, vibratory acoustic-induced reactivity prior to fetal blood sampling, and scalp pH value. RESULTS: The positive predictive value of a reactive fetal heart rate response after vibratory acoustic stimulation was 78% (95% CI 73-84%) and 97% (95% CI 94-99%) for scalp pH values of > 7.25 and > or = 7.20, respectively. Similar observations occurred with spontaneous reactivity. Of concern, 7 out of 31 (23%) occasions where the scalp blood pH was less than 7.20 appeared to be associated with a normal fetal heart rate response to vibratory acoustic stimulation. CONCLUSION: Fetal heart rate acceleration induced by vibratory acoustic stimulation was significantly associated with a normal scalp blood pH higher than 7.25. However, vibratory acoustic stimulation offers no advantage over observation of spontaneous fetal heart rate tracings and cannot safely replace fetal blood sampling during labour.

Acoustic Stimulation↗
PubMed2004

Determining the fetal scalp lactate level that indicates the need for intervention in labour.

BACKGROUND: Fetal scalp lactate testing has been shown to be as useful as pH with added benefits. One remaining question is 'What level of lactate should trigger intervention in the first stage of labour?' AIMS: This study aimed to establish the lactate level in the first stage of labour that indicates the need for intervention to ensure satisfactory outcomes for both babies and mothers. METHODS: A prospective study at Mater Mothers' Hospital, Brisbane, Australia, a tertiary referral centre. One hundred and forty women in labour, with non-reassuring fetal heart rate traces, were tested using fetal blood scalp sampling of 5 microL of capillary blood tested on an Accusport (Boeringer, Mannheim, East Sussex, UK) lactate meter. Decision to intervene in labour was based on clinical assessment plus a predetermined cut off. Main outcome measures were APGAR scores, cord arterial pH, meconium stained liquor and Intensive Care Nursery admission. RESULTS: Two-graph receiver operating characteristic (TG-ROC) analysis showed optimal specificity, and sensitivity for predicting adverse neonatal outcomes was a scalp lactate level above 4.2 mmol/L. CONCLUSIONS: Fetal blood sampling remains the standard for further investigating-non-reassuring cardiotocograph (CTG) traces. Even so, it is a poor predictor of fetal outcomes. Scalp lactate has been shown to be at least as good a predictor as scalp pH, with the advantages of being easier, cheaper and with a lower rate of technical failure. Our study found that a cut off fetal scalp lactate level of 4.2 mmol/L, in combination with an assessment of the entire clinical picture, is a useful tool in identifying those women who need intervention.

Adult↗
PubMed2006

Analysis of the expression pattern of glial cell line-derived neurotrophic factor, neurturin, their cognate receptors GFRalpha-1 and GFRalpha-2, and a common signal transduction element c-Ret in the human scalp skin.

BACKGROUND: Glial cell line-derived neurotrophic factor (GDNF) and a related family member, neurturin (NTN), as well as their cognate receptors (GDNF receptors, GFRalpha-1 and GFRalpha-2, respectively) are involved in nervous system development and murine hair cycle control. To date, their expression in human scalp skin is still unknown. MATERIALS AND METHODS: The expression pattern of these proteins was examined in human scalp skin by immunofluorescence and immunoalkaline phosphatase staining methods as well as RT-PCR (GDNF). A total of 50 normal human scalp skin biopsy specimens were examined (healthy females, 53-57 years). RESULTS: The expression of GDNF protein was strong in the epidermis and sebaceous and sweat glands. In the epidermis, GDNF protein expression was seen in all layers except the stratum corneum. It was strong in the basal layer and decreased gradually towards the granular layer. The results of RT-PCR analysis revealed that GDNF protein is synthesised in the epidermis. The expression of NTN, GFRalpha-1, and GFRalpha-2 proteins was strong in the papillary dermis and sebaceous and sweat glands. In the epidermis, NTN protein expression was absent. The expression of GFRalpha-1 and GFRalpha-2 proteins was moderate in the epidermis. The expression of c-Ret protein was consistently strong in the epidermis and sebaceous and sweat glands. These proteins were strongly expressed in both epithelial and mesenchymal compartments of human anagen VI scalp hair follicles. CONCLUSIONS: Our investigation reports, for the first time, the expression patterns of GDNF, NTN, GFRalpha-1, GFRalpha-2, and c-Ret proteins in human scalp skin. The expression of these proteins in the skin suggests their possible roles in skin homeostasis. The clinical ramifications of these observations mandate further investigations. Adly MA, Assaf HA, Hussein MR, Paus R. Analysis of the expression pattern of glial cell line-derived neurotrophic factor, neurturin, their cognate receptors GFRalpha-1 and GFRalpha-2, and a common signal transduction element c-Ret in the human scalp skin.

