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Magnetic Resonance in Medical Sciences... Jun 2021Although androgenetic alopecia (AGA) is a common cause of hair loss, little is known regarding the magnetic resonance imaging (MRI) of the AGA or scalp. This study aimed...
PURPOSE
Although androgenetic alopecia (AGA) is a common cause of hair loss, little is known regarding the magnetic resonance imaging (MRI) of the AGA or scalp. This study aimed to analyze whether MRI for hair and scalp (MRH) can evaluate anatomical changes in the scalp caused by AGA.
METHODS
Twenty-seven volunteers were graded for the severity of AGA using the Hamilton-Norwood Scale (HNS), commonly used classification system. All subjects underwent MRH; two radiologists independently analyzed the images. As a quantitative measurement, the number of hair follicles was analyzed and compared with the HNS. As a qualitative analysis, each MRH scan was visually graded in terms of the severity of alopecia, using a 4-point MR severity score. The scores were compared with the HNS.
RESULTS
The volunteers were divided into two groups of 12 and 15 males without and with AGA at their vertex, respectively. Inter-observer agreements for the hair count and the MR severity score were excellent. The mean hair count on MRI in the normal group was significantly higher than that in the AGA group (P < 10). The MR severity score in the AGA group was significantly more severe than that in the control group (P < 10). In terms of the presence or absence of thinning hair, the MR severity score was consistent with the HNS determined by a plastic surgeon in 96% of cases. MR severity scores of clinically moderate AGA cases were significantly lower than those of severe cases (P = 0.022).
CONCLUSION
MRH could depict scalp anatomy showing a clear difference between AGA and normal scalps, in both hair count and subjective visual assessment. The MR severity score was in good agreement with the clinical stages by HNS. The results support the potential of MRH as a promising imaging technique for analyzing healthy and pathological scalps.
Topics: Adult; Alopecia; Hair; Hair Follicle; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Scalp
PubMed: 32378681
DOI: 10.2463/mrms.mp.2020-0026 -
Journal of Wound Care Feb 2024This article aims to present a narrative review of current literature about the anatomical characteristics of the scalp as well as current practices in the management of... (Review)
Review
OBJECTIVE
This article aims to present a narrative review of current literature about the anatomical characteristics of the scalp as well as current practices in the management of surgical, traumatic and pressure injuries in the scalp, which are common in neurosurgery practice.
METHOD
We searched PubMed for publications and book chapters in English from 2011 to 2021. We also included commonly referenced papers that we considered relevant to the subject with publication before these dates. We used the search terms 'laceration,' and/or 'neurosurgery' and/or, 'pressure injury,' and/or 'craniotomy,' and/or 'surgical incision' in combination with 'scalp,' and/or 'wound care.' We also searched the reference lists of publications identified by the search strategy and selected those that we judged relevant.
RESULTS
We pre-selected 52 articles that covered various aspects of anatomy, pathophysiology, scalp wound management, or general wound care that we considered applied to the anatomical region of our interest. After abstract review, we selected 34 articles that met our search criteria and were included in our review.
CONCLUSION
There is limited evidence regarding classification and care of scalp wounds. As a result, many of the current practices for scalp wound management are based on evidence derived from studies involving different anatomical regions, not considering its particular anatomy, vasculature and microbiome. Further research is needed for more comprehensive and effective protocols for the management of scalp injuries. However, this present review proposes responses to the identified gaps concerning the management of scalp wounds.
Topics: Humans; Scalp; Wound Healing; Surgical Wound Infection; Surgical Wound; Craniotomy
PubMed: 38329834
DOI: 10.12968/jowc.2024.33.2.127 -
Journal of Drugs in Dermatology : JDD Jul 2023Alopecia is one of the most common dermatologic conditions affecting black patients, with a significantly negative impact on quality of life.1,2 Timely and accurate...
Alopecia is one of the most common dermatologic conditions affecting black patients, with a significantly negative impact on quality of life.1,2 Timely and accurate diagnosis is therefore critical in order to reverse or halt progression of disease.3 Unfortunately, lack of representation of skin of color (SOC) patients in the current literature may contribute to misdiagnosis as providers may be unfamiliar with the clinical spectrum of alopecia presenting in darker scalps.4 Some scarring alopecia subtypes such as Central Centrifugal Cicatricial Alopecia (CCCA) are more prevalent in certain racial groups. However, focusing solely on patient demographics and gross clinical findings may obscure accurate diagnoses. To distinguish alopecia findings in Black patients, a dedicated approach using a combination of clinical exam findings and patient history, along with trichoscopy and biopsy, is essential to prevent misdiagnosis and improve clinical and diagnostic outcomes. We present three cases of alopecia in patients of color which the initial suspected clinical diagnosis did not correspond with trichoscopic and biopsy results. We challenge clinicians to reexamine their biases and fully evaluate patients of color with alopecia. An examination should include a thorough history, clinical examination, trichoscopy, and potentially a biopsy, particularly when findings do not correlate. Our cases highlight the challenges and disparities that exist in diagnosis of alopecia in Black patients. We emphasize the need for continued research regarding alopecia in skin of color and the importance of a complete workup for alopecia to improve diagnostic outcomes.Balazic E, Axler E, Nwankwo C, et al. Minimizing bias in alopecia diagnosis in skin of color patients. J Drugs Dermatol. 2023;22(7):703-705. doi:10.36849/JDD.7117.  .
