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Cutaneous angiosarcoma in a site of healed herpes zoster.

A 57-year-old woman presented with an erythematous plaque of the left postauricular area that was diagnosed as metastatic carcinoma on clinical and histologic bases. It was revealed that herpes zoster had been diagnosed in the same dermatomal distribution 10 years previously. The lesion recurred 2 years after irradiation, and angiosarcoma was diagnosed. Recent evidence linking viral infection and vascular tumors is examined as it might apply to the pathogenesis of angiosarcoma. Repeat biopsy, reticulum stain, and electronmicroscopic examination of a lesion of the head and neck region that histologically suggests metastatic carcinoma are recommended if no primary malignancy is discovered.

Craniocerebral Trauma↗

Acne keloidalis-like lesions on the scalp associated with antiepileptic drugs.

A man developed acne keloidalis-like lesions in the scalp during treatment with diphenylhydantoin and carbamazepine for epilepsy. These drugs were suspected to play a role in the pathogenesis of this skin disease in an unusual location, based on clinical evidence and on the in vitro test, mast cell degranulation (MCD).

Acne Keloid↗

Botryomycosis. Some African cases.

Botryomycosis is a rare and chronic but readily treatable form of mycetoma. It is caused by a persistent bacterial infection and is distinguished by the formation of grains and multiple sinuses in the skin. The most usual cause is caused by Staphylococcus aureus. The authors' experience with four Transvaal cases is reported. In one case there was destruction of the skull and penetration of the cranial cavity by the botryomycotic process. Treatment with a range of common antistaphylococcal antibiotics led to astonishingly rapid recovery. Among the drugs used, cotrimoxazole was, perhaps, the most practical.

Adult↗

Cutis verticis gyrata.

When the scalp exhibits folds and furrows resembling gyri, it is termed cutis verticis gyrata. The possible etiologies may be categorized as primary essential, primary nonessential, and secondary cutis verticis gyrata. This is based on history, physical examination, and histologic criteria with or without laboratory examinations.

Adult↗

Clinical and laboratory evaluation of AIDS trichopathy.

BACKGROUND: The present study reports the incidence of trichocutaneous disorders studied in 500 patients infected with HIV 1 in a large university-based setting. Correlation of these findings with immunologic function at the time of diagnosis is presented. Unusual presentations and therapeutic interventions are discussed. Prognosis as related to various trichocutaneous disorders is elaborated. METHODS: All patients in this study were HIV 1 positive by Western blot assay. T-cell subsets were evaluated by monoclonal antibodies against T-cell surface markers. Hair disorders were analyzed by means of light hair pull test, hair mount, polarizing microscopy, trichogram, scalp biopsy, and cultures for bacteria, fungi, and mycobacteria as indicated. Trichologic manifestations were classified based upon immunologic correlation of absolute level of helper T cells/mm3. RESULTS: The majority of hair disorders in the study population occurred with helper T cell numbers of less than 150/mm3. Papulosquamous problems including seborrheic dermatitis and psoriasis were most commonly noted followed by disorders of cell growth cycle regulation and trichokeratinization, i.e., telogen effluvium and loose anagen syndrome. CONCLUSIONS: Multiple trichocutaneous disorders occur in the setting of retroviral infection. Most of these disorders occur in the setting of progressive immunoincompetence. The awareness of the disorders described here will aid the clinician in both the recognition and management of pilar aberrations in the appropriate clinical setting.

Acquired Immunodeficiency Syndrome↗

Clinical, biochemical and morphologic features of acne keloidalis in a black population.

BACKGROUND: Acne keloidalis (AK) is an important cause of morbidity in Nigeria and accounts for 1.3% of patients with skin conditions in a Nigerian dermatology clinic. Treatment is usually unsatisfactory because the etiopathogenesis is unclear. METHODS: A prospective clinico-pathological study was carried out to identify predisposing factors, viable treatment modalities, and prognostic indicators. RESULTS: The study suggested that AK is associated with the male gender seborrheic constitution, early reproductive years, and increased fasting blood testosterone concentration. Features that may predispose to the vastly predominant occipital location of the lesions include increased mast cell density and dilatation of dermal capillaries. MANAGEMENT: The main aims are diagnosis of early papules and avoidance of physical and chemical traumatizing agents. Retinoic acid analogs and antiandrogens may be helpful. CONCLUSIONS: The widespread use of irritating physical and chemical traditional treatment remedies and delay in seeking medical attention--AK is typically asymptomatic--contribute to the relatively advanced nature of the disease at the time of presentation to the specialist.

Acne Keloid↗

Use of topical minoxidil therapy for androgenetic alopecia in women.

BACKGROUND: Androgenetic alopecia is the most common cause of hair loss in men and women. Androgenetic alopecia in women begins as a diffuse and progressive thinning of the frontoparietal area of the scalp. In women, hair loss at any age is socially unacceptable and may be the basis of psychiatric illness. METHODS: A 32-week, double-blind, placebo-controlled trial was conducted in 10 European centers to assess the efficacy and safety of 2% topical minoxidil solution for the treatment of androgenetic alopecia in women. Two hundred ninety-four of the 346 women enrolled (85%) completed the 32-week trial. Photographic and computer imaging techniques were used at each visit to determine objectively the number of nonvellus hairs present in a 1-cm2 area selected as the target evaluation site. RESULTS: In the 2% minoxidil group, the mean increase in nonvellus hair count was 33 hairs, which was significantly greater than that of 19 hairs in the placebo group (P = 0.0001). The investigators observed that 44% of the patients in the 2% minoxidil group achieved new hair growth compared with 29% in the placebo group. When asked to evaluate their own hair growth, 55% of the women in the 2% minoxidil group compared to 41% of the women in the placebo group believed that they had achieved new hair growth. No clinically significant changes in vital signs were observed during the study and no serious or unexpected medical events were reported. CONCLUSION: Topical minoxidil solution was significantly more effective than placebo in the treatment of androgenetic alopecia in women.

Administration, Cutaneous↗