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PubMedDate not supplied

Contrast enhanced phototrichogram (CE-PTG): an improved non-invasive technique for measurement of scalp hair dynamics in androgenetic alopecia--validation study with histology after transverse sectioning of scalp biopsies.

Global changes of scalp hair represent the cumulative end result of discrete changes of individual hair follicle structure and/or function. Monitoring of such changes requires an accurate non-invasive method. The phototrichogram (PTG) appears to be an appropriate choice to do so. However, a known weakness of the method is the lack of detection of less pigmented or thinning hair. Balding scalp of male subjects with androgenetic alopecia (AGA) was analysed with our previously published PTG method and with contrast enhanced (CE-)PTG followed by biopsy and transverse section examination with the light microscope. As compared with PTG, the CE-PTG method significantly improved detection not only of thin but also of thick hair. Equal numbers of thick (diameter > 40 mm) hair were detected with CE-PTG and with histology. CE-PTG was also able to detect the severely miniaturised hair fiber (down to 8 mm diameter) and was comparable to scalp biopsy analysis. The latter could identify hair fibres, which did not reach the scalp surface, a measure that is considered as not clinically significant. All growth stages - anagen, catagen and telogen - as well as the empty follicle stage could clearly be observed with CE-PTG. Staging of the more severely affected hair follicles was not always possible neither with CE-PTG nor histology - even with serial sectioning. The finding of such technological advantages makes the CE-PTG a first choice method for detailed analysis of hair cycling in androgenetic alopecia - a scalp disorder characterised by extreme hair follicle miniaturisation, decreased hair pigmentation and hair thinning.

Adult↗
PubMed1980

Immunofluorescent studies of complement C3 in the hair follicles of normal scalp and of scalp affected by alopecia areata.

The deposition of complement C3 in the hair follicles of scalps of 4 normal subjects and of the affected parts of 9 patients with alopecia areata was found by the direct immunofluorescent methods. No deposition of immunoglobulins (IgG, IgA, IgM, IgD and IgE) was found. In the normal scalps, complement C3 was found to be deposited in the hyaline membrane of the hair bulb and in the internal layer of connective tissue sheath at the lower about 2/3 transient portion of anagen follicles, and in the thickened hyaline membrane of the catagen follicles. The deposition of complement C3 was also found in the anagen and catagen-like hair follicles even in the patients with alopecia areata, which was similar to the finding in the normal scalps. From the fact that the deposition of complement C3 was found chiefly in the transient portion of the hair follicles of the normal scalps, and that the behavior of deposition of complement C3 reflected the morphological state of hair follicles in each stage of the hair cycle, even in alopecia areata, complement C3 may be intimately related to the hair cycle, even though its significance is as yet unknown.

Adult↗
PubMed1991

A double-blind, vehicle-controlled study of clobetasol propionate 0.05% (Temovate) scalp application in the treatment of moderate to severe scalp psoriasis.

The efficacy and safety of clobetasol propionate 0.05% scalp application was evaluated in 378 patients with moderate to severe scalp psoriasis in a double-blind vehicle-controlled parallel group study. After 2 weeks of twice-daily applications, 81% receiving active drug versus 22% receiving vehicle had clearing of 50% or greater. Complete clearing was seen in 26% with active drug and 1% with vehicle. Local side effects were primarily burning or stinging in 11% and 10% of patients treated on an active or a vehicle regimen, respectively. The morning cortisol levels of 168 patients were checked at baseline and again after 2 weeks of drug therapy. Subnormal morning plasma cortisol values were seen in 5% of the patients receiving active drug and in 5% receiving vehicle; 13% of those taking active drug versus 5% taking vehicle had a 50% or greater decrease in morning cortisol at the 2-week visit compared with baseline values. Clobetasol propionate 0.05% scalp application appears to be a safe and an effective treatment for scalp psoriasis.

Administration, Topical↗
PubMed1992

Extensive scalp lifting as a reconstructive tool for a large scalp defect.

