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[UV-B comb versus betamethasone solution in scalp psoriasis].

BACKGROUND: The aim of the study was to assess the effectiveness of a UV-B-comb on scalp psoriasis versus betamethasone valerate solution. MATERIAL AND METHODS: Of 44 adult patients with scalp psoriasis, 22 were treated with a dermalight 80 psoracomb and 22 with betamethasone valerate solution, five times a week for three weeks. RESULTS: No difference in effect was found at the end of treatment. Two weeks after end of treatment a higher proportion of patients treated with UV-B-comb (7/22) had remained in remission than those treated with betamethasone valerate solution (3/22; p < 0.05). INTERPRETATION: Treatment with a UV-B-comb offers a good alternative to topical corticosteroids for patients with scalp psoriasis.

Administration, Topical↗

[Microsporum canis mycetoma of the scalp].

BACKGROUND: Mycetoma is a chronic subcutaneous tumefaction with presence of grains or granules. Etiological agents include bacteria or filamentous fungi. Mycetoma due to dermatophytes is uncommon, mainly occurring in Africa. To our knowledge, no case has been reported in the West Indies. Only two observations of Micosporum canis mycetoma in humans have been reported in the literature. We report a third case of mycetoma of the scalp caused by this fungus. CASE REPORT: A 22-year-old woman from Martinique, French West Indies, presented with an indolent tumefaction of the scalp evolving over five years. She had mental retardation due to congenital adrenal hyperplasia with 21-hydroxylase deficiency. The lesion was extracted surgically. Pathology and mycology examinations showed features of Microsporum canis mycetoma. Two months later, the scalp lesion recurred and the patient was treated with griseofulvin after surgical extraction. DISCUSSION: Mycetoma due to dermatophytes is very uncommon, mainly observed on the scalp and nape of the neck. A history of a skin lesion is frequent, leading to transcutaneous penetration of the fungus and mycetoma formation. Several dermatophyte species have been identified as causal agents (Microsporum ferrugineum, Trichophyton rubrum, Trichophyton verrucosum, Trichophyton mentagrophytes, Microsporum audouinii, Microsporum langeronii). Microsporum canis is rarely demonstrated in humans: two cases in children in Africa and Australia. Our observation was similar to the two cases in the literature: indolent and mobile tumefaction of the scalp, in a child or young adult, suggestive of lipoma or epidermal cyst, with excision leading to diagnosis. Association with tinea capitis and skin or nail involvement can also be observed.

Adult↗

Efficacy of 1% permethrin for the treatment of head louse infestations among Kosovar refugees.

We assessed the prevalence of head louse infestation and the effectiveness of 1% permethrin against head lice in Kosovar refugees. A currently infested case was defined as a person with observable crawling lice (adults or nymphs) or a person with nits on the hair shaft within a quarter-inch of the scalp. Of the 1,051 refugees screened upon arrival in the United States, 107 (10%) were infested. Crawling lice (adults or nymphs) were observed on 62 (6%) of the individuals examined. Refugees with crawling lice were treated with a pediculicide containing 1% permethrin. Of these, 57 were reexamined the next day. Twenty of the 57 individuals were reexamined 7 days after treatment. No crawling lice were found on any of the refugees examined after treatment. We conclude that 1% permethrin treatment was effective in louse control in this refugee population.

Adolescent↗

Nit wit.

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Animals↗

[Scalp diseases inducing cicatricial alopecia].

The etiology of cicatricial alopecia is unusually heterogenous and in many cases unknown. If we know the cause of alopecia it is possible to stop next evolution of the disease by proper drug treatment but only at the beginning. However the surgical treatment of cicatrices is an effective method.

Alopecia↗

Phototrichogram using videomicroscopy: a useful technique in the evaluation of scalp hair.

The purpose of our work is to contribute to the definitive standardization of the phototrichogram in view of the new possibilities offered by information technology. We placed under investigation a 1 cm2 scalp area on the vertex of 28 healthy volunteers (20 women and 8 men) between the ages of 18 and 30 (average age was 23.32 +/- 3.48 years). We performed the examination using a computerised videomicroscope equipped with lenses x 20 and x 50. The results obtained can be summarized as follows: total hair density was 260 +/- 30/cm2 in men and 300 +/- 20/cm2 in women; telogen percentage was higher in men (16.5 +/- 1.5% vs 11 +/- 1% of women); thin hairs (< 0.040 mm) were 9.4 +/- 1.8% in men and 9 +/- 2% in women; growth rate was 0.35 +/- 0.03 mm/day in men and 0.38 +/- 0.03mm/day in women. Thanks to its integration with digital imaging, the phototrichogram has undoubtedly become an examination of primary importance in trichology because of its simplicity and sensitivity even if it cannot yet be considered the ideal technique to replace all the others.

Adolescent↗

Telogen effluvium after allergic contact dermatitis of the scalp.