Topics: Humans; Alopecia; Quality of Life; Scalp; Black or African American; Bias
PubMed: 37410034
DOI: 10.36849/JDD.7117 -
Child's Nervous System : ChNS :... Sep 2018The subgaleal space is the fibroareolar layer found between the galea aponeurotica and the periosteum of the scalp. Due to its elastic and absorptive capabilities, the... (Review)
Review
INTRODUCTION
The subgaleal space is the fibroareolar layer found between the galea aponeurotica and the periosteum of the scalp. Due to its elastic and absorptive capabilities, the subgaleal space can be used as a shunt to drain excess cerebrospinal fluid from the ventricles. A subgaleal shunt consists of a shunt tube with one end in the lateral ventricles while the other end is inserted into the subgaleal space of the scalp. This will allow for the collection and absorption of excess cerebrospinal fluid. Indications for ventriculosubgaleal shunting (VSG) include acute head trauma, subdural hematoma, and malignancies.
DISCUSSION
VSG shunt is particularly advantageous for premature infants suffering from post-hemorrhagic hydrocephalus due to their inability to tolerate long-term management such as a ventriculoperitoneal shunt. Complications include infection and shunt blockage. In comparison with other short-term treatments of hydrocephalus, the VSG exhibits significant advantages in the drainage of excess cerebrospinal fluid. VSG shunt is associated with lower infection rates than other external ventricular drain due to the closed system of CSF drainage and lack of external tubes.
CONCLUSION
This review discusses the advantages and disadvantages of the VSG shunt, as well as our personal experience with the procedure.
Topics: Cerebrospinal Fluid Shunts; Humans; Hydrocephalus; Scalp; Skull; Time Factors; Ventriculoperitoneal Shunt
PubMed: 30003327
DOI: 10.1007/s00381-018-3887-6 -
Cutis Aug 2023Affixing a scalp dressing is challenging because of the presence of hair. Many methods have been recommended; their limitations include their effect on aesthetics and...
Affixing a scalp dressing is challenging because of the presence of hair. Many methods have been recommended; their limitations include their effect on aesthetics and discomfort to the patient during the procedure. We describe a method for using hairpins to affix a dressing after scalp surgery or trauma that is sturdy, does not compromise aesthetics, and does not cause additional discomfort.
Topics: Humans; Scalp; Hair; Bandages
PubMed: 37820336
DOI: 10.12788/cutis.0819 -
Journal of Plastic, Reconstructive &... Aug 2021To investigate the reconstructive effectiveness for chronic scalp erosion after deep brain stimulation (DBS).
OBJECTIVE
To investigate the reconstructive effectiveness for chronic scalp erosion after deep brain stimulation (DBS).
BACKGROUND
Deep brain stimulation (DBS) is an effective treatment for Parkinson's disease. However, this surgery is not exempt from hard-ware related complications, especially scalp erosions on scalp. Scalp erosions usually accompanied with chronic infection and wound contamination. If not arrested, infections may spread through the entire equipment which would endanger the patient's life. Along with review of previous literatures, we summarized our experience in the management of scalp erosion and implemented a systemic treatment plan for reconstruction.
METHODS
We retrospectively analyzed the clinical data of patients with chronic scalp erosion after DBS in the past 40 months. The treatment plan was composed of three sequential major steps, including wound care and conservative methods, debridement and local flap, and revaluation of the wound. In each of the cases, wound debridement and local scalp flap repair were conducted, and assisted by negative pressure wound therapy (NPWT) device and double cannula irrigation.
RESULTS
The local scalp flap survived in all 6 patients. The chronic scalp erosions all healed without refractory. The DBS devices still functioned properly after the treatments in all patients. The average follow-up period was 13.33 months (range: 4 to 23 months), and no infection recurrence or re-erosion of the scalp flap was reported.
CONCLUSION
A combination of wound debridement, local scalp flap repair, the use of NPWT device and double cannula irrigation provides effective treatment method for chronic erosion post DBS surgery.
Topics: Aged; Debridement; Deep Brain Stimulation; Female; Humans; Male; Middle Aged; Negative-Pressure Wound Therapy; Parkinson Disease; Plastic Surgery Procedures; Retrospective Studies; Scalp; Surgical Flaps; Surgical Wound Infection; Therapeutic Irrigation
PubMed: 33358678
DOI: 10.1016/j.bjps.2020.11.045 -
Acta Bio-medica : Atenei Parmensis Oct 2022Numerous details regarding preoperative planning of scalp expansion are of the utmost importance for maximizing the results of this procedure.