Extensive scalp lifting is a relatively new technique for the treatment of alopecia. Because this technique involves the undermining of the entire occipitoparietal scalp down to the hairline of the nape, a significant anterior and medial advancement is accomplished with one operation. This case report describes a patient with a large surgically induced scalp defect that was reconstructed with the use of extensive scalp lifting in combination with coronal brow lifting--thus, the intermediate cosmetic deformity of the more commonly used tissue expansion technique was completely circumvented. Why this technique can be substituted for tissue expansion or multiple rotation-transposition flaps in certain cases in elaborated.

Alopecia↗
PubMed1995

The Burow's triangle scalp reduction. A new and improved technique for paramedian scalp reduction.

BACKGROUND: The paramedian incision for scalp reduction has many advantages over the median (midline-sagittal) incision. OBJECTIVE: This report describes a method by which the paramedian incision may be modified to provide even more advantages. METHODS: In 20 patients with male pattern alopecia, an anterior and posterior paramedian incision was performed along contralateral borders of the bald scalp. The two incisions were joined in the central scalp by a trans-coronal incision. The tissue movement that followed was similar to that of a Burow's triangle advancement flap. RESULTS: The new configuration provided maximal visual access with improved tissue mobilization and ease of handling. Because the tension-bearing vector was directed parallel to the transcoronal incision, there was little tendency for the scar to widen. Because posterior "slots" or "troughs" were not created, additional corrective procedures were not necessary. CONCLUSION: The Burow's triangle scalp reduction design is cosmetically and mechanically more advantageous than traditional median and unilateral paramedian designs of equivalent length.

Alopecia↗
PubMed2005

Simultaneous multilobar electrocorticography (mEcoG) and scalp electroencephalography (scalp EEG) during intracranial vascular surgery: a new approach in neuromonitoring.

OBJECTIVE: Intraoperative neuromonitoring for intracranial vascular surgery is primarily aimed at detecting early ischemic changes to prevent subsequent infarction. Despite various neurophysiological approaches detection of early and focal ischemic changes remains difficult. This study explores the feasibility and sensitivity of intraoperative monitoring using surface EEG (scalp EEG) and multilobar Electrocorticography (mEcoG) recording during intracranial vascular procedures. METHODS: About 21 recordings were acquired in 20 patients undergoing craniotomies for intracranial aneurysms (17), superficial temporal-middle cerebral artery bypass (twice in the same patient) and arteriovenous malformation (2). The recording of scalp EEG (needle electrodes) and EcoG was performed (cupules electrodes) during all of the surgery. Signal was visually analyzed online and using spectral analysis software offline. RESULTS: Good recordings were obtained in all cases, without adding any procedural morbidity. The most common abnormalities on mEcoG were high frequency waves (23-37 Hz; HF-beta3), which appeared just after vascular occlusion and were occasionally followed by slow waves or burst suppression pattern. This focal pattern was seen in a majority of cases (20/21) on the mEcoG, but only in 4 out of 21 cases on the EEG. CONCLUSIONS: Multi-lobe (mEcoG) recording is feasible during craniotomies and detects earlier and more EEG pattern variation than surface EEG monitoring during intracranial vascular manipulations. The authors discuss the high sensitivity of this technique to ischemic changes. SIGNIFICANCE: By detecting earlier and more focal changes than scalp EEG, mEcoG may favor during surgery an increase in interactive strategies and reduction of deleterious event.

Adult↗
PubMedDate not supplied

Thickness, medullation and growth rate of female scalp hair are subject to significant variation according to pigmentation and scalp location during ageing.

