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At least 973 records · Page 54Linked to original sources

Epidermoid cyst of the scalp containing human papillomavirus.

We report an epidermoid cyst of the scalp with light microscopic and immunohistochemical evidence of human papillomavirus (HPV) infection. Light microscopic features suggesting HPV infection included papillomatosis and hypergranulosis of the cyst lining with the presence of koilocytes. Much of the keratin within the cyst demonstrated parakeratosis. Immunoperoxidase labeling for HPV antigen was noted within koilocytes. Papillomavirus infection has been reported in plantar epidermoid cysts. To our knowledge, this is the first report of a papillomavirus-infected epidermoid cyst in a site other than plantar skin. Light microscopic features of our cases differed from those of the plantar cysts. Epidermoid cysts may be induced by the papillomavirus or the virus may merely infect pre-existing cysts.

Adult↗

Malignant melanoma arising in a blue nevus with features of pilar neurocristic hamartoma.

A 65-year-old man presented with a history of a giant blue plaque of the parietal scalp since childhood. Biopsy revealed a cellular blue nevus. The blue nevus was observed for 10 years and thought to be unchanged until a new adjacent lesion was noted. Biopsy of the new lesion revealed metastatic malignant melanoma. A wide excision was performed of the original lesion which revealed malignant melanoma arising in a blue nevus. Areas within the blue nevus were consistent with a pilar neurocristic hamartoma, whereas other areas were consistent with a common blue nevus. Subsequent satellite metastases developed, with early metastases resembling blue nevi except for the absence of a stromal component and the presence of hyperchromatic nuclei. Later metastases were typical of metastatic melanoma. This case illustrates the uncommon evolution of malignant melanoma from a blue nevus. The histological features and relationship between melanoma, blue nevus, and pilar neurocristic hamartoma are reviewed.

Aged↗

Folliculotropic mycosis fungoides with large-cell transformation presenting as dissecting cellulitis of the scalp.

Follicular mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma (CTCL) in which malignant lymphocytes preferentially infiltrate hair follicles. This report describes a patient with follicular mycosis fungoides presenting in a manner similar to dissecting cellulitis of the scalp with nonhealing, draining nodular lesions. Follicular mucinosis associated with folliculotropic mycosis fungoides resulted in follicular disruption and deep dissecting cellulitis. Large-cell transformation of CTCL was present in the initial diagnostic scalp and axillary lymph node specimens. The patient died from progressive CTCL 9 months following initial diagnosis despite electron beam radiation, topical mechlorethamine, interferon-alpha, and systemic chemotherapy. This case indicates that large-cell transformation of folliculotropic mycosis fungoides is an aggressive form of CTCL, and that folliculotropic mycosis fungoides can give rise to lesions which resemble dissecting cellulitis of the scalp. Upregulation of intercellular adhesion molecule-1 (ICAM-1) on follicular epithelium adjacent to lymphocyte function-associated antigen-1 (LFA-1)-positive folliculotropic lymphoma cells in this report provides insight into lymphocyte homing mechanisms in folliculotropic MF.

Adult↗

Effective treatment of scalp psoriasis using the excimer (308 nm) laser.

BACKGROUND: Psoriasis of the scalp can be a major therapeutic challenge as response to topical medication is often inadequate. The excimer laser has potential for providing local phototherapy as its high irradiance makes treatment at this site a practical option. OBJECTIVES: To analyze retrospectively results of treating scalp psoriasis with the excimer (308 nm) laser. METHODS: Thirty-five patients were treated and all had failed intensive topical therapy. Manual separation of hair was used to provide access to the treatment site. Starting doses ranged from 300 mJ/cm(2) (type I) to 1000 mJ/cm(2) (type IV) with treatment twice weekly. RESULTS: All patients improved. Seventeen/35 (49%) of patients cleared>95% (mean: 21 treatments; range: 6-52) and 16/35 (45%) cleared 50-95%. Phototoxicity in the form of erythema and blistering occurred in all patients, particularly around the ears and nape of neck. CONCLUSION: The excimer laser is a successful approach to treatment of psoriasis of the scalp being a simple treatment that can be performed in a short period of time and which has a high rate of effectiveness.

Adolescent↗

Aplasia cutis congenita of the scalp: how much therapy is necessary in large defects?

AIM: To show that local antibiotic management and a regular inspection of aplasia cutis congenita of the skull can give an excellent result. METHOD: This case reports a girl born with aplasia cutis congenita of the skull presenting with a large aplasia of the epidermis, dermis, subcutaneous tissue and galea, including a bone defect without any additional risk factor, e.g. early eschar formation, cerebrospinal fluid leakage or uncommon dural blood vessels. RESULTS: A primarily conservative treatment with local wet and antibiotic dressings together with a systemic antibiotic treatment for the first 2 wk led to an excellent result and thus prevented untimely operative and peri-operative procedures. CONCLUSIONS: Here we have shown that conservative treatment might be an option, even if the wound diameter is greater than 1 cm(2), to prevent infants from any untimely operative procedure with an elevated operative risk if any additional risk factors are excluded.

Anti-Bacterial Agents↗

The School Health Innovative Programs: integrating school health and managed care in San Diego.

