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PubMed1976

Local treatment of psoriasis of the scalp with clobetasol propionate in alcoholic solution: a comparison of once and twice a day application.

A clinical evaluation was carried out in 53 patients with moderate to severe psoriasis of the scalp to assess the effectiveness of a 0.05% alcoholic solution of clobetasol propionate. Patients were treated on a non-selective basis with either a once a day or twice a day application. After a 2-weeks' treatment period, the results showed that there was an excellent or good response in 65% of patients treated once a day and in all of the patients on twice daily application of the topical steroid. It is recommended, therefore, that clobetasol propionate should be applied twice daily for the control of severe cases of psoriasis of the scalp.

Administration, Topical↗
PubMed1992

Accuracy and interobserver reliability of scalp ictal EEG.

We studied the accuracy and reliability of scalp ictal EEG in 137 complex partial seizures (119 temporal and 18 extratemporal) in 35 patients in whom we knew the correct site of seizure origin because all patients had been seizure-free for more than 2 years after seizure surgery. Three electroencephalographers independently determined side of seizure origin based on activity at onset of electrographic seizure (ASO), rhythmic theta and alpha (RTA), postictal findings (PIF), and the electrographic seizure as a whole. When all seizures were analyzed, including those with generalized features or obscured by artifact, we determined side of seizure onset correctly in 76% to 83% of temporal seizures and 47% to 65% of extratemporal seizures. In most of the remainder, a lateralization judgment was impossible. When analysis was confined to those seizures in which lateralization was possible, we correctly lateralized 93% to 99% of temporal seizures and 89% to 100% of extratemporal seizures. Interobserver reliability was excellent. RTA and PIF were more accurate than ASO. RTA was significantly more common in temporal seizures. Our data indicate that lateralization by scalp EEG is highly accurate and reliable.

Electroencephalography↗
PubMed1993

Seizure localization in temporal lobe epilepsy: a comparison of scalp-sphenoidal EEG and volumetric MRI.

We determined the accuracy of volumetric MRI (based on identification of unilateral hippocampal atrophy) and scalp-sphenoidal EEG (based on concordant interpretations of scalp-sphenoidal ictal EEG by three independent interpreters) for seizure focus localization in 20 patients with temporal lobe epilepsy. All patients became seizure-free or had rare seizures following temporal lobectomy. Among the 20 patients, nine (45%) met both MRI and EEG localization criteria, six (30%) met MRI localization criteria alone, three (15%) met EEG localization criteria alone, and two patients (10%) did not meet either localization criteria. In the 18 patients meeting MRI or EEG localization criteria, the predicted localization agreed with the side of temporal lobectomy. These results suggest that a noninvasive approach combining MRI and EEG will correctly localize the side of seizure onset in most patients with temporal lobe epilepsy.

Adolescent↗
PubMed1995

Ictal scalp EEG in temporal lobe epilepsy with unitemporal versus bitemporal interictal epileptiform discharges.

We investigated the ictal scalp EEG in 228 seizures of 36 patients with unitemporal (n = 25) or bitemporal independent (n = 11) interictal epileptiform discharges (IED). All patients had proven temporal lobe epilepsy since they became seizure-free or only had auras after temporal lobectomy with a minimum follow-up of 1 year. Ictal patterns at seizure onset or later in the course of the seizure were lateralized significantly more often in patients with unitemporal IED (90%, at seizure onset and 96%, later) compared with those with bitemporal independent IED (75%, at seizure onset and 78%, later). Furthermore, scalp ictal EEGs, when lateralized at seizure onset or later in the course of the seizure, were significantly more likely to predict the correct side for surgery in patients with unitemporal (98%, at seizure onset and 100%, later) than bitemporal (64%, at seizure onset and 77%, later) IED. Bilateral independent seizure onsets, asynchrony of ictal activity over the two temporal lobes, and switch of ictal activity from one to the other hemisphere are ictal patterns that are strongly correlated with bitemporal excitability.

Adolescent↗
PubMedDate not supplied

Electroanesthesia (EA) studies: EA produced by stimulation of sensory nerves of the scalp in Rhesus monkeys.

After it was learned that electroanesthesia (EA) could not be produced in a Rhesus monkey which had undergone a circumferential scalp block with 0.25% lidocaine, it was postulated that EA could be produced by electrostimulation of the sensory nerves of the scalp in the rhesus. The work reported here verifies that EA can be produced by this method in this species; it is not necessary to pass current through the head.

Animals↗
PubMed1984

Ischemic necrosis of the scalp after preoperative embolization of meningeal tumors.

The authors report two patients who suffered ischemic necrosis of their scalps after preoperative therapeutic embolic occlusion of the external carotid artery and its terminal branches for highly vascular meningeal tumors. Local anesthesia, selective catheterization of the external carotid artery, and radiopaque polyvinyl alcohol and Gelfoam as embolic agents were used. The various complications of external carotid artery embolization are reviewed. The importance of preserving normal branches of the external carotid artery (especially the superficial temporal artery) during embolization and of careful design of the scalp flap to avoid ischemic necrosis is emphasized.

