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At least 1,045 records · Page 58Linked to original sources
PubMed2003

Is androgenetic alopecia a photoaggravated dermatosis?

Progressive thinning of the scalp hair in androgenetic alopecia (AGA) results in a gradual decline in natural protection of the scalp from ultraviolet radiation (UVR). A number of pathologic conditions of the scalp are evidently related to UVR, particularly photosensitive diseases and disorders of the chronically photodamaged bald scalp. The most important chronic effects of UVR are photocarcinogenesis and solar elastosis. Besides these, erosive pustular dermatosis and 'red scalp' are distinct disorders peculiar to the balding scalp. While the consequences of sustained UVR on the unprotected scalp are well appreciated, the effects of UVR on hair loss have widely been ignored. However, clinical observations and theoretical considerations suggest that UVR may have negative effects: acute telogen effluvium from UVR has been described, and the production of porphyrins by Propionibacterium sp. in the pilosebaceous duct, with photoactivation of porphyrins leading to oxidative tissue injury, has been implicated in follicular microinflammation. Alternatively, keratinocytes themselves may respond to physicochemical stress from UVR, besides irritants and pollutants, by producing radical oxygen species and nitric oxide and by releasing proinflammatory cytokines, eventually leading to injury of the putative site of follicular stem cells in the superficial portion of the hair follicle. Since all of these processes involved in hair loss share the common feature that they are induced or exacerbated by exposure to sunlight, it is proposed that AGA is a photoaggravated dermatosis that requires photoprotection.

Alopecia↗
PubMed2004

Familial Lassueur-Graham-Little-Piccardi syndrome.

Lassueur-Graham-Little-Piccardi syndrome (LGLPS) is a rare lichenoid dermatosis characterized by progressive cicatricial alopecia of the scalp, loss of pubic and axillary hairs and keratosis pilaris. The syndrome is considered a form of follicular lichen planus (LP). Although the familial occurrence of LP is a well-described phenomenon, no familial case of LGLPS has ever been reported. We describe the occurrence of LGLPS in a mother and her daughter. HLA typing revealed HLA-DR1 in both patients. Topical tacrolimus was of partial benefit in the daughter.

Adult↗
PubMed2005

Value of direct immunofluorescence for differential diagnosis of cicatricial alopecia.

BACKGROUND: There are diverse causes of cicatricial alopecia characterized by lack of follicular ostia and irreversible loss of hair. While clinical differentiation between the causes may be difficult, particularly with regard to lichen planus (LP), lupus erythematosus (LE) and pseudopelade of Brocq (PB), it has been suggested that both histopathologic examination and direct immunofluorescence studies (DIF) are necessary for an accurate diagnosis. OBJECTIVE: The aim of this study was to evaluate the diagnostic value of DIF studies in addition to histopathology in patients with cicatricial alopecia as a clinical feature. METHODS: 136 scalp biopsy specimens received for histopathology and DIF during a 5-year period were reviewed. RESULTS: Definitive diagnosis was achieved by careful evaluation of scalp biopsies. The most prevalent diagnoses in order of frequency were LP (26%), LE (21%) and folliculitis decalvans (20%). PB was diagnosed in 10%. In most cases, the diagnosis could be made on the basis of histopathology and independently of DIF. Characteristic DIF patterns showed high specificity, but low sensitivity for LP, and high specificity and sensitivity for LE. The DIF pattern in PB showed no difference to LP. CONCLUSIONS: Histopathology permits diagnosis in the majority of cicatricial alopecias. DIF is of value in histopathologically inconclusive cases, particularly when LE is in question.

Adult↗
PubMed2005

Erosive pustular dermatosis of the scalp: a case report and review of the literature.

