SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Use of a split-thickness scalp graft for coverage of the retroauricular area after elevation of a reconstructed auricle is reported. Because there is no morbidity of the donor site and the color and texture match is excellent, the scalp can be an ideal donor site for coverage of the retroauricular area of the reconstructed auricle.
This case presents the dilemma of a scalp infection emerging at the conclusion of soft-tissue expansion. Basic principles of wound infection would dictate that the foreign body (the inflatable prosthesis) be removed and that the infection be treated before inset of the flap. The prevention of possible loss of flap length due to skin contraction during treatment of the infection was avoided by stretching the flap over the intact scalp temporarily, thus maintaining its expanded status.
The classical transposition and rotation flaps are well known. Cosmetic considerations in the scalp and forehead region limit the use of a flap design that requires a skin graft for a donor defect. On sound geometric principles, the classical flap designs are suitably modified here to have a somewhat equal proportion of transposition and rotation. This "modified rotation flap" design works to a maximum advantage in the inextensible region of the scalp and forehead by providing single-stage primary closure of moderate to large defects. No backcuts are ever necessary with this flap design. Use of this principle to modify the rotation flap design for closure of an extended midline forehead defect following rhinoplasty allows a still wider (up to 6.5 cm) midline forehead flap to be available for rhinoplasty with primary closure of the donor defect.
This case of squamous cell carcinoma of the scalp and malar region highlights the possibilities of therapeutic failure at the excisional, reconstructive, or histopathologic stage despite the performance of the appropriate, clinically indicated procedures and customary close examination of carcinoma patients and specimens. The extent of local recurrence and rapid intracerebral spread emphasize the occasionally aggressive nature of squamous cell carcinoma of the scalp and the need for early excision.
Custom prefabrication of free flaps provides an unlimited variety of applications, since flaps can be created with expendable tissues and without restriction to naturally occurring vascular territories. These principles also can be used to customize flaps that could not be completed by conventional means. We report a case of scalp reconstruction using a random-pattern abdominal flap in which a radial artery fascial flap was induced to serve as the vascular carrier. In addition to providing durable scalp coverage, the prefabricated free flap enabled salvage of an abdominal flap that would otherwise have been aborted after intermediate transfer to the forearm.
Use of a four-poster halo and corset jacket provides complete protection, access, and mobility for patients undergoing free-flap scalp reconstruction. This technique was used in a patient who required a total scalp reconstruction with a compound latissimus/serratus muscle free flap with good success. The case and technique are presented for review.
Arteriovenous fistula of the scalp secondary to punch autograft technique is a relatively uncommon occurrence, similar to traumatic scalp arteriovenous fistulas from other causes. A pulsatile subcutaneous mass with an associated thrill or bruit and symptoms including pain or headache is a common presentation. Angiography is required for full diagnostic evaluation. Angioarchitecture may appear complex, even with a single-hole fistula. Super-selective angiography and embolization facilitate surgery and provide essential information regarding angioarchitecture. Complete excision of the lesion is curative. Identification and resection of the draining vein is mandatory to ensure a complete resection. The lesion may extend across traditional anatomic planes. Ligation of proximal feeding arteries is inadequate and potentially harmful. Histopathology of the traumatic arteriovenous fistula may appear similar to that of an arteriovenous malformation. Acquired arteriovenous fistulas and congenital arteriovenous malformations are markedly similar in their ultimate histopathology, angioarchitecture, angiographic appearance, hemodynamics, and treatment requirements. They should be considered to represent a spectrum of the same disease state rather than discrete entities.
This article retrospectively reviewed a case of epithelioid sarcoma of the scalp; a treatment plan for this type of neoplasm has not been well defined in the literature because of the rarity of sarcomas in general and sarcomas located in the head and neck in particular. No comparative results can be drawn when dealing with such lesion in the scalp. Early recognition with an aggressive approach to confirm the existence of an epithelioid sarcoma is mandatory; a high index of diagnostic awareness is needed to recognize this uncommon tumor. Early diagnosis can only be auspicious. Early wide surgical resection is imperative to ensure better control of imperceptible tumor extension, and well-planned diagnostic and therapeutic intervention, rather than isolated management and referral for adjunctive treatment, is important.
