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PubMed2001

Hair and scalp mycobiota in school children in Nablus area.

Hair and scalp mycobiota of 1389 clinically normal children aged 6-12 years attending 12 schools in the Nablus District, Palestinian Authority, was assessed on three occasions over 8-month period (October 1998-May 1999) using the hair brush technique. One hundred and one fungal species belonging to 33 genera were recovered: 6 dermatophytes, 16 dermatophyte-like keratinophilic fungi, and 79 other keratinophilic fungal species. Species varied considerably in their frequency of occurrence and abundance based on their relative importance values (RIVs). The most frequent and abundant species were: Cladosporium cladosporioides, Cl. herbarum, Penicillium chrysogenum and Aspergillus flavus, Microsporum canis, Aphanoascus fulvescence and Chrysosporum sulfureum were the most frequent and abundant species of all dermatophytes and dermatophyte-like keratinophilic fungi recovered. The most frequent and abundant dermatophytes in different communities were M. canis in rural (RIV 0.87) and urban children (0.45), and Trichophyton violaceum (1.41) in refugee camp children. Chrysosporium species were the most frequent and abundant dermatophyte-like keratinophilic fungus in children from all localities followed by Aphanoascus fulvescence. Comparable results on the frequency and abundance of human hair and scalp mycobiota component fungi were obtained based on age group and sex of children. Higher number of species was recovered in spring months (73 species) than in autumn (57) and winter (44) months. Similar occurrence pattern was also noted for dermatophyte-like keratinophilic species and dermatophytes. Higher percentages of children with moderate (11-50) and heavy (< or = 50) spore loads (7.54 and 0.73, respectively) were found in urban school children community than in rural and refugee camp school children (4.7 and 0.1, respectively). Also significantly higher light (1-10) spore load percentages were found in rural (63.67) and refugee camp (62.9) than in urban children (52.6). Of all localities, school children with light spore load comprised the highest percentage of the children examined (37.4), followed by moderate (6.13), and heavy (0.41) spore load categories. However, children with undetected spore load comprised 36.05% of all children. Spore load distribution did not show clear seasonal variations in the study period. Higher percentages of moderate and heavy spore loads were found in male children (8.72 and 0.69, respectively) than in female children (3.4 and 0.1, respectively). However, higher percentages of undetected (38.3) or light spore loads (58.4) were found in females than in males (34.04 and 56.53, respectively).

Age Factors↗
PubMed2001

A unique area of the homonculus: the topography of the primary somatosensory cortex in humans following posterior scalp and shoulder stimulation.

We recorded somatosensory evoked magnetic field (SEF) to investigate the differentiation in the receptive area for the face, lower part of the posterior scalp (mastoid) and shoulder, which occupy an unique area in the homunculus. We analyzed the location of the equivalent current dipole (ECD) of SEF following electrical stimulation of the skin at the face, mastoid and shoulder in 20 normal subjects. Three deflections (1M, 2M and 3M) were obtained within 50 ms of the stimulation in 16 of 20 subjects. The peak latency of the 1M and 2M was not significantly different at any stimulus sites. The amplitude of the 1M was significantly larger following the face than mastoid stimulation (p<0.05). The 16 subjects were classified according to the locations of the ECD on stimulation of the mastoid: close to that for shoulder stimulation, but significantly (p<0.05) more superior and medial to that following the face stimulation (Type 1, eleven subjects); close to that for face stimulation, but significantly (P<0.05) more inferior and lateral to that following the shoulder stimulation (Type 2, five subjects). The site of the receptive area for the posterior scalp shows interindividual variation, possibly due to anatomical differences.

Adult↗
PubMed2002

Trace metal concentration in scalp hair of occupationally exposed autodrivers.

The concentrations of Cr, Pb, Zn, Cu, Ni and Cd were analyzed by Atomic Absorption Spectrophotometer in the scalp hair of professional male autodrivers who are occupationally exposed to the vehicular/industrial pollutants in the industrial city of Coimbatore, Tamil Nadu. The unwashed hair samples when compared with the washed hair showed a significantly higher levels of Cr, Zn and Pb. The correlation coefficient showed a strong mutual dependence on the scalp hair of the exposed individuals and no correlation was found among the trace metals except for Ni-Pb and Ni-Cd. The results in general showed a positive exogenous contribution of all the analyzed industrial trace metals. The drivers who are occupationally exposed to vehicular/industrial pollution are at risk.