BACKGROUND AND AIM
Numerous details regarding preoperative planning of scalp expansion are of the utmost importance for maximizing the results of this procedure.
METHODS
The purpose of this paper is to describe the tips and tricks useful for obtaining the best results in scalp expansion.
RESULTS
Basic concepts and operative technique are discussed and detailed.
CONCLUSIONS
In scalp reconstruction, the use of tissue expansion allows to obtain successful results, Anyhow, it is mandatory to follow some basic rules, dictated by anatomical, technical, and psychological considerations.
Topics: Humans; Scalp; Tissue Expansion
PubMed: 36300222
DOI: 10.23750/abm.v93i5.13393 -
The Journal of Dermatological Treatment Dec 2023There has been no validated tool for objectively quantifying the overall condition and characteristics of the scalp. This study aimed to establish and validate a new...
BACKGROUND AND OBJECTIVES
There has been no validated tool for objectively quantifying the overall condition and characteristics of the scalp. This study aimed to establish and validate a new classification and scoring system for evaluating scalp conditions.
METHODS
The Scalp Photographic Index (SPI) using a trichoscope grades five features of scalp conditions (dryness, oiliness, erythema, folliculitis, and dandruff) on a score of 0-3. To evaluate the validity of SPI, SPI grading was performed by three experts on the scalps of 100 subjects along with a dermatologist's assessment of the scalps and a scalp-related symptom survey. For reliability assessment, 20 healthcare providers performed SPI grading for the 95 selected photographs of the scalp.
RESULTS
SPI grading and the dermatologist's scalp assessment showed good correlations for all five scalp features. Warmth showed a significant correlation with all features of SPI and the subjects' perception of a scalp pimple had a significant positive correlation with the folliculitis feature. SPI grading demonstrated good reliability with excellent internal consistency (Cronbach's = 0.90) and strong inter- and intra-rater reliability (Kendall's = 0.84, ICC(3,1)=0.94).
CONCLUSIONS
SPI is an objective, reproducible, and validated numeric system for classifying and scoring scalp conditions.
Topics: Humans; Folliculitis; Photography; Reproducibility of Results; Scalp; Surveys and Questionnaires; Skin Diseases; Health Status Indicators
PubMed: 36809147
DOI: 10.1080/09546634.2023.2181655 -
The Journal of Craniofacial Surgery Jun 2022Microsurgical replantation is considered the best method to treat avulsion or amputation injuries of unique head parts, including the scalp, eyelid, nose, ear, lip, and...
Microsurgical replantation is considered the best method to treat avulsion or amputation injuries of unique head parts, including the scalp, eyelid, nose, ear, lip, and tongue. However, there is currently no report on microsurgical replantation of substi-tutable facial tissues in the literature. This report presents a patient with avulsed facial composite tissue composed of the skin and subcutaneous layers treated by microsurgical replantation. The present case shows that microsurgical replantation of small facial composite tissues is feasible. The authors suggest that the indication spectrum for microsurgical replantation should be expanded beyond current clinical practice.
Topics: Accidents; Amputation, Traumatic; Facial Transplantation; Humans; Male; Microsurgery; Middle Aged; Scalp; Transplantation, Autologous; Treatment Outcome
PubMed: 35240668
DOI: 10.1097/SCS.0000000000008506 -
Harefuah Oct 2016Ringworm of the scalp (Tinea Capitis), a fungal skin ailment that appears on the scalp, was treated until the early sixties by radiation therapy. It was discovered... (Review)
Review
Ringworm of the scalp (Tinea Capitis), a fungal skin ailment that appears on the scalp, was treated until the early sixties by radiation therapy. It was discovered during the seventies that radiation treatment for ringworm may be associated with a higher risk of cancerous and benign tumors in the head and neck area for patients undergoing treatment. In 1995, Israel enacted a law to compensate ringworm irradiation patients which provided monetary compensation for those who were treated between 1946 and 1960. "The Ringworm Affair" focuses on the issue of radiation treatment for ringworm and the social perceptions surrounding the ethnic identity of the patients. Common opinion in Israel holds that the target population for these treatments was limited to the children of North African immigrants, and that the treatment was intentionally administered despite knowledge of its health hazards. Furthermore, according to these beliefs, over 100,000 children of immigrants were treated. This paper examines these common arguments in light of historical and research-based data regarding the ethnic background and total number of patients treated. Moreover, this paper will examine the argument that a mass operation took place to cure those children only in Israel between 1946 and 1960. As evidence will show, these arguments are unfounded. Notably, radiation therapy was used worldwide; other populations in Israel as well as other Jewish communities in Europe and North Africa were exposed to the same treatment since the 20's. The total number of patients in Israel is less than 100,000.
Topics: Europe; Humans; Israel; Scalp; Tinea; Tinea Capitis
PubMed: 28530060
DOI: No ID Found