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At least 361 records · Page 20Linked to original sources
PubMed2001

Erosive pustular dermatosis of the scalp after skin grafting.

Erosive pustular dermatosis of the scalp is a rare condition of unknown etiology that usually occurs in the elderly and is characterized by pustules that appear on the scalp leading to scarring alopecia. The histopathology is not specific. Its onset has been related with previous trauma on the scalp. Only three cases after skin grafting have been reported. We describe a case of erosive pustular dermatosis of the scalp appearing on a split-thickness skin graft placed after excision of a basal cell carcinoma.

Basal Cell Carcinoma↗
PubMed2005

The shoelace method in congenital aplasia of the scalp and skull.

Aplasia cutis congenita (ACC) is an uncommon skin disorder characterised by the absence of some or all layers of the skin. It may involve any part of the body, but is most common in the scalp. Some scalp lesions are associated with a defect of the underlying skull or even dura. Small superficial lesions heal spontaneously. Options available for larger defects and those involving the skull include conservative management, skin grafts, composite grafts, local scalp or pericranial flaps, and free microvascular transplants. This case report presents a delayed primary closure of a scalp and skull defect with the shoelace method and a temporary skin graft. The method is simple, gives an excellent cosmetic result, and can be used in moderately sized defects, where a direct suture is not possible.

Diseases in Twins↗
PubMed1985

Scalp changes after fetal monitoring.

We prospectively studied 535 newborn infants who had been monitored during labour with scalp electrodes. Daily examination of scalp changes showed frequent transient mild lacerations, while severe complications were rare: seven (1.3%) had scalp ulceration and one (0.2%) developed scalp abscess.

Electrodes↗
PubMed1979

Chronic non-scarring folliculitis of the scalp.

Forty patients with recurrent follicular pustules of the scalp but without obvious necrosis or residual scarring were re-examined (mean 8.3 years after onset of lesions). The most common age at onset was 20-40 years. The sex ratio (M/F) was 3 : 1. Only 7 of 40 patients had concomitant acne vulgaris on the face. All patients still had active, recurring scalp lesions, although 7 out of 40 had had temporary remissions. Post-lesional scarring was not observed. Oral low-dose tetracyclines had a symptomatic effect in 7 of 11 patients. Most of the patients treated topically with steroids and alcoholic lotions experienced little or no effect. Histopathology disclosed a neutrophilic folliculitis. Bacteriological examinations showed only the usual resident microflora of the scalp with P. acnes being the most frequent species. In 3 cases (5 examined pustules), P acnes was isolated from the content of the pustules without being found on the skin surface over the pustule. Chronic non-scarring folliculitis of the scalp probably constitutes a disease entity.

Adolescent↗
PubMed1989

The ridgeback anomaly. A new follicular pattern of the scalp.

A patient with an anomaly of hair pattern development is described. Scalp hair follicles generally grow at a downward inclination to the scalp surface. Normal whorled patterns appear in the posteroparietal area. The patient described was noted to have a whorled hair pattern located over the right temporoparietal region, growing in a clockwise direction. The remainder of the scalp adopted the upward follicular growth pattern of the posterior portion of the whorl, directed toward the apical anatomic axis. A ridge of hair over the nape of the neck reversed direction, similar to hair growth on the Rhodesian Ridgeback dog, growing in a downward manner. The relationship of this new hair pattern to current theories of scalp hair pattern development is reviewed.

Animals↗
PubMedDate not supplied

Scalp and forehead reconstruction using free revascularized tissue transfer.

OBJECTIVE: To examine the indications for, and the success of, free flap reconstruction in patients with forehead and scalp defects. DESIGN: Case series. SETTING: Two tertiary referral university teaching hospitals. Patients Twenty-six consecutive patients, aged 31 to 85 years, presenting with 26 scalp defects, 5 forehead defects, and 1 combined defect (size, 70-672 cm(2)). Three patients required resection and repair of the dura at surgery. Intervention Patients were staged according to the size of the defect and the viability of surrounding tissue; free flap reconstruction was performed where indicated. MAIN OUTCOME MEASURES: Flap survival, complications, and disease-free and overall survival. RESULTS: Thirty-four free flap reconstructions were performed (24 latissimus dorsi free flaps, 4 scapular free flaps, 3 rectus abdominis free flaps, and 3 radial forearm free flaps). One failed 2 weeks postoperatively, and 2 required exploration (1 for arterial ischemia and 1 for a hematoma). There were 3 cases of donor site morbidity (2 early seromas and 1 late abdominal hernia). One patient died of a pulmonary embolus 1 week postoperatively. Disease-free survival was 48% at 5 years and overall survival was 59% at 5 years, with a median follow-up of 24 months. CONCLUSIONS: Free revascularized tissue transfer is a reliable and safe way of reconstructing large scalp or forehead defects after traumatic injury or neoplastic resection. The muscle-only latissimus dorsi free flap for scalp reconstruction and the cutaneous scapular free flap for the forehead have proved successful in selected patients with a low complication rate and satisfactory cosmesis.