Adult↗
PubMed2003

Hypotrichosis simplex of the scalp is associated with nonsense mutations in CDSN encoding corneodesmosin.

We have identified nonsense mutations in the gene CDSN (encoding corneodesmosin) in three families suffering from hypotrichosis simplex of the scalp (HSS; OMIM 146520). CDSN, a glycoprotein expressed in the epidermis and inner root sheath (IRS) of hair follicles, is a keratinocyte adhesion molecule. Truncated CDSN aggregates were detected in the superficial dermis and at the periphery of hair follicles. Our findings suggest that CDSN is important in normal scalp hair physiology.

Base Sequence↗
PubMed1999

Peribulbar innervation and substance P expression following nonpermanent injury to the human scalp hair follicle.

The hair pluck procedure alters the anatomy of the anagen hair bulb. Hemorrhage can occur in the mesenchymal sheath and breaks at the proximal epithelium, above or around the upper third of the dermal papilla, have been reported. We hypothesized that innervation, as identified with protein gene product 9.5 (PGP 9.5), and expression of the neuropeptide Substance P (SP) within the dermal papilla would also be altered following plucking. We focused on studying SP as this neuropeptide has been associated with several cellular responses, including anagen hair growth in the C57BL/6 mouse model. Four millimeter punch biopsies were obtained from the occipital scalp of two healthy adults. Hair was then plucked and additional biopsies were obtained immediately, and at 1 d, 1 wk, and 1 mo after plucking. Each set was processed for immunohistochemical analyses and in-focus optical sections of the dermal papilla were captured by laser scanning confocal microscopy and later reconstructed into single images. Following injury, SP was expressed in a disorganized pattern below the dermal papilla. There was also a significant reduction in labeled neuronal cells, and SP expression was enhanced within peribulbar blood vessels at 1 d and 1 wk. By 1 mo, peribulbar nerves, vessels, and SP expression were similar to baseline observations. It remains to be ascertained whether PGP 9.5, also known as unbiquitin hydrolase, and SP are involved in the proliferation of new matrix cells in the human scalp hair follicle following injury.

Adult↗
PubMed2001

Topical 5-aminolaevulinic acid photodynamic therapy for extensive scalp actinic keratoses.

Scalp actinic keratoses (AKs) are common, particularly in elderly bald males. Cryotherapy and 5-fluorouracil are effective for localized AKs but are limited in extensive disease. Topical 5-aminolaevulinic acid photodynamic therapy (5-ALA PDT) is an alternative. We treated four patients with extensive scalp AKs with low light dose, low dose-rate topical 5-ALA PDT using a broad-spectrum visible light source. Three patients cleared and one showed significant improvement. Remission lasted 6 months.

Aged↗
PubMed2002

Arrector pili muscle: evidence of proximal attachment variant in terminal follicles of the scalp.

BACKGROUND: There is general agreement that the proximal attachment site of the arrector pili (AP) muscle, via elastic tendons, is the bulge region, where follicular stem cells are situated. A variant of this insertion, in which the AP muscle surrounds the follicle circumference, has been described in human facial vellus hair follicles. OBJECTIVES: To investigate whether terminal hair follicles of the human scalp may also present this variant of proximal insertion of the AP muscle. METHODS: Histological and immunohistochemical methods were used. RESULTS: At the bulge level, bundles of the AP muscle were seen to encircle the entire hair follicle. CONCLUSIONS: Terminal follicles of the human scalp may also present this variant of proximal insertion of the AP muscle.

Hair Follicle↗
PubMed2002

Complete remission of a radio-resistant cutaneous angiosarcoma of the scalp by systemic treatment with liposomal doxorubicin.