We have described a 6-day-old male infant who presented with Neisseria gonorrhoeae conjunctivitis and a scalp abscess. Delivery was complicated by rupture of the membranes 24 hours before delivery and fetal monitoring for four hours. The rare scalp abscesses caused by gonococci cleared with penicillin therapy.
Granuloma annulare is a dermatologic condition of unknown etiology. It most frequently presents on the extremities and trunk as skin-colored nodules arranged in an annular pattern. The lesions are usually asymptomatic and resolve spontaneously. Granuloma annulare is more common in females than males. Subcutaneous granuloma annulare is a subtype of granuloma annulare that affects children. It rarely occurs on the face and scalp and is extremely rare in the periocular region. Subcutaneous granuloma annulare is often misdiagnosed because it is not included in the differential diagnosis. Due to the rarity of facial presentation of granuloma annulare, we present a case of subcutaneous granuloma annulare of the eyelids and scalp in a 4-year-old child.
Local anesthetic infiltration has been proposed to decrease postoperative pain. The aim of this study was to determine whether scalp infiltration with bupivacaine or ropivacaine would improve analgesia after supratentorial craniotomy for tumor resection. Eighty patients were recruited into a randomized double-blind study. Infiltration was performed after skin closure with 20 mL of saline 0.9% (placebo group, n = 40), of 0.375% bupivacaine with epinephrine 1:200,000 (bupivacaine group, n = 20), or of 0.75% ropivacaine (ropivacaine group, n = 20). Postoperative analgesia was provided with patient-controlled morphine IV analgesia (PCA). The study was continued until PACU discharge, which occurred early in the morning following surgery. Results are reported on 37 patients in the placebo group, 20 in the bupivacaine group, and 19 in the ropivacaine group because 4 patients experienced postoperative complications and were excluded from the study. Morphine titration at arrival in the postanesthesia care unit was necessary more often in the placebo group (62% of the patients) than in the 2 treated groups (19% in each, P = 0.02). The median quantity of morphine administered during the first 2 postoperative hours, including initial titration administered by a nurse and PCA-administered morphine, was lower in each treated group than in the placebo group (P < 0.01). The median morphine consumption up to the 16th postoperative hour was not significantly different among the 3 groups. There was no difference in the visual analogue scale scores among the 3 groups at any time. Scalp infiltration with either bupivacaine or ropivacaine had a statistically significant effect on morphine consumption during the first 2 postoperative hours.
Tumors of the thyroid and parathyroid glands may develop together or separately in patients who previously have been exposed to head and neck irradiation. Whether cranial irradiation confers an increased risk for pituitary adenoma remains unknown. We report the case of a 52-year-old woman who was treated during childhood for tinea capitis with scalp irradiation and later in life developed a prolactin-secreting tumor, a parathyroid adenoma, a benign thyroid lesion, and a basal cell carcinoma of the skin. She was treated successfully with bromocriptine and surgical removal of the parathyroid adenoma. Molecular analysis of the parathyroid tissue failed to demonstrate any abnormality of the multiple endocrine neoplasia Type 1 gene. This case report is the first to describe a prolactin-secreting tumor that developed in association with other endocrine neoplasia after head and neck irradiation. Our case suggests that multiple endocrine neoplasia may develop in a sporadic pattern after scalp irradiation.
The correlation between source asymmetry in the brain and the potential amplitude asymmetry on the scalp was studied by a two-dimensional (2-D) numerical model of the head. The model employed computerized tomography (CT) images to define the different compartments of the head. The source was modeled by a dipole layer in the occiput for an occipital source (visual evoked potential generators) or a dipole layer around the cortex representing spontaneous activity generators. The volume conductor equation for the potential distribution was solved numerically using a finite volume method for two CT images; one had relatively symmetric left-right anatomy while the other had a falx deviation of 6 degrees between the occiput and the nasion-inion line. By examining several arrangements of sources, it has been demonstrated that source asymmetry can cause nonnegligible asymmetry in the potential amplitude at the homotopic points on the scalp. This asymmetry, that is not related to real physiologic or psychological origin, should be taken into consideration in any EEG potential distribution analysis.