Female↗
PubMed1993

Ultrastructural localization and quantification of extracellular calcium binding sites in mouse vibrissa and human scalp follicles.

The purpose of these experiments was to determine if an extracellular calcium binding site gradient is evident in freshly dissected or cultured mouse vibrissa and human scalp follicles and to measure possible drug effects on this gradient. Mouse vibrissae were cultured with or without either minoxidil or pinacidil, and human scalp follicles were cultured with or without epidermal growth factor. Anagen vibrissa and scalp follicles were dissected and placed in culture for 4 h to 4 days, then fixed in a solution containing lanthanum chloride and prepared for either quantitative energy-dispersive X-ray microanalysis (X-ray) or qualitative transmission electron microscopy (TEM). Since lanthanum has a high charge density it displaces Ca2+ ions from anionic binding sites. TEM analysis revealed extensive accumulation of electron-dense lanthanum deposits in the intercellular compartment of differentiating cells in the hair shaft and inner root sheath in the apex of the follicular bulb. Sparse lanthanum precipitate was observed in the intercellular space of the proliferative cells at the base of the bulb. This gradient of lanthanum precipitate was evident in both freshly dissected and cultured vibrissa and scalp hair follicles, irrespective of treatment with drugs that grow hair or epidermal growth factor. X-ray microanalysis indicated that percent by weight of lanthanum was markedly higher in the apex compared to the base of the follicular bulb in vibrissa and scalp follicles. These qualitative and quantitative data demonstrate that an extracellular calcium binding site gradient exists in cultured vibrissa and scalp hair follicles, and that this gradient is not significantly affected by hair growth altering drugs including minoxidil or pinacidil, and epidermal growth factor.

Adult↗
PubMed1983

Scalp blood flow measured by the xenon clearance technique and transcutaneous PO2 in the fetal lamb.

Scalp blood flow and transcutaneous (tc) PO2 were measured in four fetal lambs at 130-135 days of gestation. Scalp blood flow was measured by the xenon clearance technique using a technetium source to correct for changes in distance from the detector. The effect of circular pressure, the so-called "tonsure effect" on scalp flow and tcPO2, was evaluated by pressing a ring on the scalp. A circular pressure between 20-30 mmHg markedly reduced local scalp blood flow and was sufficient to reduce tcPO2 to zero. We found evidence of significant recirculation of xenon in the fetal circulation indicating right-left shunting. This study showed that the tonsure effect seriously affected scalp blood flow and tcPO2 in the fetus.

Animals↗
PubMed1990

Scalp blood flow, measured by laser Doppler flowmetry, and transcutaneous PO2 and PCO2 in the lamb.

To describe the relation between scalp blood flow and transcutaneous PO2 and PCO2, these three signals were recorded simultaneously in eight experiments on four healthy lambs in the first weeks after birth. Scalp blood flow was recorded by a laser Doppler flow sensor that was incorporated in the transcutaneous PO2 electrode. Scalp blood flow was varied by applying a circular pressure on the scalp surrounding the sensors. A decrease in laser Doppler blood flow was associated with a decrease in transcutaneous PO2 and an increase in transcutaneous PCO2, according to a hyperbolic curve. The steep parts of the hyperbolic curves were observed at low scalp blood flow, whereas the flat parts were found at high flow values. Even during heat-induced hyperemia only a small part of these hyperbolic curves showed a reasonable independence of the transcutaneous blood gas values of changes in blood flow. In view of the previously observed decrease in intrapartum scalp blood flow, the present data render the transcutaneous measurement of blood gas values doubtful for fetal monitoring during labor.

Animals↗
PubMed2006

Essential trace and toxic element distribution in the scalp hair of Pakistani myocardial infarction patients and controls.

