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Results for “SCALP DERMATOSES”

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At least 343 records · Page 19Linked to original sources
PubMed1991

A double-blind, vehicle-controlled study of clobetasol propionate 0.05% (Temovate) scalp application in the treatment of moderate to severe scalp psoriasis.

The efficacy and safety of clobetasol propionate 0.05% scalp application was evaluated in 378 patients with moderate to severe scalp psoriasis in a double-blind vehicle-controlled parallel group study. After 2 weeks of twice-daily applications, 81% receiving active drug versus 22% receiving vehicle had clearing of 50% or greater. Complete clearing was seen in 26% with active drug and 1% with vehicle. Local side effects were primarily burning or stinging in 11% and 10% of patients treated on an active or a vehicle regimen, respectively. The morning cortisol levels of 168 patients were checked at baseline and again after 2 weeks of drug therapy. Subnormal morning plasma cortisol values were seen in 5% of the patients receiving active drug and in 5% receiving vehicle; 13% of those taking active drug versus 5% taking vehicle had a 50% or greater decrease in morning cortisol at the 2-week visit compared with baseline values. Clobetasol propionate 0.05% scalp application appears to be a safe and an effective treatment for scalp psoriasis.

Administration, Topical↗
PubMed1992

Eosinophilic pustulosis of the scalp in childhood.

BACKGROUND: Among sterile pustulosis in childhood, a pruritic relapsing eosinophilic variant beginning in infancy and located mostly in the scalp was first described as eosinophilic pustular folliculitis in infancy by Lucky and colleagues in 1984. OBJECTIVE: Our purpose is to describe such a condition in five boys and one girl and comment on differential diagnosis and relation with Ofuji's disease. METHOD: This is a clinicopathologic study. RESULTS: All patients had scalp pustules beginning in infancy or early childhood that were unresponsive to antibiotic therapy. Lesions also occurred on other areas but the scalp was the major site of involvement. Although secondary infection was demonstrated in one case, the lesions were primarily sterile. Smears of pustules showed a variable proportion of eosinophils. Histopathologic findings suggested a major role for eosinophils in this disorder because dermal eosinophilia was noted in all patients. The inflammatory pattern was not similar to Ofuji's disease. Transient blood eosinophilia was recorded in five patients. Topical steroids relieved inflammatory episodes. Dapsone was tried in one case with apparent benefit. CONCLUSION: Eosinophilic pustulosis of the scalp in childhood is a self-limited disease that can be relieved by topical steroids.

Child, Preschool↗
PubMed1992

Ectodermal dysplasias associated with clefting: significance of scalp dermatitis.

Several clinical syndromes are characterized by ectodermal dysplasia (ED) in association with clefting of the lip and/or palate. The three most commonly recognized entities are (1) the EEC syndrome (ectodermal dysplasia, ectrodactyly, cleft lip/palate); (2) the Rapp-Hodgkin syndrome with ectodermal dysplasia, cleft lip/palate, and mid facial hypoplasia; and (3) the Hay-Wells or AEC syndrome (ankyloblepharon, ectodermal defects, cleft lip/palate). The clinical characteristics of these entities as well as several less common syndromes are reviewed and summarized. The presence of scalp dermatitis in patients with the AEC syndrome and less often the Rapp-Hodgkin syndrome is emphasized.

Cleft Lip↗
PubMed1992

Lichen planopilaris: clinical and pathologic study of forty-five patients.

BACKGROUND: We review the findings in a large series of patients with lichen planopilaris. OBJECTIVE: Clinical, histologic, and direct immunofluorescence findings were reviewed in 45 patients. METHODS: Scalp biopsy specimens for routine histologic examination and direct immunofluorescence were reviewed. Clinical data and follow-up were obtained. RESULTS: Women were affected more commonly and had patchy hair loss, with perifollicular erythema, perifollicular spines, and scarring. Half had or developed glabrous skin, mucous membrane, or nail changes typical of lichen planus. Follicular involvement was limited to the infundibulum and isthmus and included lichenoid inflammation and cytoid formation, with few or no changes in interfollicular epidermis. Direct immunofluorescence showed cytoid body staining with anti-IgM and anti-IgA and patchy or linear fibrinogen deposition along the basement membrane zone. The various therapeutic options used were usually unsuccessful. CONCLUSION: To make the correct diagnosis, patients with scarring alopecia should be evaluated histologically and with direct immunofluorescence. They should also be followed up to assess whether lichen planus develops elsewhere.

Adrenal Cortex Hormones↗
PubMed1993

Erosive pustular dermatosis of the scalp.

Three cases of erosive pustular dermatosis of the scalp are reported. In all patients the dermatosis was characterized by pustular, erosive, and crusted lesions; in addition, two patients had areas of scarring alopecia. The results of laboratory tests, bacteriologic and mycologic investigations, and histopathologic examination were nondiagnostic. Although erosive pustular dermatosis of the scalp is characterized by a nonpathognomonic clinical and histopathologic picture, it probably represents a disease entity.