Erosive pustular dermatosis of the scalp (EPDS) is a rare entity characterized by pustular, erosive and crusted lesions of the scalp with progressive scarring alopecia. The aetiology is unknown, but predisposing factors have been reported such as trauma, skin grafting, prolonged exposure to UV light of a bald scalp as well as co-existence of auto-immune diseases. Laboratory data, bacteriological and mycological investigations and histopathology are generally not diagnostic. A 45-year-old Caucasian man with 1-year-old pustular, erosive and crusted lesions on his bald scalp was seen. Laboratory data, including auto-immunity, bacteriological and mycological investigations were negative. Histopathology was not diagnostic showing a diffuse polymorphous infiltrate involving the dermis. A diagnosis of EPDS was made. The patient was treated with topical and systemic antibiotics and steroids as well as oral nimesulide with no or partial response. Consequently, isotretinoin (0.75 mg/kg/day) was started obtaining complete resolution in few months. No relapse after 1 year of follow-up was seen. EPDS represents a distinct disease with a history of relapsing and unsatisfactory response to common treatments. Systemic retinoids may be considered as a potentially resolutive choice.

Administration, Topical↗
PubMed1994

Subcutaneous palisading granuloma of the scalp in childhood.

Subcutaneous palisading granulomas, lesions characterized by collagen necrosis and chronic inflammatory changes, may present as ill-defined, immobile, nontender masses of the scalp. They are frequently multiple and may vary in size over time. Imaging studies rarely show involvement of the calvarium. The histological pattern of palisading histiocytes around necrobiotic granulomas is seen in association with a variety of systemic illnesses but more commonly occurs as an isolated entity in childhood. They are unlikely to herald rheumatological disease unless the erythrocyte sedimentation rate is elevated. In the presence of juvenile rheumatoid arthritis, histological confirmation is usually not indicated. If the lesions are not associated with any other clinical symptoms excisional biopsy may be indicated to establish a diagnosis. The nodules need not be removed as they will spontaneously regress.

Child, Preschool↗
PubMed1997

Erosive pustular dermatosis of the scalp in skin grafts: report of three cases.

Three patients developed erosive pustular dermatosis of the scalp (EPDS). Two of them, both males, had previously undergone surgical excision for squamous cell carcinoma and basal cell carcinoma, and a female experienced avulsive trauma of the scalp. The erosive lesions and crusts were located at the site of a skin graft; microbiological cultures were negative for bacterial and fungal growth. Histological examination ruled out pustular bullous disorders. Topical therapy with corticosteroids and antibiotics resulted in clinical remission in only 2 cases. The third case showed a tendency to recur despite numerous therapeutic attempts with oral dapsone and isotretinoin. We conclude that surgical trauma is a possible cause of EPDS. Our patients seem to be the first reported cases of EPDS in skin grafts following plastic surgical procedures.

Administration, Cutaneous↗
PubMed1997

Scarring folliculitis in the ectrodactyly-ectodermal dysplasia-clefting syndrome. Histologic, scanning electron-microscopic and biophysical studies of hair.

Several clinical syndromes are characterized by ectodermal dysplasia (ED) in association with clefting of the lip and/or palate. In these syndromes, alopecia is primarily due to abnormalities of the hair shaft associated with increased hair fragility. Scalp dermatitis is yet another peculiar finding, primarily seen in the ankyloblepharon-ED-clefting (AEC) syndrome. We report on a 16-year-old patient with ectrodactyly-ED-clefting (EEC) syndrome, who exhibited a scarring alopecia due to deep folliculitis. On scanning electron microscopy, irregular torsion and longitudinal grooving of the hair shaft (pili torti et canaliculi) were observed. Quantitative determinations of the elastic and viscous parameters of hair demonstrated a normal viscosity but a significantly reduced hair elasticity, indicating either an abnormal composition or a disordered arrangement of microfibrils within the apparently normal keratin matrix. In contrast to the erosive scalp dermatitis of early onset in the AEC syndrome, alopecia in this case of EEC syndrome demonstrated follicular scarring with onset during puberty. We question a possible role of the anatomical hair abnormality in the pathogenesis of chronic deep folliculitis in this and clinically related syndromes.