The biological importance and/or significance of human hair colour is unknown even though greying is obviously associated with ageing. In order to further characterise hair pigmentation in relation with hair growth variables we evaluated 3 scalp sites (top of the head (T): left and right and occipital(O)) in 12 untreated menopausal women (age range: 49-66 years: average 59.63 +/- 5.66) who presented complaining of hair loss and/or diffuse alopecia. Controls were 12 non menopausal sexually mature woman (7 age range 15-21 and 5 age range 38-48) not complaining of hair loss. One hair sample (whenever possible n = 60) was taken one month after clipping from T and O on each person; menopausal women were sampled twice. The following measures were performed with a light microscope: diameter (average min-max., microm), medulla (0% = absent to 100% = fully developed) and linear hair growth rate (mm/day). The hairs were categorised as pigmented (P) or non-pigmented (white, W) as compared with a black and white reference card. A total of 3343 hairs were analysed with 2-factor analysis of variance (ANOVA). A global comparison (all hairs) showed that the average diameter of W hair (67.68 microm) exceeded that of P hair (57.41 microm) (p = 0.0001) and this was maintained on all 3 scalp sites. In addition, the medulla of W hair (23.91%) appeared more developed than the medulla of P hair (12.21%) (p = 0.0001) and was more expressed in W T hairs as compared with W O hairs (p = 0.0325). There was also a significant interaction between site and pigmentation (p = 0.0074). Growth rate of W hairs (0.38 mm/d) was higher than that of P hairs (0.35 mm/d) (p = 0.0001) and there was a significant variation according to scalp sites (p = 0.0001). There was also a significant interaction between site and pigmentation (p = 0.0062) with the following rank order: O W (0.40 mm/d), T W (0.37 mm/d), O P (0.37 mm/d) and T P (0.34 mm/d). Subgroups of W and P of paired thickness in the range of 50 to 80 pm consistently showed a 10% faster growth rate of W. Previous studies have shown that growth rate and diameter declines in age and alopecia i.e. in hair thinning. Our data shows that the reduced growth rate of terminal hairs is in fact limited to the pigmented hairs. The mechanisms by which white hairs are spared these ageing changes are not yet understood. Less pigmented hairs are usually undetected by photo- graphic techniques used for drug trials. The potential role of drug induced modifications of hair pigmentation should be taken into account during the interpretation of efficacy except if contrast-enhancement has been applied.

Aged↗
PubMed1978

Measurement of fetal scalp pH by continuous-recording scalp electrode and correlation with capillary blood pH.

Experience with the use of a continuous-recording scalp electrode for fetal pH in subcutaneous scalp tissue is described. After initial problems, the correlation with capillary blood pH, taken by fetal scalp blood sampling, was found to be good, and it is concluded that this method is accurate enough to merit further trials in clinical practice. Residual technical problems remain which should not prove insurmountable.

Acid-Base Equilibrium↗
PubMed1981

Immunofluorescence studies on complement components in the hair follicles of normal scalp and of scalp affected by alopecia areata.

The deposition of complement components (Clq, C4 C3, C5 and C9) and properdin in scalp hair follicles was examined by the immunofluorescence method in patients with alopecia areata and in normal subjects. C3, C5 and C9 were found deposited there. The complement deposition was most frequent in the case of C3 and less frequent in C9 and C5. There was no difference regarding deposition between normal subjects and patients with alopecia areata. No deposition of Clq, C4 or properdin was observed in the hair follicles of the scalp. These findings suggest a relationship between the hair cycle and the activity of C3 and its late complement components in the scalp.

Adolescent↗
PubMed2002

The theoretical relation of scalp Laplacian and scalp current density of a spherical shell head model.

The theoretical relation between the scalp Laplacian (SL) and the scalp current density (SCD) is derived for a spherical shell head model. The result shows that they are related by a function of spatial frequency. For practically available low spatial frequencies, they are approximately linearly related to each other, so the SL estimate may be considered as an approximate SCD estimate in practice.

Algorithms↗
PubMed2006

Validation of scalp coverage scoring methods for scalp hair loss in male pattern hair loss (androgenetic alopecia).