Adult↗
PubMed2000

Extraskeletal Ewing's sarcoma of the scalp.

Extraskeletal Ewing's sarcoma/primitive neuroectodermal tumour (EES/PNET) is a rare disease entity. Scalp EES/PNET has been reported rarely. We report a case of an 11-year-old boy who had painful and rapidly growing subcutaneous nodes over the scalp and neck. The final diagnosis was EES/PNET after biopsy and immunohistochemical assay. The patient underwent surgical excision, chemotherapy and radiotherapy with a dose of 2000 cGy. Now he has been free of disease for two years. Early awareness and treatment of this rare disease, and wide resection followed by chemotherapy and radiotherapy might improve patients' long-term survival.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Radical treatment of angiosarcoma of the scalp using megavoltage electron beam therapy.

Angiosarcoma of the scalp is a multifocal neoplasm that is often initially managed by wide excision and surgical reconstruction. Invariably, adjuvant radiotherapy is required to improve local control. Primary radical radiotherapy to the scalp is not well documented. The major limitation is the technical problem of treating homogeneously an extensive superficial curved volume. We describe a practical technique that can be administered with a standard linear accelerator capable of high-energy electron production. The technique uses a multiple abutted fixed field set-up at constant source to surface distance and the patient is immobilized in a custom wax helmet which also serves to optimize the electron absorbed dose in the treatment volume. Surgical excision and reconstruction is reserved for the salvage of local relapse.

Hemangiosarcoma↗
PubMed2002

Improved dose homogeneity in scalp irradiation using a single set-up point and different energy electron beams.

Homogeneous irradiation of the entire or a large portion of the superficial scalp poses both technical and dosimetric challenges. Some techniques will irradiate too much of the underlying normal brain while other techniques are either complex and involve field matching problems or may require sophisticated linear accelerator (linac) add-ons such as intensity modulated radiation therapy (IMRT)/electron multileaf collimation. However, many radiotherapy facilities are not equipped with such treatment modalities. We propose a practical treatment technique that can be delivered with a standard linac capable of producing high energy electrons. The proposed technique offers a simple alternative for achieving results equivalent to IMRT. Dose homogeneity throughout the treatment volume is achieved by aiming different energy electron beams at differential areas of the treatment surface to achieve improved dosimetry and rapid treatment delivery, while using a single set-up point. We introduced this treatment technique at our institution to treat superficial cancers of the scalp and other irregular surfaces.

Brachytherapy↗
PubMed1983

Application of posterior neck dissection in treating malignant melanoma of the posterior scalp.

Utilization of a posterior neck dissection in the treatment of nine patients with malignant melanoma of the posterior scalp is presented. Seven of nine patients presented with metastatic disease present in the posterior neck after initial treatment elsewhere. Four of the seven patients developed regional disease 4 months to 4 years following initial diagnosis. Variables dictating surgical treatment included the Clark's level, Breslow depth of invasion of original lesion, evidence of metastatic disease, and type of melanoma. The surgical technique of the posterior neck dissection is graphically depicted and the indications outlined. The posterior neck dissection is mandatory to adequately resect the primary lymphatics of the posterior scalp. Controlled studies are urged to determine the efficacy of prophylactic surgical lymphadenectomy in malignant melanoma of the head and neck.

Adult↗
PubMed2004

[Large scalp and skull defect in patient with aplasia cutis congenita].

Aplasia cutis congenita is a rare condition characterized by the absence of skin layers. It is most common on the scalp, middle line, and it can be seen as a congenital ulcer involving periosteum, skull and dura. We present the case of a female newborn infant with a dysmorphic facies, a large scalp and skull defect exposing the dura. There was no cerebrospinal fluid leakage. The rarity of cases with large defects and small series reported make difficult to determinate the ideal treatment for aplasia cutis congenita. More studies are necessary to define the etiology and best management of this patients.

Ectodermal Dysplasia↗
PubMed1993

Modified coronal incision: distribution of stress in the scalp and cranium.

Coronal incision or bitemporal incision is useful for wider visualization in craniofacial surgery. In volume-expanding surgery such as fronto-orbital advancement, however, the incisional scar in the temporal scalp is often undesirably wide and conspicuous. We modified the coronal incision to avoid the widened scar. Further, we analyzed the resulting stress distribution using the finite element method (FEM) to determine whether or not the modification we adapted was effective. The modified method of coronal scalp incision that we used for craniofacial surgery is practical and technically easy. FEM analysis showed that our method was effective in terms of mechanical strength. The simulated surgical craft model is presented and is concluded to be beneficial for further analysis in craniofacial surgery.

Cicatrix↗
PubMed2002

Skin cancer after X-ray treatment for scalp ringworm.