Adult↗
PubMed1993

A clinical and pathologic study of histiocytosis X in adults.

BACKGROUND: Histiocytosis X is a neoplastic disorder of Langerhans cells that usually occurs in children. Because histiocytosis X rarely occurs in adults, the diagnosis can frequently be missed by both clinicians and pathologists. OBJECTIVE: The purpose of this investigation was to characterize the clinical and pathologic findings of histiocytosis X in adults. METHODS: A retrospective study of four adults with histiocytosis X was undertaken. Paraffin-embedded biopsy specimens were stained with a panel of antibodies including S-100, vimentin, Ham-56, leukocyte common antigen, proliferating cell nuclear antigen (PCNA), UCHL-1, CD43, and Ki-1. RESULTS: The predominant lesions were papules and pustules that usually involved the groin, axilla, and scalp. Histologically the infiltrate exhibited a periappendageal distribution. Strong positive staining for PCNA appeared to correlate with the clinical course. CONCLUSION: Histiocytosis X in adults has a predilection for skin sites rich in appendages and histologically shows a periappendageal infiltrate. PCNA staining of the histiocytes may indicate progressive disease and serve as a useful prognostic marker.

Adult↗
PubMed1993

Langerhans cell histiocytosis and dermatophytosis.

Langerhans cell histiocytosis (LCH) is regarded as a disorder of histiocytic cell proliferation of the Langerhans type, probably resulting from altered immunoregulation. Cutaneous involvement is frequent and often appears as a scaling papular eruption that resembles seborrheic dermatitis; when limited to the scalp, scaling and erythema may also be confused with tinea capitis. We describe four patients who had LCH and documented dermatophyte infection versus colonization of the scalp. Fungal cultures should be considered in patients who have LCH with scalp involvement who do not respond to standard treatment; similarly, it may be appropriate to obtain a skin biopsy specimen from patients with recalcitrant tinea capitis to rule out the presence of underlying LCH.

Child, Preschool↗
PubMed1993

A randomized, double-blind, placebo-controlled trial of ketoconazole 2% shampoo versus selenium sulfide 2.5% shampoo in the treatment of moderate to severe dandruff.

BACKGROUND: Ketoconazole is highly effective against the yeast Pityrosporum ovale, an organism believed to be involved in the pathogenesis of dandruff. OBJECTIVE: Our purpose was to evaluate the safety and effectiveness of ketoconazole 2% shampoo versus selenium sulfide 2.5% shampoo and placebo shampoo in patients with moderate to severe dandruff. METHODS: Features assessed included adherent and loose dandruff scores, presence or absence of irritation, itching, yeast cells, and global improvement rating by the investigator. RESULTS: A total of 246 patients were included. Mean total adherent dandruff score declined throughout the treatment period with both ketoconazole 2% and selenium sulfide 2.5% shampoos significantly better than placebo at all visits. Ketoconazole was statistically superior to selenium sulfide at day 8 only (p = 0.0026). Both medicated shampoos were significantly better than placebo for reducing irritation and itching. Of the nine adverse experiences reported during the treatment phase, all involved patients treated with selenium sulfide 2.5% shampoo. CONCLUSION: Both ketoconazole 2% shampoo and selenium sulfide 2.5% shampoo are effective in the treatment of moderate to severe dandruff; however, ketoconazole 2% shampoo appears to be better tolerated.

Adolescent↗
PubMed1995

Acne keloidalis nuchae: treatment with excision and second-intention healing.

BACKGROUND: Acne keloidalis nuchae (AKN) is a chronic inflammatory disorder of the posterior aspect of the neck and occipital region of the scalp. Despite numerous medical and surgical treatment modalities, few offer cure or a superior cosmetic result for patients with extensive disease. OBJECTIVE: Our purpose was to determine whether excision with second-intention healing is an effective therapeutic modality for AKN. METHODS: Excision of the involved area to the level of the muscle fascia or deep subcutaneous tissue was performed in six patients. Postoperative sites healed by second intention. RESULTS: Four of six patients had a horizontal elliptic excision of the involved area that included the posterior hairline, with good to excellent results. The other two, who received nonelliptic excision of affected scalp that spared the hairline, had slower wound healing and poor contraction. CONCLUSION: Best results were achieved in excision of AKN with second-intention healing when the excision was a horizontal ellipse of the posterior aspect of the scalp including the posterior hairline.

Acne Keloid↗
PubMed1995

Malignant proliferating trichilemmal cyst.

We report a case of a metastasizing proliferating trichilemmal cyst. A 78-year-old man had multiple common and two proliferating trichilemmal cysts, one of which showed malignant transformation as evidenced by lymph node metastases. Despite surgical removal of the malignant tumor, extensive metastatic disease rapidly occurred. This case exemplifies the difficulties in diagnosis and treatment of these rare tumors and their unpredictable course.

