[Scabies of the scalp in adults].
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A postmarketing study was conducted on 236 patients from 23 centres suffering from moderate to severe dandruff with a combination of ketoconazole and zinc pyrithione (1%) for a duration of 4 weeks with 2 weeks further follow-up. Scoring of dandruff was done on a 0-10 scale for each of the 6 regions of scalp at each week up to 6 weeks. The results indicate that there was a consistent improvement in dandruff scores over the treatment period and a reduction of > 90% was seen for all areas of scalp individually as well as collectively as compared to baseline. The treatment also showed significant improvement in other signs and symptoms such as erythema and itching, with a highly favourable adverse event profile. The overall assessment for global improvement by investigators showed good-excellent results with high acceptability amongst the patient population for the treatment. A combination shampoo of ketoconazole (2%) and zinc pyrithione (1%) offers a safe and effective option in the treatment of dandruff.
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BACKGROUND: Eosinophilic pustular folliculitis (EPF) is an inflammatory disorder of unknown etiology. In infants this disorder is characterized by recurrent episodes of sterile pustules primarily or exclusively involving the scalp with occasional involvement of the face, trunk and extremities. There are few reports of EPF in children. OBJECTIVE: To describe the clinical features and evolution of four pediatric patients and to discuss the main differential diagnoses. METHODS: Biopsy specimens were examined, pustules were cultured and laboratory tests were analyzed. RESULTS: Four patients (3 males and 1 female) aged 7-18 months presented with self limiting recurrent pruritic papules and pustules on the scalp. In one patient, the lesions were mainly localized on the extremities. Cultures for bacteria, fungi and viruses were negative. No systemic disease was found. Topical steroids were effective in three patients but pustules recurred after treatment was stopped. Cetirizine and Hydroxacen were administered in two corticoid-resistant patients with fair response. No other systemic therapy was administered. Peripheral eosinophilia was detected in three patients. CONCLUSIONS: EPF in infants seems to be a clearly defined entity. Although few cases have been described in children, this dermatosis is undoubtedly more frequent than suggested by the literature. Consequently, pediatricians should be aware of its existence.
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In the parietal region of a newborn male child, two skin lesions are found. An according sceletal defect could not be proved. These skin lesions are well known in the family of the mother. In the last three generations one member of the family showed those defects. A survey of literature gives more than 20 reports concerning these lesions in families, reporting cases where brothers and sisters are concerned up to three generations, and several cases where the underlying bone is concerned too.
BACKGROUND: Physiological and pathological skin eruptions are extremely common in neonates and are often presented to the general practitioner as either a primary or incidental problem at consultation. OBJECTIVE: To discuss the presentation and treatment of common dermatological conditions presenting in the first six months of life. DISCUSSION: Common conditions such as pityrosporum folliculitis, neonatal acne, cradle cap, eczema and food allergy are discussed. The rarer conditions of zinc deficiency and neonatal lupus are described because they may pose significant potential medical consequences.
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A 32 year-old woman developed generalised lichenoid eruptions on her body followed by diffuse loss of scalp hair of the anagen effluvium type. She was receiving several anti-tubercular drugs, including rifampicin, isonicotinic acid hydrazide (INH), pyrazinamide, and ethambutol, for abdominal tuberculosis. INH, which is a leading cause of drug eruptions in the above group of drugs was withdrawn. However, the other antitubercular drugs were continued along with 40 mg of prednisolone in a single daily morning dose. The latter was discontinued slowly over a period of 10 weeks. There was complete recovery of hair loss and the regrowth started after 12 weeks of alopecia. Such anagen effluvium with lichenoid eruption following INH therapy has not been observed previously. The complete recovery from anagen effluvium is difficult to explain, but it could have been because of the early initiation of corticosteroid.
A case of lice infestation of the hair in a 24 year-old man was reported. After the entomological identification of adults and immature stages of the vector; it was confirmed that the only existing parasite was Phtihirus pubis Linnaeus 1758, a hematophagous insect that usually infests pubis, armpit, eyelids, and other parts of the body but is rarely found in the head.
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Health care providers frequently encounter human infestations of scabies and lice. When a person is identified as having either of these infestations, he/she should be treated. More importantly, their close contacts should be examined and treated if needed. It is vital for dermatology nurses to understand the epidemiology, transmission, symptoms, distribution, diagnosis, complications, and treatment for scabies and lice infestations.