Adolescent↗
PubMed1997

Controversies in medical mycology.

Questions and controversies involving many aspects of medical mycology have increased in recent years. Case histories are described in which fungal infection causes unexpected and atypical problems. Molecular techniques of diagnosis need to be used alongside traditional culture methods. Increased drug use has led to genuine concerns and differing views regarding the definition and development of resistance by fungi. The use and value of combinational antifungal therapy and the employment of immunomodulatory agents concomitant with antimycotics have been debated. Nonetheless, good standards have been developed in the testing of antifungal agents. These, together with the commercial viability of antifungal drugs and hence increased interest in their development, mean that although we have entered the golden age of mycology we have also entered the golden age of antifungal therapy.

Adolescent↗
PubMed1996

Differential diagnosis of scalp trichilemmal cyst on MRI.

The characteristic MRI of scalp trichilemmal cysts is reported. The feature of an iso-intense area on T1-weighted images is unique to trichilemmal cysts. MRI is helpful in diagnosing the trichilemmal cyst and useful in distinguishing cystic tumors on the median scalp from a cranial malformation, meningo- or encephalocele.

Adult↗
PubMed1996

Ivermectin-responsive crusted scabies in HTLV1 carrier.

We report a case of HTLV1 infection revealed by crusted scabies and widespread dermatophytosis in an African woman. HTLV1 infection was not complicated by adult T cell leukemia or myelopathy. Crusted scabies is a marker of HTLV1 infection. The importance of oral ivermectin therapy in crusted scabies is emphasized.

Aged↗
PubMed1995

Primary cutis verticis gyrata or pachydermia verticis gyrata: a peculiar scalp disorder of mentally retarded adult males.

BACKGROUND: Primary or idiopathic cutis verticis gyrata (CVG) is often associated with mental retardation or chronic schizophrenia. OBJECTIVE: The aim of the present study was to evaluate the prevalence of primary CVG and its histological aspects in a psychiatric adult population. METHODS: Eighty-three hospitalized psychiatric adult patients were examined for the primary form of CVG. Forty-nine (44 males and 5 females) out of them were schizophrenic, 16 (14 males and 2 females) were mentally retarded and the remaining 18 were affected by different psychiatric disorders. RESULTS: Three males, 2 mentally retarded and 1 schizophrenic, were found to be affected and the clinical diagnosis was confirmed histologically. CONCLUSION: The high prevalence of primary CVG in males with mental retardation might be explained by ethnic factors or by the use of an adequate diagnostic methodology, improved by shaving the scalp hair in patients suspected to be affected. The term pachydermia verticis gyrata is suggested for the primary CVG, which is the most common scalp disorder in such a population.

Adult↗
PubMed1995

The antifungal activity of a coal tar gel on Malassezia furfur in vitro.

OBJECTIVE: Seborrhoeic dermatitis is associated with Malassezia furfur, but the exact role of this lipophilic yeast is still unclear. The in vitro antifungal activity of a coal tar gel, the base of the gel and coal tar (Stantar) itself has been evaluated against 54 different M. furfur strains, isolated from patients suffering from dandruff, seborrhoeic dermatitis and pityriasis versicolor. METHODS: Minimum inhibitory concentrations (MICs) of the tested agents were measured by the agar dilution technique. RESULTS: The coal tar gel was found to be able to inhibit growth of 52 out of 54 investigated M. furfur isolates in vitro at MIC values between 625 and 10,000 micrograms/ml-corresponding to 3-5 micrograms/ml coal tar. However, the gel base also appears to be a less potent inhibitor of in vitro growth of M. furfur. In addition, it could be demonstrated that coal tar alone has an antifungal potential on M. furfur in vitro. MIC values from 250 to 5,000 micrograms/ml for coal tar were found. Presumably, both coal tar as the active ingredient and the gel base contribute to the in vitro activity of the coal tar gel against M. furfur. CONCLUSIONS: It is suggested that the effect of coal tar gel ointment in dandruff and seborrhoeic dermatitis therapy in vivo may be at least partly due to an antifungal activity of the coal tar but also of the gel base.