The pathogenesis of heart disease has been associated with changes in the balance of certain trace elements. The aim of this study was to evaluate the Zn, Fe, Cu, Cr, Ni, Pb, and Cd contents in scalp hair samples of myocardial infarction (MCI) patients hospitalized in the cardiac ward of National Hospital in Hyderabad city (Pakistan). Scalp hair samples were collected from 193 patients (104 male, 89 female) of 3 age groups (46-60, 61-75, and 76-90 yr), for a comparative study, 200 normal, healthy subjects (103 male, 97 female) of the same age groups residing in the same city were selected. All metals in scalp hair samples were assessed by a flame/ graphite furnace atomic absorption spectrophotometer, prior to microwave-assisted and conventional wet acid digestion methods. Results were calculated in micrograms per gram. The mean values of Fe and Zn of scalp hair samples of MCI patients were significantly reduced compared to the control subjects of both genders. The mean Fe concentrations in male patients were 19.42, 12.36, and 6.98 vs 30.69, 24.42, and 16.75 for the control patients in the three age groups (46-60, 61-75, and 76-90 yrs, respectively). The mean Zn concentration in male patients were 169.2, 149.4, and 107.7 microg/g vs 206.1, 188.0, and 154.4 microg/g for the control group (p < 0.002, 0.004, and 0.001) in all three age groups, respectively. These differences were also observed in the female study groups. The mean values of Pb, Cd, and Ni were significantly high in patients compared to healthy subjects (mean Pb in male patients: 11.85, 12.89, and 14.52 those of female patients were 11.88, 12.73, and 14.21 vs the male controls patients (6.08, 7.56, and 8.56) and female controls (5.99, 7.41, and 8.25) for all three age groups, respectively. The concentration of Ni and Cd in the scalp hair samples of the heart patients of both sexes were significantly higher compared to the control; in the case of Ni the range of significant difference for males was found to be p < 0.001-0.009 and for females to be p < 0.0.002-0.007 and significantly high concentration of Cd were observed in hair samples of patients than in controls in the range for males (p < 0.001-0.009) and in females (p < 0.001-0.011). The Zn/Cu and Zn/Cd ratios in the scalp hair (p < 0.01) of the diseased groups were significantly lower than that of the healthy groups. Deficiency of essential trace metals and high level of toxic metals might play a role in the development of heart disease in the subjects of this study. Toxic metals might also cause diminished absorption of essential elements.

Aged↗
PubMed1998

Balding hair follicle dermal papilla cells contain higher levels of androgen receptors than those from non-balding scalp.

Androgens can gradually transform large scalp hair follicles to smaller vellus ones, causing balding. The mechanisms involved are unclear, although androgens are believed to act on the epithelial hair follicle via the mesenchyme-derived dermal papilla. This study investigates whether the levels and type of androgen receptors in primary lines of cultured dermal papilla cells derived from balding scalp hair follicles differ from those of follicles from non-balding scalp. Androgen receptor content was measured by saturation analysis using the non-metabolisable androgen, [3H]mibolerone (0.05-10 nM) in a 9-10 point assay. Pubic dermal fibroblasts and Shionogi cells were examined as positive controls. Repetitive assays of Shionogi cells showed good precision in the levels of androgen receptor content (coefficient of variation = 3.7%). Specific, high affinity, low capacity androgen receptors were detected in dermal papilla cells from both balding and non-balding follicles. Balding cells contained significantly (P < 0.01) greater levels of androgen receptors (Bmax = 0.06 +/- 0.01 fmol/10(4) cells (mean +/- S.E.M.)) than those from non-balding scalp (0.04 +/- 0.001). Competition studies with a range of steroids showed no differences in receptor binding specificity in the two cell types. The higher levels of androgen receptors in cells from balding scalp hair follicles with similar properties to those from non-balding scalp concur with the expectations from their in vivo responses to androgens. This supports the hypothesis that androgens act via the dermal papilla and suggests that cultured dermal papilla cells may offer a model system for studying androgen action in androgenetic alopecia.

Adult↗
PubMed2006

Review of scalp alopecia due to a clinically unapparent or minimally apparent neoplasm (SACUMAN).