Adult↗
PubMed1988

Orbital surgery. The technique of coronal scalp flap approach to the qateral orbitotomy.

Lateral orbitotomy may be performed using a coronal scalp flap to provide exposure of the lateral orbital wall and rim. A coronal incision is made across the scalp. The scalp flap is developed anteriorly to expose the orbital margin from the superior orbital rim to the zygomatic arch. The temporalis muscle is dissected from its bony attachments and bluntly retracted, providing maximal exposure of the lateral orbital wall. The orbitotomy proceeds as required. The case concludes with a layered closure. In selected patients, the coronal scalp flap provides improved exposure and postoperative aesthetics compared with approaches in which the skin and muscle layer are incised directly over the lateral orbit. Complications are infrequent.

Humans↗
PubMed1999

Different contribution of joint and cutaneous inputs to early scalp somatosensory evoked potentials.

To elucidate whether the frontal components of scalp somatosensory evoked potentials (SEPs) depend on the type of peripheral input, we compared scalp SEPs in response to electrical stimuli applied to: (i) the proximal phalanx of the thumb, involving both deep and cutaneous afferents; and (ii) the distal phalanx of the thumb, involving cutaneous afferents, but excluding joint inputs coming from the interphalangeal articulation. We applied the same dipolar model that we built to explain the scalp SEP distribution to median nerve stimulation in previous investigations. Cortical SEPs after proximal stimulation were generated by three dipolar sources, one of which was likely to account for the frontal scalp N30. When we analyzed SEPs for distal (purely cutaneous) stimulation, the frontal and central recordings showed a clear reduction in amplitude of the negative responses having a latency of about 30 ms. Moreover, when applying the dipole model derived from analysis of responses to proximal stimulation to SEPs to distal stimulation, the source corresponding to the N30 distribution showed no activity, suggesting a strong relationship between joint and tendinous inputs and the activity of the N30 generator.

Adult↗
PubMed1984

The use of scalp hypothermia in the prevention of doxorubicin-induced hair loss.

A randomized clinical trial was performed to determine the effectiveness of scalp hypothermia in the prevention of hair loss associated with doxorubicin. Twenty-six patients were randomized to receive scalp hypothermia or chemotherapy alone. Data were analyzed on 25 patients: 12 in the treatment group and 13 in the control group. There was acceptable hair preservation in 75% of the patients who received the scalp hypothermia; only 8% of the patients in the control group had acceptable hair preservation (P = 0.0009). The data were further broken down into patients receiving low-dose doxorubicin and high-dose doxorubicin. Side effects were minimal. The results support the use of scalp hypothermia in reducing doxorubicin-induced alopecia.

Adult↗
PubMed1993

Congenital scalp defects and vitreoretinal degeneration: redefining the Knobloch syndrome.

An apparently autosomal recessive syndrome of hereditary vitreoretinal degeneration (VRD) with retinal detachment, high myopia, and congenital encephalocele was described in 1971 by Knobloch and Layer [J Pediatr Ophthalmol 8:181-184]. Clinical confirmation of the presence of encephaloceles was lacking, and no neuropathologic studies were reported. We have evaluated a similarly affected family with 2 sibs with high myopia, VRD, and occipital scalp defects. Histologic examination of the scalp defects showed heterotopic neuronal tissue in both instances. The older girl has had a unilateral retinal detachment. Her other eye and both eyes of the younger sib have so far been treated successfully with prophylactic retinal cryotherapy. Both children have normal to above normal intelligence. The family reported by Knobloch and Layer [1971] and the sibship herein described appear to represent a distinct autosomal recessive trait. Analysis of the associated defects suggests an underlying defect in early cephalic neuroectodermal morphogenesis. Data from these families imply that congenital occipital scalp defects rather than true encephaloceles may, as is true in some cases of Meckel syndrome, accompany Knobloch syndrome. The presence of a congenital midline scalp defect should alert the clinician to possible underlying central nervous system and/or ocular pathology and should lead to consideration of further diagnostic evaluations and prophylactic measures.

Child↗
PubMed1995

Subcutaneous masses of the scalp and forehead: diagnosis by fine-needle aspiration.