OBJECTIVE: After observing 2 cases of acute telogen effluvium induced by allergic contact dermatitis to hair dyes, we decided to evaluate the effects of acute contact dermatitis of the scalp on the hair cycle. DESIGN: Single-center, 6-month study of consecutive patients affected by acute scalp dermatitis. SETTING: Department of Dermatology, University of Bologna, Bologna, Italy. PATIENTS: Diagnosis of allergic contact dermatitis of the scalp was confirmed by patch testing. Eight women presenting with acute contact dermatitis of the scalp entered the study. Hair shedding was evaluated monthly for 6 months by pull test and wash test. Increased hair loss was detected in 4 of the 7 patients who completed the study. Hair loss was mild to moderate and appeared 2 to 4 months after the episode of scalp dermatitis. A scalp biopsy specimen from 2 patients confirmed the diagnosis of telogen effluvium. CONCLUSIONS: Allergic contact dermatitis of the scalp should be included among the possible causes of telogen effluvium. The pathogenesis of telogen effluvium caused by contact dermatitis is unknown but may be related to cytokine release during the inflammatory process.

Acute Disease↗

Dissecting cellulitis in a white male: a case report and review of the literature.

Dissecting cellulitis is an uncommon, chronic, progressive suppurative disease of unknown etiology. It is characterized by painful papules and nodules, interconnecting sinus tracts, purulent drainage, and scarring alopecia. This disease predominately affects young black men, but is rarely reported in white males. The refractory nature of this process makes treatment difficult. We report a case of dissecting cellulitis in a white male, which responded to oral isotretinoin.

Administration, Oral↗

Comparative efficacy of treatments for pediculosis capitis infestations: update 2000.

OBJECTIVE: To evaluate the pediculicidal and ovicidal activity of 5 head lice products. DESIGN: In vitro pediculicidal and ovicidal product comparison. SETTING: Tropical field station in Panama. PARTICIPANTS: Head lice and eggs were harvested from healthy children infested with Pediculus capitis. INTERVENTION: Within 2 hours of capture, lice were placed in continuous, direct contact with the pediculicide products and observed at regular intervals. Fresh, viable eggs were immersed in the pediculicides for 10 minutes, rinsed, air-dried, and incubated for 2 weeks. MAIN OUTCOME MEASURES: Percentage of lice dead at regular observation intervals between 5 minutes and 3 hours of continuous exposure to the pediculicide and percentage of eggs not hatched after 2 weeks. RESULTS: All lice treated with Ovide lotion (0.5% malathion) were dead within 10 minutes and none of the eggs hatched. There was no significant change in the effectiveness of 0.5% malathion lotion or A-200 shampoo compared with the results of an earlier study (1986). There were significant declines in the pediculicidal activity of RID and the ovicidal activity of lindane. Nix (1% permethrin), which was not on the market at the time of the original study, killed lice in less than 30 minutes, and ovicidal activity ranged from 73% to 90% (diluted and undiluted, respectively). CONCLUSIONS: Ovide lotion (0.5% malathion) was the fastest-killing pediculicide and the most effective ovicide. One percent lindane shampoo was the slowest-acting pediculicide and least effective ovicide. Nix was highly effective in both undiluted and diluted forms.

Animals↗

Necrotizing fasciitis of the scalp in a neonate.

We report an 11-day-old baby who presented with necrotizing fasciitis of the scalp from which Escherichia coli was cultured. Treatment consisted of administration of parenteral broad-spectrum antibiotics and debridement. Skin grafting of the resulting scalp defect was not permitted by the parents. The wound healed with scar tissue over 3 months.

Anti-Bacterial Agents↗

Scalp psoriasis: topical calcipotriol 50 micrograms/g/ml solution vs. betamethasone valerate 1% lotion.

Forty-two patients aged between 6 and 61 years (mean: 33.5 years) with psoriasis of the scalp were enrolled in this study. Twenty-seven patients (69%) were males and 15 (31%) were females. The aim of our study was to evaluate the efficacy, safety and tolerability of topical calcipotriol 50 micrograms/g/ml solution vs. betamethasone valerate 1% lotion in the treatment of psoriasis of the scalp. The study was randomized with the twice-daily application of either calcipotriol solution or betamethasone valerate lotion for 6 weeks. Treatment evaluation was clinically based on signs of psoriasis (thickness, redness, scaliness) which were scored from 0 = absent to 4 = severest possible involvement and was performed at the start of treatment and at weeks 2 and 6 of treatment. The results showed a marked improvement and clearance at the end of treatment in 15 (72.8%) of the 24 patients in the calcipotriol group and in 13 of the 18 patients (72%) in the betamethasone group. The mean total sign score at baseline was 5.1 in the calcipotriol group and 5.4 in the betamethasone valerate group. At the end of treatment, this score was decreased to 2.1 and 1.49, respectively. No significant adverse effects were reported in either group except in two patients (8.3%) in the calcipotriol group who developed signs of irritation including itching and erythema. In conclusion, both drugs were effective and well tolerated in the treatment of scalp psoriasis but in some patients calcipotriol had to be given for more prolonged courses.

Administration, Topical↗