Neoplastic cells, both malignant and benign, local occurring and metastatic, can cause alopecia of the scalp. However, the infiltration of neoplastic cells is sometimes not florid; a condition known as "scalp alopecia due to a clinically unapparent or minimally apparent neoplasm" (SACUMAN). Neoplastic cells can nevertheless destroy hair follicles by inducing fibroplasias via inflammatory mediators, attracting inflammatory cells and/or replacing normal cellular populations. The infiltrative nature of such an alopecia can be unapparent or only minimally apparent. The most common neoplasm in which an uncomplicated, minimally or unapparent scalp alopecia occurs and no infiltrate of cancer is suspected is metastatic breast carcinoma. Other causes include squamous and basal cell carcinomas, angiosarcoma, gastric carcinoma, placental site tromphoblastic tumor, and mycosis fungoides. Syringoma-like proliferations can underlie alopecia. It is unclear whether these proliferations are true syringomas or normal findings. In conclusion, neoplasms causing cicatricial alopecia of the scalp are very rare, so generalizations from the limited number of case reports are of uncertain importance. Moreover, it is likely that many cases of neoplasms causing cicatricial alopecia of the scalp are diagnosed as inflammatory alopecia and not neoplasms, thus depriving us of a full accounting and understanding of this entity. Dermatologists must be aware that in rare cases a bland scalp alopecia can represent a new or recurring, local or metastatic neoplasm.

Alopecia↗
PubMed1999

Malignant fibrous histiocytoma of the scalp. Multidisciplinary treatment.

BACKGROUND: Malignant fibrous histiocytomas (MFH) are uncommon in the skin, and even less frequent on the scalp. On the scalp they are often very difficult to excise and it is even more difficult to close the resulting wound. OBJECTIVE: To review all malignant fibrous histiocytomas diagnosed and treated in our Department during the past 6 years, and to describe the multidisciplinary procedure employed to treat one special case of aggressive malignant fibrous histiocytoma on the scalp that recurred twice. RESULT: Malignant fibrous histiocytomas represent 0.01% of malignant cutaneous tumors in our area. The immediate results after a multidisciplinary treatment performed on a recurrent malignant fibrous histiocytoma located on the scalp were excellent, but recurrence was observed 6 months later. Two years later we have also treated another case of MFH on the scalp. The same surgical technique was performed, but the patient received high-dose-methotrexate-based neoadjuvant chemotherapy (HD-MTX). One year later, this patient is still alive and no signs of recurrence have been detected. CONCLUSION: When malignant fibrous histiocytoma occurs on the scalp it must be treated immediately by means of an excision with a large peripheral edge of 2 cm from the visual or CAT limits of the lesion, since the first treatment must be definitive.

Adult↗
PubMed2001

[A simple and effective technique for reconstructive surgery of medium-sized scalp defects].

From June to December 1999, eight patients aged from 16 to 30 years with scalp defects ranging from 9-11 cm in the tonsural region secondary to high-voltage electrical burns underwent scalp reconstruction via a technique based on the Orticochéa method, but which was less complicated in design, easier to carry out, and also more efficient. The entire scalp was prepared for surgery subgalea, but in no case was the dura mater exposed. Then four local flaps were taken, i.e., two temporal, one frontal, and one occipital flap. The width of each flap was the same size as the diameter of the scalp defect, and the base of each flap included the main regional blood vessels: A straight-forward advancement technique for the four flaps was not sufficient to completely cover such scalp defects, and a rotational approach was also introduced. In fact, the originality of the presently-described technique lies in the rotational approach, which is extremely efficient. It is carried out via three backcuts, beginning with the first temporal flap, then the second temporal flap, and if necessary the occipital flap; but never the frontal flap. These backcuts are performed in such a way that they are subsequently hidden by hair growth. In the present study, no skin graft was necessary, and no complications were reported. All the patients were satisfied with the results of surgery, both as regards the cosmetic aspect and regrowth of hair, and also as regards scalp sensitivity.

Adolescent↗
PubMed2003

Identification of Malassezia species isolated from scalp skin of patients with psoriasis and healthy subjects.

The role of Malassezia species in psoriasis is still undetermined, but several reports have associated these lipophilic yeasts with the development of skin lesions in psoriasis. The aim of our study was to analyze the prevalence of Malassezia species in the scalp lesions of patients with psoriasis and assess the distribution of the species according to patient sex, age, and duration of the disease. Forty psoriatic patients with scalp involvement and the same number of clinically healthy individuals were included in the study. The samples were obtained by scraping the skin surface of the scalp of all subjects and then incubated on modified Dixon agar. The yeasts isolated were identified by their morphological and physiological properties according to Guillot et al method. M.globosa in its yeast phase was a predominant species (55%), followed by M.slooffiae (18%) and M.restricta (10%), the latter being the most common species isolated from healthy scalp skin. We found significant difference in the distribution of Malassezia species between psoriatic and healthy scalp skin and in the distribution of Malassezia species according to the severity of the scalp involvement.

Adolescent↗