We report our cytologic findings and clinical correlations in benign (N = 2) and malignant (N = 16) subcutaneous masses of the scalp (N = 15) and forehead (N = 3), studied by fine-needle aspiration (FNA). Diagnoses were divided in 3 groups: (1) Scalp plasmacytoma (as a manifestation of multiple myeloma) (6 cases) was the most frequent diagnosis. In one patient it was the presenting manifestation of the disease. (2) Miscellaneous malignancies included 8 carcinomas, 1 melanoma, and 1 malignant lymphoma. The scalp or forehead mass was the initial presentation and FNA was the initial diagnostic approach in five patients. (3) A single case each of pilar-type keratinous cyst and hematoma were the only benign masses encountered. In conclusion, a significant number of subcutaneous masses of the scalp or forehead represent metastatic or systemic malignancies, and they may be the initial manifestation of the disease. Rapid and accurate diagnosis by FNA provides guidelines for appropriate therapy, especially in those patients who present with advanced disease.

Adult↗
PubMed1998

Accumulation of fluconazole in scalp hair.

The accumulation in scalp hair of the antimycotic triazole, fluconazole, was studied during and after administration. Fluconazole 50 mg was administered to 12 healthy subjects as a single capsule each day for 28 days. The concentration of fluconazole 5 hours after administration was measured in different 1-cm sections of scalp hair at intervals during treatment and for 6 months after the end of treatment. In each section of scalp hair the concentration of fluconazole increased during treatment and was consistently higher than values found in plasma. For example, the mean concentration in the first hair section on day 28, 19.8 micrograms/g, corresponded to a mean penetration ratio relative to plasma of 9.42. During administration, the maximal concentration of fluconazole was found in the first hair section. After cessation of administration, the measured concentrations of fluconazole decreased and greater concentrations were found in the distal hair sections, presumably as a result of hair growth. Fluconazole was detectable, however, in the hair of 9 of the 12 subjects even 6 months after treatment. The mean concentration of fluconazole in hair bulbs on day 28 was 12.1 micrograms/g (n = 6), corresponding to a mean penetration ratio of 5.99. In a second study, fluconazole was administered as a single oral 150-mg capsule per week for 4 weeks to a group of 8 healthy subjects. The mean fluconazole concentration in whole scalp hair 5 hours after the last dose was 3.2 micrograms/g.

Adult↗
PubMed1992

Hair growth following scalp microvascular flap transfer for baldness due to burn injury.

A female patient, 8 years of age, presented with baldness of the right scalp following deep scalds from boiling soup landing on the head, neck, and chest. The depth of the burn was severe enough to cause baldness. She was primarily advised to wear a wig to address the problem of baldness on one side. Surgery was planned to use uninjured scalp skin to offer hairy skin coverage of the bald site. A left scalp skin flap (2.5 by 7 cm) based on the superficial temporal artery and vein was transferred to the bald area, with microvascular anastomosis to the superficial temporal vessels on the right side. There was complete survival of the flap with uneventful recovery and satisfactory growth of hair. Hair growth from the flap was comparatively thicker than from the rest of the scalp. This microvascular flap has produced sufficient hair to cover the entire area of the baldness and the patient does not need to wear a wig.

Alopecia↗
PubMed2002

Modelling the response of scalp sensory receptors to transcranial electrical stimulation.

Transcranial electrical stimulation of the brain causes considerable discomfort to the patient. The purpose of the study was to find out whether this could be affected by the choice of stimulation parameters. A spherical volume conductor model of the head and active compartmental models of a pyramidal motor nerve and scalp nociceptor were used in combination to simulate the scalp nociception to transcranial electrical stimulation. Scalp nociceptors were excited at distances of several centimetres from the electrodes. The size of the excited scalp area correlated with the length of the stimulation pulse. The area was 12.3, 20.4 and 26.0 cm2, for a 10 micros, 100 micros and 1 ms constant current pulse, respectively. With a 100 micros constant current pulse, the threshold for motor excitation was 205mA and, for nociception, it was 51 mA. There was no significant difference between constant current and capacitor discharge pulses or between electrodes of different sizes. The results imply that the use of very short stimulation pulses can reduce the pain. If a topical anaesthesia is used to reduce the pain, it has to be applied on a large area around the electrodes.

Computer Simulation↗
PubMed2005

Resistor mesh model of a spherical head: part 1: applications to scalp potential interpolation.

