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Flow cytometric analysis of cell cycle kinetics of anagen scalp hair correlated with plasma androgens in hirsutism.

Cell kinetics of anagen scalp hair bulbs obtained from hirsute (n = 13) as well as healthy (n = 10) females were analysed by DNA-flow cytometry. The cell cycle kinetics in hirsutism revealed a significant increase of S-phase cells (10.2%) and a significant decrease of G0/1-phase cells (80.7%) compared with healthy females (S-phase 7.5%, G0/1 phase 86%). Moreover, dehydroepiandrosterone sulfate (DHEA-S) levels and cell cycle kinetics obtained from the hirsute females yielded a strong correlation between the height of S-phase percentages and DHEA-S values, whereas no correlation could be proved between testosterone levels and DNA-FCM data. Therefore, the weak androgen DHEA-S is assumed to be one hormonal factor influencing the cellular growth kinetics of hair bulbs in androgen-sensitive scalp areas.

Adult↗

[Congenital cutaneous aplasia of the scalp. Apropos of 4 cases].

Report of four cases of congenital defects of the scalp. In two of these cases, the skin defect was associated with a skull defect and in one, there were other cranial deformities. In each case, the lesion seemed isolated in otherwise normal children. This study contains a review of congenital scalp defects. The different aspects of this rare disease are presented and the treatment is discussed with reference to natural evolution. The authors differentiate between cases with isolated lesion and cases with associated malformations or abnormalities, malformation syndromes, as has been previously defined. In the case of skull defects, it is thought that immediate reparatory surgery must be performed, to prevent infection and hemorrhage of sagittal venous sinus, as it was the case in one of the four children. The covering of the defect can be realized with rotated skin flaps, which seem preferable to any form of plastic surgery, for cosmetic reasons, and for the secondary treatment of the skull defect, if this is necessary. When spontaneous closure of the bone defect, is not noted, which occurs generally in the case of large defects, it seems reasonable to close the latter by cranio-plasty, to protect the brain. In one of the four cases reported, this technical approach of the lesion was used, with a good result being reported, four years later.

Calcinosis↗

[The theory of current fields induced by scalp electrodes].

In order to solve the problem of electrostimulation with the help of scalp electrodes the simplified general theory was developed. The analysis was carried out in a framework of multilayer sphere-cable. The formuli of potential on the surface of scalp and in the volume of brains were worked out. The theory was concretized for traditional bipolar and new differential ways of fixing of the stimulating electrodes. The goal is to use the obtained theory for numerical estimation of electrical parameters of brain envelopments and for calculation of the values of electrical field in the volume of brains.

Brain↗

Lumbar epidural analgesia with bupivacaine in labor. Determination of drug concentration and pH in fetal scalp blood, and continuous fetal heart rate monitoring.

Lumbar epiduval analgesia with bupivacaine was given to 37 women for uncomplicated labor. After the blcokade serial determinations of pH and bupivacaine concentration were made in fetal scalp blood and maternal venous blood and there was continuous monitoring of the fetal heart rate. Fetal scalp blood pH was within normal limits and no pathologic FHR tracings were elicited by the blockade, although a temporary decrease of the baseline fetal heart rate irregularity was seen in about one-fifth of the cases. Fetal drug concentrations were low and about one-fourth of corresponding maternal values. After reinjection of bupivacaine the degree of drug accumulation was fairly similar in fetal and maternal blood.

Adolescent↗

Correlation of fetal heart rate-uterine contraction patterns with fetal scalp blood pH.

The significance of fetal heart rate-uterine contraction (FHR-UC) monitoring as a means of predicting the condition of the fetus during labor was studied by correlating 460 fetal pH determinations obtained from 216 patients with the analysis of the 20-minute FHR-UC record preceding the fetal scalp blood sample. Both qualitative and quantitative analyses of the FHR-UC record were performed. The results indicate a less than 10% chance of fetal pH less than or equal to 7.250 with an normal baseline FHR and no periodic changes or with periodic accelerations, early decelerations, and uncomplicated baseline bradycardia or tachycardia. Variable or delayed decelerations with a total surface area (TSA) of 1-100 for the 20-min period were associated with a fetal pH less than or equal to 7.250 in 23 and 34% of cases, respectively. Variable or delayed decelerations with a TSA greater than 100 had a 35 or 47% chance of fetal pH less than or equall to 7.250. It is concluded that FHR-UC monitoring can be used to screen the innocuous from the ominous periodic change but that fetal scalp blood pH must be obtained to identify accurately the true from the false-positive ominous pattern.