We report an 80-year-old man suffering from an angiosarcoma of the scalp. Because of the wide extent of the lesions, surgery was not performed. Instead, the patient was treated with electron-beam radiation. Later, the patient failed to benefit from radiotherapy demonstrated by a local relapse and new malignant lesions. Additionally, a cervical lymph node metastasis appeared for the first time. Subsequently, we successfully administered liposomal doxorubicin (Caelyx(R)). Shortly after administration of two cycles the scalp angiosarcoma showed a clear regression. Following six cycles, the patient clinically showed a complete remission of all skin lesions and the cervical lymph node; metastasis was confirmed by histology and fine needle aspiration, respectively. Liposomal and pegylated doxorubicin, a cytostatic drug belonging to the anthracyclines, has already shown to be effective and mostly well tolerated in the therapy of acquired immune deficiency syndrome-related Kaposi's sarcoma and very recently in cutaneous T-cell lymphoma, too. Caelyx(R) appears to be a promising alternative to conventional treatment of cutaneous angiosarcoma.

Aged↗
PubMed2001

Treatment of multiple scalp basal cell carcinomas by photodynamic therapy.

The use of surface protoporphyrin IX fluorescence detection to delineate multiple superficial basal cell carcinomas on a patient's scalp is described. Photodynamic therapy (PDT) was subsequently performed with clearance of six and partial clearance of the remaining two tumours. The treated lesions have not recurred during 12 months of follow-up. The opportunity to combine diagnostic fluorescence detection with subsequent treatment by PDT offers an effective and practical management option. PDT is a tissue-sparing modality with low morbidity and good cosmesis, leading us to propose 5-aminolaevulinic acid-PDT for multiple superficial basal cell carcinomas of the scalp.

Aged↗
PubMed2003

Cutaneous metastasis to the scalp from squamous cell carcinoma of the cervix.

Carcinoma of the cervix is a common neoplasm. Early detection and improved treatment techniques have resulted in better control of cancer and longer survival, however, invasive and metastatic disease still occur. Cervical cancer usually spreads through direct local extension and via the lymphatics, haematogenous metastasis is relatively infrequent and cutaneous metastases are very rare. Metastasis to the scalp is extremely rare and only three cases of scalp metastasis from cervical cancer have been reported in the literature. We now report a patient with cervical cancer who presented with metastasis to this very unusual site.

Carcinoma, Squamous Cell↗
PubMed2003

Giant lichenification of the scalp.

Lichenification is characterized clinically by thickening of areas of skin as a result of the itch-scratch cycle and therefore is seen in conditions associated with chronic pruritus. The characteristic feature of giant lichenification is the occurrence of tumour-like growths with a warty cribriform surface. We describe a renal transplant patient presenting with giant lichenification of the scalp following an attack of herpes zoster at the same site. Chronic pruritus following scalp dysaethesia secondary to herpes zoster was considered the most likely explanation for the occurrence of these lesions.

Adult↗
PubMed2003

Scalp necrosis in temporal arteritis.

Giant cell arteritis is a systemic disease of the elderly which affects large and medium-sized arteries and which may occur in association with polymyalgia rheumatica. Scalp necrosis is a rare cutaneous complication of giant cell arteritis, and this dermatological presentation is not commonly reported.1-4 Giant cell arteritis should be considered in all elderly patients with scalp ulceration. We describe two patients who presented in this manner.

Aged↗
PubMed2003

Ciclopirox gel for seborrheic dermatitis of the scalp.

BACKGROUND: Seborrheic dermatitis is a common inflammatory skin disorder that usually occurs in patients with pre-existing seborrhea. The etiology of seborrheic dermatitis is uncertain. Typically, sites dense with sebaceous glands support growth of the lipophilic yeast Malassezia furfur. Ciclopirox (Loprox) gel is a hydroxypyridone, broad-spectrum antifungal agent proven effective against the yeast M. furfur. OBJECTIVE: A multicenter, randomized, double-blind, vehicle controlled study of 178 subjects evaluated the efficacy of ciclopirox gel in treating seborrheic dermatitis of the scalp. METHODS: One hundred and seventy-eight subjects were randomized to apply either ciclopirox gel 0.77% twice daily, or vehicle twice daily for 28 days. Subjects' signs and symptoms of severity (erythema, scaling, pruritus and burning) were rated on a scale of 0-3 (none to severe); for inclusion, a minimum score of 4, for the sum of the individual ratings was required. Efficacy evaluations were performed at baseline, days 4, 8, 15, 22, 29, and at end-point (final visit, up to day 33). The primary efficacy variable was clinical response assessed by a global improvement, based on a scale of 0-5 (100% clearance to flare of treatment area). Changes in signs/symptoms severity scores within the target lesion were also evaluated. RESULTS: Global evaluation scores demonstrated that significantly more ciclopirox-treated subjects achieved over 75% improvement compared with vehicle at days 22, 29, and endpoint (P < 0.01). Change-from-baseline mean score for total signs and symptoms was significantly greater in ciclopirox subjects compared with vehicle subjects at the same time points as above (P < 0.001), as well as day 15 (P < 0.01). Twenty-nine percent of subjects rated ciclopirox as having excellent cosmetic acceptability. There were only mild adverse events, with the most common being burning sensation in 13% of ciclopirox subjects and 9% of vehicle subjects. CONCLUSION: Ciclopirox gel is effective and safe in the treatment of seborrheic dermatitis of the scalp.