Managed care organizations (MCOs) are being recruited to support school health services delivered in school clinics. Schools without clinics already provide numerous health services and could provide more if they had support from managed care organizations. This article describes the first two years of a San Diego-based collaborative consisting of MCOs, school districts, and other health care agencies. By establishing trust, developing overriding principles, and creating an interagency communication infrastructure, this collaborative has encouraged shared management of many student health issues. Because the agreements apply to all schools, programs can reduce high rates of absenteeism district-wide and avoid unnecessary doctor appointments for common health problems. These collaborative agreements are designed to be financially self-sustaining. However, data collection, the logistics of obtaining parental consent, and getting health professionals to communicate with each other in new ways remain to be significant challenges.

Adolescent↗

From eradication to resistance: five continuing concerns about pediculosis.

A school nurse, serving in the capacity of infection control officer, is responsible for managing head lice infestations. The nurse's concerns on the student and parent levels include dispelling misconceptions about lice, screening, motivating correct treatment, and providing follow-up. The nurse's responsibility to the community as a whole also involves putting into practice policies that prevent the spread of infestations without promoting pediculicide resistance.

Adolescent↗

School nurses' perceptions of and experiences with head lice.

Researchers examined school nurses' perceptions of head lice, perceived self-efficacy in dealing with head lice, and personal experience in reducing head lice problems. Survey data from a two-wave mailing from 382 school nurses found most nurses supported a "no-nit" rule of forced absenteeism of any child with nits in their hair (60%). They perceived OTC treatments for head lice as very effective in killing adult lice (66%), and 9% perceived them as not effective. Nurses had a high efficacy expectation regarding their ability to control head lice (63%), and they had high outcome expectations regarding the results of their work with students and families of students (66%). Most nurses received their information about head lice from professional journals (76%) and professional conferences/conventions (62%).

Adult↗

Pemphigus vulgaris--the potential for error: a case report.

The importance of correlation, referral, and collaboration between dermatology, or any other medical department, and the oral health profession is reported through a case presentation. A case of pemphigus vulgaris diagnosed from a tongue biopsy and confirmed by immunofluorescence is reported. The patient was treated for actinic keratosis of the scalp for 16 months due to inadequate biopsy material. The diagnostic value of proper biopsy material is stressed. The clinical manifestations leading to a misdiagnosis between actinic keratosis and pemphigus vulgaris are discussed.

Biopsy↗

Isolation of llama antibody fragments for prevention of dandruff by phage display in shampoo.

As part of research exploring the feasibility of using antibody fragments to inhibit the growth of organisms implicated in dandruff, we isolated antibody fragments that bind to a cell surface protein of Malassezia furfur in the presence of shampoo. We found that phage display of llama single-domain antibody fragments (VHHs) can be extended to very harsh conditions, such as the presence of shampoo containing nonionic and anionic surfactants. We selected several VHHs that bind to the cell wall protein Malf1 of M. furfur, a fungus implicated in causing dandruff. In addition to high stability in the presence of shampoo, these VHHs are also stable under other denaturing conditions, such as high urea concentrations. Many of the stable VHHs were found to contain arginine at position 44. Replacement of the native amino acid at position 44 with arginine in the most stable VHH that lacked this arginine resulted in a dramatic further increase in the stability. The combination of the unique properties of VHHs together with applied phage display and protein engineering is a powerful method for obtaining highly stable VHHs that can be used in a wide range of applications.

Amino Acid Sequence↗

Fast, noninvasive method for molecular detection and differentiation of Malassezia yeast species on human skin and application of the method to dandruff microbiology.

Malassezia fungi have been the suspected cause of dandruff for more than a century. Previously referred to as Pityrosporum ovale, Pityrosporum orbiculare, or Malassezia, these fungi are now known to consist of at least seven Malassezia species. Each species has a specific ecological niche, as well as specific biochemical and genetic characteristics. Malassezia yeasts have fastidious culture conditions and exceedingly different growth rates. Therefore, the results of surveys of Malassezia based on culture methods can be difficult to interpret. We developed a molecular technique, terminal fragment length polymorphism analysis, to more accurately survey the ecology of Malassezia yeasts without bias from culture. This technique involves fluorescent nested PCR of the intergenic transcribed spacer (ITS) ITS I and ITS II region ribosomal gene clusters. All known Malassezia species can be differentiated by unique ITS fragment lengths. We have used this technique to directly analyze scalp samples from subjects enrolled in a demographic scalp health study. Results for subjects assigned composite adherent scalp flaking scores (ASFS) <10 were compared to those for subjects assigned composite ASFS >24. Malassezia restricta and M. globosa were found to be the predominant Malassezia species present in both groups. Importantly, we found no evidence of M. furfur in either group, indicating that M. furfur can be eliminated as the causal organism for dandruff. Both groups also showed the presence of non-Malassezia fungi. This method, particularly when it is used in combination with existing fungal ITS databases, is expected to be useful in the diagnosis of multiple other fungal infections.

DNA, Fungal↗

Surveillance of insecticide resistance in head lice using biochemical and molecular methods.

Treatment of head louse infection is primarily through topical insecticides. However, there is growing evidence of resistance. A representative population sample was tested using biochemical and molecular methods; it was shown that, in Wales, treatments containing pyrethroids are likely to be less effective in controlling head louse infection than those containing organophosphates.

Animals↗

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↗