Aged↗
PubMed1995

Mycetoma caused by Acremonium falciforme: successful treatment with itraconazole.

Mycetoma has not been previously reported in Korea. A case of mycetoma caused by Acremonium falciforme in a 72-year-old man is described. The patient had a single, large, well-demarcated, erythematous, swollen, black, escharlike lesion and three small satellite lesions on his right temporal area. He was treated with itraconazole, and all lesions healed with residual scars in 70 days.

Acremonium↗
PubMed1996

Primary intracranial malignant tumour mistaken for a postburn scalp Marjolin's ulcer.

This report presents an apparent squamous cell carcinoma over a burn scar in the scalp (Marjolin's ulcer) that was resected and soft tissue expanders inserted in the hair-bearing scalp. In the postoperative period the patient developed neurological impairment with a CT scan showing a parasagittal brain tumour infiltrating the skin. The tumour was resected and the resultant skin and cranial defect were covered with an expanded scalp flap. Histological examination showed malignant angioblastic meningioma. The tumour recurred aggressively, leading to the death of the patient. The case is considered very unusual, as a brain tumour does not seem to be a reasonable suspect in the differential diagnosis of a chronic ulcer over a burn-induced scalp scar.

Adult↗
PubMed1991

Evaluation of a total scalp electron irradiation technique.

A dosimetric evaluation of a total scalp electron-beam irradiation technique that uses six stationary fields was performed. The initial treatment plan specified a) that there be a 3-mm gap between abutted fields and b) that the field junctions be shifted 1 cm after 50% of the prescribed dose had been delivered. Dosimetric measurements were made at the scalp surface, scalp-skull interface, and the skull-brain interface in an anthropomorphic head phantom using both film and thermoluminescent dosimeters (TLD-100). The measurements showed that the initial technique yields areas of increased and decreased dose ranging from -50% to +70% in the region of the field junctions. To reduce regions of nonuniform dose, the treatment protocol was changed by eliminating the gap between the coronal borders of abutted fields and by increasing the field shift from 1 cm to 2 cm for all borders. Subsequent measurements showed that these changes in treatment protocol resulted in a significantly more uniform dose to the scalp and decreased variation of doses near field junctions (-10% to +50%).

Electrons↗
PubMed1993

Total scalp treatment of mycosis fungoides: the 4 x 4 technique.

PURPOSE: A technique for treating mycosis fungoides confined to the scalp using a method known as the 4 x 4 technique is presented. METHODS AND MATERIALS: Uniform dose distribution on the scalp and acceptable "hot spots" along five match lines is accomplished by using four sets of four fields (i.e., 4 x 4) on the patient. Precise and reproducible patient and field alignment was accomplished with a solid thermoplastic mask, which is the surface on which match lines are drawn. In-vivo dosimetry (thermoluminescent dosimeters and film) are easily attached to the mask which also provides a portion of the 7 mm bolus used to shift the characteristic 6 MeV electron depth dose toward the skin surface. RESULTS: In-vivo dosimetry demonstrated that single fraction match line doses are within 25% to 30% of central axis dose. Shifting these match lines to four locations reduces these "hot spots" to satisfactory levels (less than 120%). Three patients have been treated with this technique and each patient continues to have a complete clinical response at 14 to 21 months post treatment. In addition, each patient has excellent cosmetic results with no evidence of acute or chronic side effects at the match lines. CONCLUSION: The 4 x 4 technique has proven to be useful in the treatment of mycosis fungoides confined to the scalp.

Adult↗
PubMed1986

Devastating scalp infections.

The treatment of scalp wounds is occasionally complicated by infection. Although infected scalp wounds are generally limited and readily treated, they can progress to devastating proportions if not promptly and aggressively managed. This report highlights three such cases of severe infection: extensive subgaleal abscess, fatal necrotizing fasciitis, and widespread carbunculosis. The authors emphasize the need for proper assessment of scalp wounds, meticulous cleansing and closure of all fresh wounds, definitive drainage of newly infected wounds, and adherence to sound surgical principles in managing these wounds.

Abscess↗
PubMed1991

Massive subgaleal hematoma following minor head trauma.

A 23-month-old child developed massive head swelling secondary to a subgaleal hematoma several days following minor head trauma. When seen in the emergency department, the child was felt to be otherwise well and hemodynamically stable and was discharged with close follow-up. The hematoma subsequently resolved over the ensuing two weeks. This case represents an uncommon, but dramatic complication of minor head trauma and serves to illustrate the need for physicians to recognize this entity as well as manage it effectively. The major pitfalls in managing these patients are failure to recognize this entity and, particularly in the infant, failure to carefully assess the hemodynamic status.

Fascia↗