A resistor mesh model (RMM) has been implemented to describe the electrical properties of the head and the configuration of the intracerebral current sources by simulation of forward and inverse problems in electroencephalogram/event related potential (EEG/ERP) studies. For this study, the RMM representing the three basic tissues of the human head (brain, skull and scalp) was superimposed on a spherical volume mimicking the head volume: it included 43 102 resistances and 14 123 nodes. The validation was performed with reference to the analytical model by consideration of a set of four dipoles close to the cortex. Using the RMM and the chosen dipoles, four distinct families of interpolation technique (nearest neighbour, polynomial, splines and lead fields) were tested and compared so that the scalp potentials could be recovered from the electrode potentials. The 3D spline interpolation and the inverse forward technique (IFT) gave the best results. The IFT is very easy to use when the lead-field matrix between scalp electrodes and cortex nodes has been calculated. By simple application of the Moore-Penrose pseudo inverse matrix to the electrode cap potentials, a set of current sources on the cortex is obtained. Then, the forward problem using these cortex sources renders all the scalp potentials.

Brain↗
PubMed2000

[Soft tissue reconstruction after scalping injury caused by a dog bite].

The reconstruction of soft-tissue damage on the part of the head which is covered with hair is aimed not only at repairing the damage in such a way that it will withstand mechanical strain but also at the restoring the hair on the scalp. In a 5-year-old boy with a scalping injury involving second- and third-degree soft-tissue damage over an area of 20 x 12 cm after a dog bite, surgery was initially performed to transform the damage into purely second-degree damage, which was then repaired with a split skin graft. One year later, the scalp containing the hair was stretched with the aid of two skin expanders over a period of 3 months, so that the split skin graft area could be removed and the hair on the scalp restored.

Animals↗
PubMed2005

The timing and intensity of transcranial magnetic stimulation, and the scalp site stimulated, as variables influencing motor sequence performance in healthy subjects.

OBJECTIVE: The increasing therapeutic use of transcranial magnetic stimulation (TMS) in disorders of cortical excitability raises the need for reliable stimulus variables. Stimulation of cortical motor areas influences motor programming and execution. We investigated the effects of TMS delivered over various cortical motor areas during the reaction time (RT) on the execution of sequential rapid arm movements in healthy subjects. METHODS: Subjects performed a five-submovement (S1-S5) motor sequence mainly involving upper limb proximal muscles. RT and movement time (MT) were measured. We delivered late (close to movement onset) and early (close to the go signal) TMS over the primary motor area (M1-FDI hot-spot for the first dorsal interosseus, M1-D hot-spot for the deltoid muscle), the premotor (PM) area, and the supplementary motor area (SMA), using subthreshold and suprathreshold intensity, single and triple pulses. RESULTS: The motor sequence showed a characteristic pattern of submovement duration, S2-S3-S4 being faster than S1 and S5. Late TMS prolonged RT only when high-intensity pulses were delivered over M1-FDI. Single- and triple-pulse TMS over M1-D or M1-FDI significantly prolonged MT with a dose-related effect. Suprathreshold triple-pulse TMS over the PM-but not over the SMA-also lengthened the MT but did not change RT. Early triple-pulse TMS reduced the RT independently from the stimulus intensity and scalp site. SMA and PM-but not M1-D-stimulation also reduced the MT. Single-pulse TMS over the SMA, despite being delivered through a double-cone coil, did not change RT or MT. CONCLUSIONS: TMS-induced changes in the kinematics of a sequential arm movement depend closely on the timing of TMS interference, the scalp site stimulated, and the intensity (and number) of stimuli delivered. Late TMS interference inhibits, whereas early interference facilitates, motor performance. The cortical motor region most sensitive to TMS-induced inhibition is that below the scalp site for M1-FDI. In contrast, TMS-induced facilitation has no strict topographic organization. Particularly for MT (although inhibitory and facilitatory effects both depend on stimulation at high intensities) intensity is less crucial than timing of interference and scalp site.

Adult↗
PubMed2006

Aplasia cutis congenita of the scalp: is there a better treatment strategy?

BACKGROUND: Aplasia cutis congenita (ACC) is a rare disease of unknown etiology, involving any site of the body. The scalp is the most frequent location, followed by the forearms, knees, both sides of the trunk, and neck, in decreasing order of frequency. Superficial lesions may heal spontaneously and seldom result in morbidity or mortality. However, in patients with large scalp and skull defects, there are risks of infection and bleeding. Conservative treatment has been described and advocated, but some authors have highlighted the disadvantages of this treatment modality. On the other hand, several authors claim that aggressive surgical treatment has an important role for large defects. MATERIALS AND METHODS: In this paper, we report three newborns with ACC of the scalp, two large defects and a medium one, respectively, treated conservatively and surgically. CONCLUSION: The management of ACC of the scalp is still controversial. Our series suggests that conservative treatment should be performed for initial management in newborns.

Abnormalities, Multiple↗