Antifungal Agents↗
PubMed1994

Molluscum contagiosum mimicking sebaceous nevus of Jadassohn, ecthyma and giant condylomata acuminata in HIV-infected patients.

We report on three HIV-infected homosexual male patients with atypical manifestations of mollusca contagiosa (MC). Their clinical presentation mimicked sebaceous nevus of Jadassohn, ecthyma and giant condylomata acuminata. HIV-infected patients feature MC with atypical morphology in about two thirds of the cases. The atypical aspects of MC concern the localization, morphology, growth pattern and size of the lesions. MC is a late manifestation of HIV infection and mirrors marked cellular immune deficiency. We conclude that in HIV-infected patients all tumorous lesions should be biopsied because the clinical characteristics are often not specific enough for a definite diagnosis.

AIDS-Related Opportunistic Infections↗
PubMed1993

Cerebriform intradermal nevus. A clinical pattern resembling cutis verticis gyrata.

A clinical case resembling cutis verticis gyrata due to a cerebriform intradermal nevus (CIN) is reported. Such a lesion is diagnosed on clinical and histopathological grounds. Some aspects are particularly discussed, such as complications of CIN, including the potential development of malignant melanoma, prognosis and different possibilities in the therapeutic approach. It is stressed that early diagnosis, broad surgical excision and plastic reconstruction are major issues. Different techniques of surgical extirpation and scalpflap reconstruction are presented.

Adult↗
PubMed1992

Psoriatic alopecia: acute and chronic hair loss in 47 patients with scalp psoriasis.

Symptomatic hair loss and alopecia were seen in psoriatic lesions of the scalp in 47 patients. Remarkably, in 66% of the cases it was an inaugural manifestation, and in 36% the scalp was exclusively involved. Therefore 34% of the patients presented with a primary manifestation of isolated scalp psoriasis. Hair loss varied in intensity from protracted to moderate and massive (36% in tufts). It presented as acute (51%), chronic (36%) or chronic recurrent (13%). Thirteen patients (28%) became aware of the hair loss with the beginning of therapy. The alopecia was found to be circumscribed in 75% of the cases and diffuse in 25%. In 2 cases psoriatic alopecia also manifested itself at sites other than the scalp. The telogen count was found to be increased up to 25-86% in the florid stage. Examinations under the light microscope showed a patchy perifollicular lymphohistiocytic infiltrate in the upper and middle dermis with adnexotropia in several cases. This infiltrate can alter the follicle epithelium and may lead to a granulomatous foreign-body reaction with destruction of the hair follicle. After topical antipsoriatic treatment, most of the reexamined patients showed complete hair regrowth, while 5 developed a residual scarring. Therefore, in the patient with circumscribed or diffuse symptomatic alopecia, with or without scarring, psoriatic alopecia should be considered.

Acute Disease↗
PubMed1992

Cutaneous complications of artificial hair implantation: a pathological study.

Five patients who developed severe cutaneous complications after artificial hair implantation were subjected to a scalp biopsy. The pathology showed the presence of hyperplastic epidermal proliferations that produced infundibulum-like structures around the implanted fibers in the superficial dermis. A dense acute inflammatory infiltrate surrounded the artificial fibers in the superficial dermis. In the deep dermis a granulomatous infiltrate was present whereas in the hypodermis the inflammatory infiltrate was sparse and the fibers were embedded in fibroplasia. The pathology of a patient who did not present any skin inflammation after artificial hair implantation showed similar pathological features but the absence of acute inflammation suggesting that bacterial infections play a major role in the development of the cutaneous complications of hair implantation. Since definitive treatment of the infections is ineffective until the fibers are removed from the scalp, surgical treatment was required in 2 of our patients.

Adult↗