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[Folliculitis nuchae scleroticans--successful treatment with 13-cis-retinoic acid (isotretinoin)].

Acne keloidalis nuchae is characterized by keloidal papules and plaques. The lesions are located on the occipital scalp and posterior neck. This rare therapy-resistant condition is nearly always seen in men, particularly in negroes. Advanced stages of the disease require surgical excision with split-thickness skin grafts or treatment with a CO2 laser. Oral therapy with 13-cis-retinoic acid (isotretinoin) in a 23-year-old white man resulted in remarkable improvement within a few weeks.

Administration, Oral↗

Effects of sulfur and salicylic acid in a shampoo base in the treatment of dandruff: a double-blind study using corneocyte counts and clinical grading.

The effectiveness of sulfur 2 percent and salicylic acid 2 percent either alone or in combination in a shampoo base was determined in a double-blind controlled study using two methods of evaluation: clinical assessment of scaling and corneocyte counts (the number of desquamating cells/cm2). Forty-eight subjects (twenty-nine men and nineteen women) with moderate to severe scaling shampooed their hair under supervision twice a week for five weeks, using one of four formulas: sulfur 2 percent plus salicylic acid 2 percent in a shampoo vehicle; sulfur 2 percent in a shampoo vehicle; salicylic acid 2 percent in a shampoo vehicle; or the shampoo vehicle alone. On days 0, 7, 14, 21, 28, and 35 the degree of scaling was assessed, and specimens were taken for corneocyte counts. Significantly greater and earlier reductions in both degree of scaling and corneocyte counts were seen in subjects treated with the formula containing both sulfur 2 percent and salicylic acid 2 percent in the shampoo base than in those who received either active ingredient alone or the shampoo vehicle.

Adult↗

Treatment of alopecia areata with squaric acid dibutylester.

Fourteen of 18 patients with extensive alopecia areata completed a course of weekly treatments with the topical allergen squaric acid dibutylester in acetone. The concentration of squaric acid was varied as needed to maintain a moderate dermatitis. Only one area of alopecia was treated in each patient until marked hair growth occurred. The remainder of the scalp was then treated. Four patients (28.5%) had complete regrowth of hair during treatment; one of these patients had recurrent alopecia after stopping treatment. Ten patients (71.4%) were treatment failures. Of these ten failures, seven developed a moderate dermatitis and hair regrowth but experienced recurrent alopecia with continued treatment. One patient failed to maintain an adequate persistent dermatitis, and two failed to grow any hair despite the presence of dermatitis. Successful results in these patients correlated with (1) a duration of alopecia of less than two years, (2) the development of a moderate dermatitis within three weeks of starting treatment, (3) persistent hair growth within two months of developing dermatitis, and (4) an age of 16 years or older.

Allergens↗

[Erosive pustulous dermatitis of the scalp].

We present a 46-year-old female patient suffering from progressive, pustular and erosive lesions of the scalp. The nosology and the differential diagnosis of this disease entity, called erosive pustular dermatosis of the scalp, are discussed.

Alopecia↗

[Mycoses caused by Trichophyton megninii in Galicia (with review of the taxonomy of this dermatophyte)].

The taxonomy of the dermatophyte Trichophyton megninii has been the subject of much discussion since it was first isolated by Sabouraud in 1893. Initially he named it Trichophyton à culture rose and later T. rosaceum. It has been confused with the Microsporum (Epidermophyton) gallinae described by Megnin. Nowadays most mycologists consider T. rosaceum to be a synonym of the T. megninii, although some French authors still use Sabouraud's denomination. It is an exclusively anthropophilic dermatophyte with a broad geographic distribution, but in general a low incidence in most countries, except in Portugal, Corsica and Sardinia where it causes infections of both hairy and glabrous skin zones and nails in humans. T. megninii is an uncommon cause of ringworm in Spain and is mainly restricted to Galicia, and even there the incidence is low; it has been isolated only five times in our clinical practice with two more cases described previously in the literature, and predominantly affects females. Case reports show that it produces slowly evolving lesions with little local symptomatology on the scalp and is recalcitrant to conventional antifungal treatment. Its identification in culture should be based on the macroscopical appearance of the colony and by its absolute requirement for 1-histidine.

Adult↗