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Subclinical speckled perifollicular melanosis of the scalp.

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.

Adult↗

The life of a head louse.

When children return to school after the summer holiday, cases of head lice appear to increase. Ian Burgess describes the life cycle of the head louse and dispels some of the myths about transmission of this insect. A second article discusses the detection and treatment of head lice.

Age Distribution↗

Detection combing.

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Animals↗

A preliminary pilot survey on head lice, pediculosis in Sharkia Governorate and treatment of lice with natural plant extracts.

Twelve different representative areas in Sharkia Governorate were surveyed for head lice, Pediculus humanus capitis. The pre-valence was investigated among 120 houses containing 2,448 individual, with different age, sex and socioeconomic status. Examination was done by naked eye aided with hand-lens. A total of 137 individuals were infested. Infestation rates were higher in the rural areas with low socioeconomic levels, concrete houses with over-crowded family members. Children had significantly higher infestation rates than adults. Males had lower infestation rates than females. However, the hair length and permanent hair washing were the factors accounted for both age and sex difference in prevalence of pediculosis. Head lice infestations were found all over the year, but increased in summer and spring. One hundred infested patients (90 females and 10 males) with different aged and hair length were treated with tour mixed cream from plants Lawsonia alba L. (Henna). Trigonella faemum-gracanum (Fenugreek), Hibiscus cannabinus (Hibiscus) and Artemisia cina (Wormseed). The head lice completely disappeared within a week among those patients treated by henna mixed with aqueous extract of sheah (100%) or mixed with helba (75%) or with karkada (50%).

Adolescent↗

Head lice.

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Animals↗

Invasive synergistic fungal infection after motor vehicle collision.

Primary invasive fungal infections occur after direct contact or direct inoculation of the skin with fungal spores. Rhizopus species and Aspergillus terreus are opportunistic fungal species that rarely cause disease in immunocompetent hosts. In susceptible patients, infection may progress rapidly. Aggressive surgical debridement and use of systemic antimycotic agents may successfully control disease and prevent systemic dissemination. We describe the case of a patient with a scalp infection, caused by Rhizopus species and A. terreus, that occurred after contact with pavement during a motor vehicle collision. Control was achieved with repeated debridement and use of systemic antifungal therapy.

Accidents, Traffic↗

[Cutaneous myiasis. A case of double infestation with Dermatobia hominis larvae].

We describe a case of imported double cutaneous infestation with Dermatobia hominis acquired in Central America. The characteristic clinical picture is a growing furuncular lesion with continuous secretion from a small central orifice. Because of the resemblance to a bacterial infection, there is a risk of diagnostic failure. Increasing incidence of imported myiasis may be expected as a result of increased travel activity to endemic areas. A certain knowledge of this disease is therefore required.

Adult↗

Perifolliculitis capitis abscedens et suffodiens successfully controlled with topical isotretinoin.

Perifolliculitis capitis abscedens et suffodiens (or dissecting folliculitis of the scalp or dissecting cellulitis of the scalp or dissecting perifolliculitis of the scalp) is a rare entity and constitutes the equivalent over the scalp, of hidradenitis suppurativa and acne conglobata. Etiologic factors are unknown. Diagnosis is proven histologically. Management is very difficult and consists in systemic administration or intralesional injection of several drugs or in surgical manipulations. An 18 year-old white patient with cystic infiltrations, alopecia plaques, pustules and other inflammatory elements (clinicohistological features consistent with dissecting folliculitis of the scalp), is presented. Isotretinoin topical application assured successful control of the disease and averted the evolution of the clinical aspect to scarring alopecia and nodule formation. Topical isotretinoin exercises a curative, inhibitory and antiproliferative action, in perifolliculitis capitis abscedens et suffodiens.

Administration, Topical↗

Frontal fibrosing alopecia.

Two cases of frontal fibrosing alopecia in post menopausal women, one of them biopsy-proven, are reported. Both women showed a progressive marginal alopecia and none had multifocal areas of involvement typical of lichen planopilaris nor the mucosal or cutaneous lesions of lichen planus. However, scalp biopsy specimens from the frontal hair margin showed perifollicular fibrosis and lymphocytic inflammation. Because the histologic findings are indistinguishable from those seen in lichen planopilaris, frontal fibrosing alopecia is considered a variant of lichen planus pilaris with a particular specific localization and usually onset in the postmenopausal age.

Aged↗

A study of pediculosis capitis among primary school children in Delhi.

A cross-sectional study was conducted among primary school children of four of the government run schools of Delhi during July-October 2001. Out of a total of 940 study subjects studied 156 (16.59%) were found to be infested with head louse. Significantly higher proportions of girls (20.42%) were found to be infested as compared to boys (13.86%). 65.38% of those infested were aware of the infestation. Those who shared both bedding and comb showed a statistically higher significance as compare to others. Manual removal of head louse and nits was practiced by 69.60% of those aware of the infestation. Majority had knowledge of transmission of head louse by comb/brush, 66.08% had knowledge about control of head louse infestation spread by manual removal 7.34% mentioned other means like kerosene oil and lime powder. Since head louse infestation is a common problem of school going children both parents and teachers along with the students should be taught how to recognize the infestation. Also school health teams should be responsible for treatment and prevention of louse infestation besides carrying our other school health service functions.

Child↗

Linear lupus erythematosus profundus on the scalp following the lines of Blaschko.

We describe a 10-year-old Japanese girl presenting linear alopecia on the scalp and forehead. Histological examination showed fat degeneration with mucin deposit and periappendageal infiltrate of mononuclear cells. We diagnosed her as having linear lupus erythematodes profundus with a linear configuration following the lines of Blaschko.

Alopecia↗