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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.
OBJECTIVES: In this paper, we explored the use of quadratic classifiers based on Mahalanobis distance to detect mental EEG patterns from a reduced set of scalp recording electrodes. METHODS: Electrodes are placed in scalp centro-parietal zones (C3, P3, C4 and P4 positions of the international 10-20 system). A Mahalanobis distance classifier based on the use of full covariance matrix was used. RESULTS: The quadratic classifier was able to detect EEG activity related to imagination of movement with an affordable accuracy (97% correct classification, on average) by using only C3 and C4 electrodes. CONCLUSIONS: Such a result is interesting for the use of Mahalanobis-based classifiers in the brain computer interface area.
Based on the clinical presentation of some skin pigmentation disorders it is thought that a bicompartmental functional system exists in the epidermal melanocyte population. It corresponds to the perifollicular and interfollicular compartments, respectively. The present study was undertaken looking for the presence of such a system on scalp unaffected by pigmentary disorders. The scalps of 100 men with incipient to severe androgenic alopecia were examined using a videocamera equipped with an internal ultraviolet light-emitting unit. The face, trunk and limbs were similarly examined in 45 of these adults and in 13 children of both sexes. In 92 men, a subclinical hypermelanosis was found as a speckled pattern centered on every single follicle. With increasing baldness severity, another epidermal hyperpigmentation pattern involving the interfollicular area was superimposed to the perifollicular pattern. These stereotyped patterns of subclinical melanoderma were also disclosed on the face of adults, but not in children. In addition, the spotty perifollicular pattern was discrete or not apparent on the other parts of the body. It is concluded that the perifollicular subclinical melanotic pattern is a regional characteristic of cephalic skin, perhaps related to the local production of melanocortins, particularly alpha-MSH by the pilosebaceous unit.
OBJECTIVE: To observe the short-term effect of patients with poly-infarctional vascular dementia (PIVD) treated by CT positioning scalp circum-needling (SCN) combined with Chinese herbal medicine. METHODS: Eighty-nine patients of PIVD were enrolled and divided into the treated group (n = 57) and the control group (n = 32). They were all treated with oral taking of Fuyuan mixture (FYM, consisted of ginseng, medlar, salvia, bitter cardamon, etc). To the treated group, SCN was applied additionally with the unilateral area around the reflecting region (localized by CT) in scalp as main needling points and Ganshu, Shenshu, Zusanli, Hegu as supplementary points. Two courses of SCN were performed. The changes of clinical symptoms, intelligence and hemorrheological characteristics in patients were analysed. RESULTS: After two courses of treatment, the total effective rate in the treated group was 96.5%, which was better than that in the control group (75.0%), with significant difference (u = 2.423, P < 0.01); HDS scores increased in both groups after treatment, showing significant difference as compared with that before treatment (P < 0.01), hemorrheologic parameters were also apparently improved. CONCLUSION: CT positioning SCN combined Chinese herbal medicine treatment has definite therapeutic effect in treating PIVD.
Localized hair shedding caused by Pheidole ants is reported as a newly recognized type of hair loss, mimicking alopecia areata. We report two cases from Kerman, Iran. This sudden hair loss demonstrates that ants such as the Pheidole dimorphic species can cause hair shedding. Fairly clean cutting of the scalp hair takes place just a few micrometers above the skin surface and simulates alopecia areata or mechanical shaving of scalp hair. This infestation has not been reported from other countries, and this report is the second from Iran.
Pityriasis versicolor (tinea versicolor) is a common superficial fungal infection of the skin involving the hyphal (filamentous) form of Pityrosporum orbiculare. Clinical cutaneous infection is common in humid, tropical climates, but declines to less than 5 percent in temperate climates. Isolated face or scalp involvement is rare. We present a boy living in a temperate region who had sudden onset of scalp and hairline involvement with tinea versicolor.