Administration, Topical↗
PubMed2003

Cutaneous angiosarcoma of the face and scalp presenting as alopecia.

An 83-year-old woman presented with a 6-month history of hair loss and painless bruising involving her forehead and scalp. She was otherwise well. Skin biopsy of her scalp confirmed angiosarcoma with a significant increase in miniaturized and telogen hair follicles and some tumour-associated scarring hair loss. She was commenced on the chemotherapeutic agent paclitaxel and then subsequently the semi-synthetic taxane docetaxol. Treatment was terminated because of lack of response and adverse effects. Alopecia is an uncommon presentation in angiosarcoma and in this case there was a mixed pattern of focal scarring and follicular miniaturization. The latter was present only in areas of tumour involvement and not in a typical pattern distribution for androgenetic alopecia. The direct role of tumour in follicular miniaturization and alopecia is speculated and the implications of this for novel future treatment strategies is discussed.

Aged↗
PubMed2002

Motion sickness and migraine: optokinetic stimulation increases scalp tenderness, pain sensitivity in the fingers and photophobia.

The aim of this study was to determine whether scalp tenderness and photophobia, two well-recognized symptoms of migraine, develop during the motion sickness induced by optokinetic stimulation. To investigate whether motion sickness has a general influence on pain perception, pain was also assessed in the fingertips. After optokinetic stimulation, nausea increased more and headache persisted longer in 21 migraine sufferers than in 15 non-headache controls. Scalp tenderness increased during optokinetic stimulation in nauseated subjects, and pain in the fingertips increased more and photophobia persisted longer in migraine sufferers than controls. These findings suggest that the disturbance responsible for nausea also sensitizes trigeminal nociceptive neurones or releases inhibitory controls on their discharge. A low nausea threshold and a propensity for sensitization to develop rapidly in nociceptive pathways may increase susceptibility to migraine.

Adult↗
PubMed1999

Spindle cell lipoma of the scalp: a case report and review.

Cutaneous surgeons frequently evaluate and manage soft tissue tumors arising on the head and neck of adults. Of these, the most common tumor is the lipoma, and specific mesenchymal variants of lipoma occur classically on the head and neck. We describe a case of a large spindle cell lipoma of the posterior scalp, in order to highlight the classic location and differential diagnosis of the lipoma variants presenting commonly in this anatomic region. In addition, we review the role of preoperative imaging studies of scalp soft tissue tumors and discuss how imaging may assist the dermatologic surgeon in establishing the diagnosis and designing a rational surgical approach.

Diagnosis, Differential↗
PubMed1999

Scalp extension--a quantitative study.

The authors have compared the results of scalp reductions with extenders with their earlier results of scalp reductions without extenders. The extenders seem to prevent "stretch-back" and provide 30 to 86% more effectiveness when a second reduction is performed 4 weeks later.

Alopecia↗
PubMed2001

Renal cell carcinoma metastatic to the scalp: case report and review of the literature.

BACKGROUND: Renal cell carcinoma metastatic to the skin is rare. OBJECTIVE: To illustrate by a case report the clinical presentation and management of the disease. METHODS: We present a case of renal carcinoma metastatic to the skin of the scalp that occurred 6 years after removal of her kidney. The tumor was diagnosed using frozen tissue and paraffin sections. RESULTS: Cutaneous metastasis treated by excision. CONCLUSION: Renal cell carcinoma may metastasize to the skin of the scalp. Our case illustrated an interesting ipsilateral metastasis that occurred 6 years after treatment of her primary tumor. Physicians, dermatologists, pathologists, and Mohs surgeons should be aware of this entity.

Aged↗