Female↗

Percutaneous absorption of coumarin, griseofulvin and propranolol across human scalp and abdominal skin.

The objective of this study was to investigate the role of the transfollicular pathway in the diffusion process of chemicals through excised human skin in vitro. Skin was obtained from 5 cadavers (3 males, 3 females) within 24 h of death. The age of the subjects varied between 18-77 years. Three radiolabelled drugs, namely 14C-coumarin, 3H-propranolol and 3H-griseofulvin, were studied. The permeation parameters such as flux, lag time, diffusion coefficient and permeability constant were determined across scalp and abdominal skin using the Thomas Diffusion Cell. For all tested substances the flux through scalp skin was higher than across abdominal skin and the lag time was decreased. The differences were statistically significant at p less than 0.05 for coumarin and propranolol. These data suggest that the transfollicular pathway in permeation might have a significant impact on the diffusion parameters for some drugs. Also, in the case of coumarin, permeability seems to be epidermis/dermis-controlled, whereas for griseofulvin and propranolol the Stratum corneum apparently is the permeability limiting barrier.

Abdomen↗

Nevus lipomatosus cutaneus superficialis of the scalp.

A 12-year-old boy with nevus lipomatosus cutaneus superficialis of the scalp is described. Asymptomatic plaques made up of varying sized aggregates of elastic soft papules were observed on the occipital region. Histologic examination of a biopsy specimen revealed ectopic fat tissue in the dermis. Two types of nevus lipomatosus cutaneus superficialis can be differentiated clinically. The classic types, with multiple lesions in a zonal distribution, occur most often on the lumbar region, buttocks, and thigh. The other types, which involve a solitary papule or nodule, have no favored location. This is the first report of multiple lesions in a zonal distribution occurring characteristically on the scalp.

Biopsy↗

Basal cell carcinoma of the scalp in a black patient.

Basal cell carcinoma rarely occurs in black persons. When it does occur, it most often involves the sun-exposed areas of the face. Basal cell carcinoma of the scalp often occurs after other predisposing events such as radiation damage, nevus sebaceus, or systemic conditions such as arsenic exposure or immunosuppression. We report the unusual case of a basal cell tumor arising de novo on the scalp of a black patient with none of these predisposing conditions.

Biopsy↗

[Physiopathological approach to seborrhea of the scalp].

Objective assessment of seborrhea of the scalp has seldom been reported in the literature. We have used a variant of the method described by Saint-Léger and Lévêque to measure the sebum excretion rate in normal scalp, male pattern alopecia, pityriasis amiantacea, pityriasis capitis and alopecia areata. The sebum excretion rate was significantly increased in male pattern alopecia, significantly decreased in pityriasis amiantacea and showed a trend towards reduction in alopecia areata. Pityriasis capitis was not associated with changes in the excretion of sebum.

Adolescent↗

Propylene glycol in the treatment of seborrheic dermatitis of the scalp: a double-blind study.

Thirty-nine patients with seborrheic dermatitis of the scalp were treated in a double-blind controlled study with a solution containing either 15 percent propylene glycol, 50 percent ethanol, and 35 percent water, or a solution containing 50 percent ethanol and 50 percent water. Two patients did not return for follow-up. Sixteen of eighteen (89 percent) in the group treated with propylene glycol showed healing, compared to six of nineteen (32 percent) in the other group. In twenty patients quantitative cultures for Pityrosporum orbiculare were taken. The number of organisms was reduced significantly after treatment with the propylene-glycol-containing solution but not in the other group. This propylene-glycol-containing solution was easy to apply, cosmetically attractive, and may be an alternative to corticosteroids for the treatment of seborrheic dermatitis of the scalp.

Adult↗

Congenital midline porencephaly: a new brain malformation associated with scalp anomaly.

5 cases of dysgenetic hydrocephaly associated with scalp anomalies are described. This brain-scalp anomaly complex is characterized by congenital hydrocephalus, alopecia or cephalocele in the parietal midline and symmetrical defect of the bilateral posterior cerebral mantle along the midline. Midline septal structures of the cranial cavity and tentorium cerebelli were also defective and replaced by a huge dorsal CSF cavity. Histological features of the covering membrane of the dorsal cyst indicate that this new brain anomaly is the consequence of a porencephalic process and we postulate the 'midline porencephaly'. Cerebral angiography is the most valuable method for the diagnosis of this anomaly and its venous phase reveals dysgenesis of the galenic drainage as well as of the dural sinuses.