Some 2,224 children given X-ray therapy for tinea capitis (ringworm of the scalp) have been followed for up to 50 years to determine cancer incidence, along with a control group of 1,380 tinea capitis patients given only topical medications. The study found a relative risk (RR) of 3.6 (95% confidence interval, 2.3-5.9) for basal cell skin cancer (BCC) of the head and neck among irradiated Caucasians (124 irradiated cases and 21 control cases), in response to a scalp dose of about 4.8 Gy. No melanomas of the head and neck have been seen, and only a few squamous cell carcinomas. About 40% of irradiated cases have had multiple BCCs, for a total of 328 BCCs. Although 25% of both the irradiated and control groups are African-American, only 3 skin cancers have been seen among them, all in the irradiated group, indicating the importance of susceptibility to UV radiation as a cofactor. Light complexion, severe sunburning and North European ancestry were predictive of BCC risk in the irradiated group, but chronic sun exposure was not. Children irradiated at young ages had the highest BCC risk. The RR for BCC risk is approximately constant with time since exposure, suggesting that risk will probably last for a lifetime.

Age Factors↗
PubMed1992

Cultured dermal papilla cells from androgen-dependent human hair follicles (e.g. beard) contain more androgen receptors than those from non-balding areas of scalp.

Androgens stimulate hair growth in many areas, e.g. the beard; they also induce regression and balding on the scalp with increasing age in genetically disposed individuals. The cause(s) of this biological conundrum is unknown but age-related; androgen-potentiated changes also occur in the prostate. The mesenchyme-derived dermal papilla situated at the base of the hair follicle is thought to play an important role in regulating the growth and development of the follicular epithelium. Since androgens probably act on the hair follicle via the dermal papilla, cultures of dermal papilla cells from human hair follicles with differing responses to androgens in vivo have been established and their ability to bind androgens assessed. Receptor binding was assayed by saturation analysis (0.05-10 nmol/l) using the synthetic non-metabolizable androgen, [3H]mibolerone. Shionogi 115 cells were also assayed as a positive control. Specific high-affinity low-capacity androgen receptors were identified in 12 dermal papilla primary cell lines with similar characteristics to established androgen receptors. Cells from androgen-sensitive follicles (beard, scrotum and pubis) contained higher levels of androgen receptors than those derived from relatively androgen-insensitive non-balding scalp follicles whether the receptor content was calculated in relation to cell number, protein or DNA content of the cells. These results support the hypothesis that androgens act on hair follicles via the dermal papilla in vivo and demonstrate that dermal papilla cells exhibit an altered phenotype in culture which depends on the body site from which they were derived.(ABSTRACT TRUNCATED AT 250 WORDS)

Androgens↗
PubMed1998

Multiple scalp aneurysms caused by atypical temporal arteritis--case report.

A 55-year-old male suffered sudden onset of dysarthria and mild left hemiparesis due to a right intracerebral small hemorrhage. On admission, six subcutaneous elastic hard lumps were found on the scalp with painless and regular pulsation. The lumps were located along the course of the bilateral superficial temporal arteries (5 locations) and the occipital artery. The patient did not have symptoms of headache or blurred vision associated with temporal arteritis. The largest lump was removed for cosmetic reasons and definitive diagnosis. Histological examination demonstrated many infiltrating inflammatory cells along the entire vascular wall but without giant or fibrinoid necrosis. These multiple scalp aneurysms were probably caused by atypical temporal arteritis.

Aneurysm↗
PubMed2002

Rapid expansion of benign scalp neurofibroma caused by massive intratumoral hemorrhage--case report.

A 62-year-old man with neurofibromatosis type 1 presented with rapid growth of a scalp mass. Head computed tomography demonstrated a large extracranial tumor of soft tissue density with massive intratumoral hematoma. Cerebral angiography demonstrated remarkable hypervascularity of the tumor. Preoperative embolization and total removal of the tumor was performed. The tumor contained a large amount of intratumoral hematoma (500 ml). The histological diagnosis was neurofibroma without malignant transformation. Benign scalp neurofibroma showing massive intratumoral hemorrhage is rare. Rapid growth or intratumoral hemorrhage in neurofibroma may be an indicator of malignant transformation.

Hemorrhage↗
PubMed2005

Myositis ossificans of the temporal muscle as a primary scalp tumor. Case report.

A 38-year-old woman presented with a rare case of myositis ossificans in the temporal muscle manifesting as left temporal scalp mass with mild pain. The mass was elastic-hard and seemed to be located in the temporal muscle. Magnetic resonance imaging revealed a heterogeneously enhanced mass in the muscle. The tumor was resected. The histological diagnosis was myositis ossificans. The clinicopathological features of scalp myositis ossificans may mimic other soft tissue tumors, requiring care for the differential diagnosis.

Adult↗
PubMed1997

Effect of ketoconazole 2% shampoo on scalp sebum level in patients with seborrhoeic dermatitis.

Twenty patients with scalp seborrhoeic dermatitis were treated twice weekly with ketoconazole 2% shampoo for 4 weeks. Clinical assessment, culture for P. ovale on Dixon broth and lipid measurement at two places were made before treatment and after 2 and 4 weeks. Significant improvement of the severity of seborrhoeic dermatitis (p < 0.001) and negative mycological tests by 19 (95%) of patients were observed. The scalp lipid content remained unaltered in 11 patients with an initial lipid value over 220 micrograms/cm2 but increased in those with lower initial values. This is probably due to the improvement of sebum delivery onto skin surface as a result of the elimination of the follicular occlusion.

Administration, Topical↗