Phase-space dissimilarity measures (PSDM) have been recently proposed to provide forewarning of impending epileptic events from scalp electroencephalographic (EEG) for eventual ambulatory settings. Despite high noise in scalp EEG, PSDM yield consistently superior performance over traditional nonlinear indicators, such as Kolmogorov entropy, Lyapunov exponents, and correlation dimension. However, blind application of PSDM may result in channel inconsistency, whereby multiple datasets from the same patient yield conflicting forewarning indications in the same channel. This paper presents a first attempt to solve this problem.
Human scalp skins were treated with 20 mM ethylenediaminetetraacetic acid and terminal hair follicles were extracted with the epidermis. Some terminal hair follicles were morphologically preserved well and provided opportunity to examine three-dimensional distribution of CAM5.2 (K8, 52.5 kD) reactive Merkel cells. In anagen terminal hair of the scalp numerous immunoreactive Merkel cells were distributed in the presumptive bulge area. Distinct swelling as in the bulge of human vellus hair was usually absent; however, in rare instances anagen terminal hair demonstrated unilateral prominent swelling with dense aggregation of Merkel cells. In telogen hair the bulge becomes indistinguishable from the regressed end of the club hair follicle but Merkel cells continued to be abundant. We found morphologic variation of the bulge such as formation of knoblike swellings and villous projections. Interestingly, Merkel cells were also located in these structures. Palisading stockade-like nerve endings were observed surrounding the follicular epithelium at the sebaceous gland level. Merkel cells were sparse in this follicular segment. Variable number of Merkel cells were also scattered in the infundibulum of terminal hair in no association with peripheral nerves.
The accumulation of lead in human scalp hair was compared in male and female children and adults from various locations in the United Sates, Japan, Yugoslavia, Iran, and South Africa. The most significant variables which influenced the concentration of lead in hair were ingestion of lead-containing substances, exposure to lead of environmental origin, place of residence, site from which the hair specimen was sampled relative to its distance from the scalp, and age. The least significant variables were sex and nutritional deficiencies.
Large-scale data comparing reactions to surfactants between scalp and back and arm are lacking. The sensitivity of responses between scalp and back and arm were explored utilizing an open-application model for testing the potential irritancy of sodium lauryl sulphate (SLS). 10 bald male Caucasians (mean age 56 +/- 9 years) were enrolled. We conducted 5 successive washings: for each wash, the technician pipetted 1 ml of 20% SLS solution into a glass cylinder placed on the designated area with hand pressure that prevented the cylinder leaking. The test area was then rubbed with a Teflon Policeman scrubber for 1 min. Post scrubbing, the solution was absorbed dry with a plastic pipette and blotted by gently applying paper tissues. After a 5-min rest, the procedure was repeated for 4 more times for a total of 5 times. Skin-irritancy assessments by visual scoring and instrumental measurements were made at 30 min and 24 h thereafter and squamometry at the end of last washing. Results indicated that most param- eters revealed that the back was most sensitive to the SLS challenge. Thus, these data support the current standard skin-compatibility testing procedure, employing the back for potential irritation testing of hair care products.
A 36-year-old woman visited our hospital with a five month history of persistent pustulation, crusting, and alopecia on the vertex of the scalp. No pathological organisms were isolated from the lesions. Histological examination revealed non-specific changes of chronic inflammation with destroyed follicles. Antibiotic therapy produced no response, but steroid therapy was effective. From these observations, a diagnosis of erosive pustular dermatosis of the scalp (EPDS), as described by Pye et al., was made. The patient also had Hashimoto's thyroiditis, autoimmune hepatitis, and Takayasu's aortitis. The laboratory studies revealed an increased erythrocyte sedimentation rate, C-reactive protein 3+, hypergammaglobulinemia, and various auto-antibodies, suggesting the possibility of a pathogenesis common to both this dermatosis and the autoimmune diseases.