A case of malignant mixed tumour arising from minor salivary gland tissue in the right parapharyngeal space with metastasis to the scalp is described. Both the clinical presentation and the histological picture were unusual. The simultaneous discovery of the primary parapharyngeal tumour and its scalp metastasis, the relatively young age of the patient (43 years-old), the origin of the tumour in minor salivary gland tissue, and the presence of a benign stromal component in the metastasis are features not commonly described in the three entities covered by the term "malignant mixed tumour". We believe this case represents a distinct variant, whose behaviour and progression have not been previously well documented.
The worl and cow-like shape scalp hair patterns. They are patterns considered normal and others aberrant. Because they are associated with disorders of early brain and craniofacial development, 300 newborn infants were studied. Only 6 had congenital malformation without anomaly scalp hair patterns associated. In the rest of newborn infants the location and direction of the whorls and cow-like were the same see in the children studied previously. Are necessary big series for affirm if really exist aberrant patterns.
Radiologic findings of a case with scalp plexiform schwannoma-an unusual variant of the benign, solitary schwannoma in the skin-are reported. T2-weighted MR imaging exhibited the most specific features: a multinodular pattern and hypointense capsule that separated the tumor from surrounding soft tissue. A surgical specimen was histologically confirmed as schwannoma. The MR imaging findings reported herein may aid in the preoperative diagnosis of this relatively rare scalp tumor.
AIMS: Scalp-EEG interictal epileptiform discharges (IEDs) may be less predictive of the outcome of frontal lobe epilepsy surgery than of temporal lobe epilepsy surgery. We identified factors associated with the location of scalp-EEG IEDs in intractable frontal lobe epilepsy. METHODS: Ten factors were assessed in a retrospective review of 53 patients with either concordant (frontal lobe seizure focus) or discordant (generalized or outside frontal seizure focus) IED or both, who had excellent surgical outcomes. The Fisher exact test and the Wilcoxon rank sum test determined statistically significant associations. RESULTS: Thirty-six patients (68%) had concordant IED, 24 (45%) discordant IED, and 17 (32%) both. Younger age at onset was significantly associated with discordant IED (mean, 7.5 years versus 17 years for patients without discordant IED; P < 0.01), whereas duration of epilepsy was not. Seizure foci at the frontal convexity were associated with concordant IED. About 72% of patients with a convexity seizure focus had concordant IED, compared with only 33% of patients with mesial frontal foci having concordant IED (P = 0.06). CONCLUSIONS: Early seizure onset in intractable frontal lobe epilepsy is associated with IEDs discordant with seizure focus. Frontal convexity seizure foci are more likely than mesial frontal seizure foci to be associated with concordant discharges.
The advent of fast foods, increased mechanization,advanced telecommunication and improved living standards have caused human beings to adopt sedentary life styles leading to lesser means of expending calories, accumulation of body fat and tendency to be obese. Plastic surgery can be of great help in supporting patients in their attempts at weight reduction by removing resistant body fat and excising redundant skin that may not succumb to other means of weight reduction. The authors present an unusual case of a young gentleman who developed a rare laxity of the scalp following a drastic weight reduction. Scalp reduction led to a significant cosmetic improvement and psychological acceptance of body image. A review of literature and discussion on the management of this unusual case follows.
Scalp involvement by psoriasis requires a ted treatment suited to the particularities of the anatomical site In course of time, the improvement of therapeutic agents and the galenic refinement have enhanced both the efficacy and cosmetic acceptability of the scalp care. The main therapeutic classes encompass keratolytics, dermocorticosteroids and vitamine D3 analogues. The patient compliance is reported to be best for the liquid or foam formulations.
Necrotizing fasciitis is a rare, rapidly progressing soft tissue infection, characterised by extensive necrosis of subcutaneous fat and fascia with relative sparing of skin and underlying muscle. It is usually caused by toxin producing virulent bacteria. Although it can occur in otherwise healthy patients, the disease is usually seen in conjunction with immune deficiency disorders, intravenous drug abuse, peripheral vascular disease and diabetes. Necrotizing fasciitis is more frequent in abdominal wall, perineum and extremities. Involvement of the head and neck structures and especially the scalp is rare. We treated a diabetic and chronic renal failure patient with necrotizing fasciitis of the scalp without any complication.