Agenesis of Corpus Callosum↗

Scalping injuries: new technique for stabilization of flaps to the skull.

Extensive scalping injuries offer a unique challenge for tissue coverage because of the wide expanse of bone and lack of deep soft tissue or significant perforating vessels. For smaller injuries, pedicle flaps offer ideal coverage. Larger defects can be covered by omental flaps. Coverage with a free muscle flap followed by split-thickness skin grafting offers optimal long-term coverage. Two new techniques are introduced. The wire-button technique offers stabilization, and the halo frame provides good support and protection for a new free-flap graft and may increase the success rate of flaps in patients with scalping injuries.

Humans↗

Reconstruction of extensive tissue defects of the scalp by microsurgical composite tissue transplantation.

Two cases of severe and extensive electrical burns of the scalp and skull are presented. Large segments of composite groin tissue were successfully transplanted to cover the scalp defects. Microvascular surgical techniques were employed. Both patients had short postoperative hospitalizations. It is possible that a cranioplasty may now be performed as a second stage under the healed full-thickness skin. The advantages of providing a thick protective skin cover in a single operation are outlined.

Adolescent↗

Optimization of the source derivations from the scalp surface.

The selectivity of source derivations (SD) is computer-calucla ted using different combinations of electrodes and different interelectrode differences, with a view to the optimization of the method. For this purpose, the method described by Nunez and Katznelson (1981) is used to calculate surfaces in the brain tissue from the points of which a single current source will determine the same potential in a given point on the scalp surface. The lines of these surfaces are given for different planes. The calculations show that the selectivity increases with the decrease of the interelectrode distances, as well as when more electrodes are used. With a small number of electrodes for SD and especially when one central and two lateral electrodes are used, there exist brain areas in which the generators cause a potential with opposite sign on the scalp surface.

Electrodes↗

[Histiocytoid hemangioma of the scalp].

We report a case (the second from France) of histiocytoid haemangioma, an entity created by Rosai et al. (14) in 1979 to accommodate several cutaneous and extra-cutaneous diseases hitherto known under other names and characterized histologically by the proliferation of vessels with peculiar "histiocytoid" endothelial cells. Our patient was a 56-year old woman who developed, within a few weeks, a slightly haemorrhagic nodule of the scalp. The histological examination, performed in a private laboratory, led to a diagnosis of cavernous angioma or angioleiomyoma. Two months after the lesion was removed, the condition recurred in the form of about 10 sessile subcutaneous nodules, 3 to 20 mm in diameter; the nodules were firm, painless, little pruriginous and sometimes ulcerated. An old-standing lymph node enlargement was palpable on the right side of the posterior aspect of the neck. The rest of the scalp was normal. Physical examination of the skin and mucosae revealed no other abnormality. These alarming lesions were suggestive of metastasis or angiosarcoma. X-ray films of the skull were normal, as were the results of blood examination; in particular, there was no eosinophilia. Histology showed a papillomatous epidermis, while the superficial and mid dermis were occupied by a lobulated vascular proliferation. The vessels were of the capillary type; they were lined with two or three layers of endothelial cells remarkable for their large indented nucleus and for their abundant eosinophilic cytoplasm bulging out into the lumen. These vessels were surrounded by fairly dense nodular masses of small lymphocytes with a few histiocytes and some neutrophils. There were no lymphoid follicles.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis, Differential↗

The correction of scalp hair defects by tissue expansion.

This paper presents the results and complications in the correction of partial scalp alopecia in ten patients using the technique of 'tissue expansion'. The average size of defect that was covered by expanded hair bearing scalp was 45.9 cms2, and the largest defect covered measured 11 X 6 cm. This series indicates that tissue expansion is now one of the most promising methods available for dealing with the difficult problems of partial alopecia which can present to surgeons and physicians in a wide range of specialties.

Adolescent↗

Alopecia and drug eruption of the scalp associated with a new beta-blocker, nadolol.

Infiltrative dermatitis and marked alopecia of the scalp appeared shortly after a new beta-blocker, nadolol (Corgard), was prescribed for the treatment of a patient with hypertension. Cessation of the beta-blocker therapy, after four months of therapy, was followed by a dramatic involution of the eruption, and total regrowth of scalp hair occurred within three months. The associated eruption and rapid regrowth of hair upon discontinuation of nadolol distinguish this alopecia from the telogen effluvium previously associated with other beta-blocker drugs, such as propranolol (Inderal) and metoprolol (Lopressor).

Alopecia↗