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Hair and scalp disorders in blacks.

Hair and scalp disorders in blacks and the properties of hair in blacks that make it behave differently are described. Hair disorders commonly seen now are the result of permanent and relaxer damage, heat, and traction alopecias. Presently, the most common scalp disorders in blacks are keloidal folliculitis and dissecting cellulitis of the scalp. Treatment modalities for these disorders are reviewed.

Alopecia↗

[Reflections on dermatophytes].

In light of his experiences especially in tropical regions, the author makes some remarks about dermatophytes and dermatophytia, which they cause. The following main items are: 1. The dermatophytes lead a saprophytic life. 2. Exceptionally, they can invade nonkeratinized tissue and cause "dermatophytic disease", perhaps mycetomas. 3. 45 percent of the ringworm of the scalp heal before puberty. 4. In the tropical regions, trichophytosis caused by endothrix-species are often of inflammatory nature, the favus appears often without scutula formation (afavic). 5. One can heal a substantial percentage of the ringworm of the scalp with a single dosis of 12 tablets (125 mg each) of fine particle griseofulvin. 6. Athlete's foot has also other causes than only dermatophytes.

Adolescent↗

[Steatocystoma multiplex].

A 50 years old male patient with numerous cysts over the scalp since the age of 48 is reported in whom the lesions appeared abruptly in two crops in a short period of time. Several biopsies were done showing most of them the typical histologic characteristics of steatocystoma multiplex. The authors remark in this patient the nonhereditary character of the condition, appearing late in life with an eruptive character and strict limitation over the scalp, features that are not often seen in steatocystoma multiplex. The authors pointed out that not all the cysts showed the typical histopathological picture of the disease. Therefore several biopsies must sometimes be done, before the diagnosis is established.

Epidermal Cyst↗

[Scalp infection caused by B-streptococci in a newborn infant following internal cardiotocography].

The paper reports on a newborn developing a scalp abscess 10 days after birth due to fetal monitoring with scalp electrodes. B-streptococci were isolated from purulent material after surgical intervention. The recovery was uneventful after therapy with appropriate antibiotics and removal of the pus (incision). In a short review of literature the authors discuss some of the aspects of infections arising in connection with use of scalp electrodes for fetal monitoring.

Abscess↗

[Nosologic position of demodicidosis in humans].

In 20 patients with rosacea and rosacea-like eruptions Demodex folliculorum mites were found in high numbers within lesional skin. In one patient Demodex folliculorum could be demonstrated in pits and burrows in the epidermis of the scalp. In other instances the mouth parts of the mites were closely related to the follicular epithelium. Recent parasitologic findings showed that in spite of their name (Demodex = "sebaceous worm") the mites derive their nutritive requirements from cellular proteins obtained by epithelial destruction. To clarify the pathogenetic significance of hair follicle mites in man as suggested by these histological findings as well as their known ability to form organisational centers of foreign body granulomas, further epidemiologic and immunologic studies are needed. Topical antiparasitic agents did not offer any therapeutic advantage over traditional preparations used for rosacea and seborrheic dermatitis.

Adolescent↗

[Reconstruction of the large scalp defect by free flap transplantation].

The reconstruction of a large scalp defect is extremely difficult on many occasions and repeated operations or a long-term hospitalization is often required. In addition, unsatisfactory results are not unusual. However, it is now possible to perform reconstruction by a one-stage operation of free tissue transplantation (free flap) using microsurgical vascular anastomosis which has rapidly developed in the past ten years. We performed reconstructions applying latissimus dorsi musculocutaneous, greater omentum, groin and scapular flaps. The advantages with the free flap are: (1) one-stage reconstruction is possible; (2) no restrictions on the postoperative position, (3) the flap, which is independent of the blood supply from the recipient, well survives on the recipient with an insufficient blood supply and (4) the damage at the donor site can be minimized. On the other hand, its disadvantages are as follows: (1) the operation requires microsurgical vascular anastomoses; and (2) recipient vessels should be normal. The above report was based on favorable results we obtained in 6 cases of reconstruction with free flap applying microvascular techniques.

Aged↗