Full-thickness defects of the scalp following cancer resection are reconstructive challenges when bone is exposed. Local, regional, and/or free tissue transfer have all been described for reconstruction when the pericranium is exposed. We examined the surgical outcomes from 23 patients who underwent placement of bovine collagen constructs. Thereafter, delayed skin grafting was performed. The average age of the patients was 70 years. All patients had one of the following: melanoma (n = 13) squamous cell carcinoma (n = 5), angiosarcoma (n = 2), basal cell carcinoma (n = 1), spindle cell carcinoma (n = 1), or malignant pilar tumor (n = 1). The average defect size was 51 cm, with a range of 9 cm to 169 cm. Average time between bovine construct placement and skin grafting was 30 days. Histologic studies demonstrated persistence of the construct and infiltration of nascent fibroblasts. Six patients had delayed healing due to microabscesses in the constructs. All wounds eventually healed. In the elderly, this is a simple method to treat full-thickness scalp defects.
The authors report a case of cavernous hemangioma in the occipital region, which resembled sinus pericranii, protruded in the recumbent posture. A 28-year-old male was admitted with a chief complaint of an occipital fluctuating mass, 5cm in diameter, accompanied by slight pain. The skull X-P was normal. A direct puncture revealed that the lesion was a blood cyst. A cystogram by percutaneous needle puncture revealed paramedian blood pooling with some draining veins but did not show any transcranial communicating vessels. A T2 weighted MR image demonstrated a well demarcated high intensity lesion just beneath the corium. The subtotally removed specimen turned out to be a cavernous hemangioma. We discerned a conceptual confusion of pseudosinus pericranii with scalp cavernous hemangioma, based on the literature review. And we propose that scalp cavernous hemangioma, even if it changes its size according to posture, should not be simply designated as sinus pericranii.
OBJECTIVE: To observe the effect of scalp acupuncture (SA) on the glucose metabolism in different regions of brain in patients with depression by positron emission computed tomography (PET). METHODS: Twelve depressive patients were treated by scalp acupuncture on middle line of vertex (MS5), middle line of forehead (MS1) and bilateral lateral line 1 of forehead (MS2), once a day for six days per week, and received PET detection on different region of brain before and after 6 weeks acupuncture treatment. Semiquantitative analysis was used to compare the average values of radioactive count gotten from various brain regions before and after treatment, which could reflect the condition of glucose metabolism at the brain region detected. RESULTS: SA could increase the glucose metabolism at bilateral frontal lobes, bilateral parietal lobes, right occipital lobe, right caudate nucleus, right cingulated gyrus and left cerebellum and decrease that at right temporal lobe and bilateral thalamus. CONCLUSION: SA on MS5, MS1 and MS2 in depressive patients could influence the glucose metabolism in various brain regions. It primarily illustrated that the mechanism of SA in treating depression is related with its regulation on cortex-limbic circuitry dysfunction and increase the glucose metabolism in various brain regions.
OBJECTIVE: To summarize our experiences with 18 cases of repeated tissue expansion for treating extensive scalp and facial soft tissue defects. METHOD: Tissue expansion was performed for 1 or 2 times after the primary expansion for repairing large scalp and facial soft tissue defects ranging from 9 cm x 5 cm to 16 cm x 12 cm using re-expanded flaps. The indications, complications and experiences in the treatment were discussed. RESULT: Satisfactory results were obtained in all the 18 cases. On the follow-up conducted 6 months postoperatively, the repaired defects presented excellent appearance and functional recovery without additional scars. CONCLUSION: Repeated tissue expansion is an effective technique for repairing large tissue defects in the head and face.
A case of localized neonatal herpes simplex virus (HSV) infection involved a prior fetal scalp electrode site. Rupture of the fetal membranes, placement of the fetal scalp electrode and delivery occurred within 30 minutes. The mother had no previous history of genital lesions, and no herpetic lesions were noted at delivery.