BACKGROUND: Global evaluation of hair loss in male subjects affected by androgenetic alopecia has been proposed as a means for monitoring changes over time, including placebo-controlled drug efficacy studies. Because of the potential impact of subjectivity (e.g. placebo effect) of clinical investigators, global photographs (GPs) have been introduced as a more objective record. Examination of paired before and after pictures and rating on a seven-point scale (from greatly decreased -3 to greatly increased +3) have been historically introduced by United States of America (US) experts. METHODS: Based on published GPs and original GPs obtained at our clinical research facility, we developed a training set in order to allow European Union (EU) observers to practice and compare with ratings by the US experts. RESULTS: After training with the seven-point scale, there was a positive correlation between three US and three EU ratings (n=52 paired images from 35 different subjects, r=0.795). The results of a test-retest evaluation was performed on 18 paired images from the initial image collection by the three EU experts. Correlation r=0.806 and identical scores in 78% of cases documents a reproducibility similar to the single one US expert published data (119 subjects, retest correlation 0.76 with 75% identical duplicate ratings). Seventeen subjects taken from a placebo-controlled trial had GPs at 6 and 12 months. The average difference between an efficacious drug treatment and the placebo were almost similar in the US (0.833) as in the EU (0.689) expert panels. We also trained the EU experts in performing the scalp coverage scoring (SCS), a novel system for the global evaluation of scalp hair in vivo and on GP. SCS was performed on single images (randomised as to time and treatment) taken from the same set of 17 paired GPs. This showed a between-group difference of 0.055 at 6 months and 0.201 at 12 months, i.e. 5% improved coverage in favour of the active group. CONCLUSION: After completion of our study, US and trained - calibrated EU experts seem equally valuable in comparing before-after GPs. SCS can also be used on GPs and may support the clinical investigator during inclusion of test subjects and for real-time efficacy evaluation during the trial.

Alopecia↗
PubMed1997

[Scalp expansion in treatment of scalp defect with skull exposure].

We repaired the scalp defect and skull exposure with scalp expansion. The technique consisted of two stages. First, expander was implaned an then N. S injected to its enough volume. The size of the expander was estimated by the formula that 1 cm2 needs 4 ml expansive volume. The incision was made at normal skin. Second flap was transferred. The expander was removed and the external skull which was necrotic severed. There were five patient with eight flaps at all, followed up for 6 months to 1 year. The hair grew. The results were satisfactory. This method not only treated the disease, but also avoided alopecia.

Adolescent↗
PubMed1993

[Saccadic eye movement related scalp potentials--scalp distribution of presaccadic slow negative potential].

We studied scalp distribution of presaccadic slow negative potential (PSN) among saccadic eye movement related scalp potentials in 17 normal subjects performing self-paced voluntary saccades in light (VS). There was a widespread PSN beginning at 1400 msec prior to saccades, maximum at the vertex. Amplitudes of PSN were greater over frontocentral electrodes contralateral to the direction of the saccades. These findings are consistent with reflection of activation of the supplementary motor area, and the frontal eye field contralateral to the direction of the saccades. On the other hand, amplitudes of PSN were relatively greater over occipital electrodes ipsilateral to the direction of the saccades. In addition, we studied PSN in 6 normal subjects performing self-paced voluntary saccades in darkness (VSD). PSN with VSD did not extend to occipital electrodes in comparison with PSN with VS. Occipital component of PSN with VS may reflect activation of other cerebral cortices which relate to visual inputs.

Adult↗
PubMedDate not supplied

Erosive pustular dermatosis of the scalp after perinatal scalp injury.

We report four infants born with necrotic caput succedaneum that led to a scarring alopecia with ongoing inflammation and persistent scale-crust. These lesions did not significantly improve with topical or oral antibiotics, but did respond somewhat to topical corticosteroids. Alopecia with chronic erosive scale-crust and a moderate response to topical corticosteroids are findings consistent with a diagnosis of erosive pustular dermatosis of the scalp.

Humans↗
PubMed2005

Human scalp dermal papilla and fibrous sheath cells have a different expression profile of matrix metalloproteinases in vitro when compared to scalp dermal fibroblasts.

The dermal papilla is a cluster of specialised mesenchymal cells at the bottom of the mammalian hair follicle, embedded in a loose extracellular matrix. These cells have the capability to induce and support hair growth via close epithelial-mesenchymal interactions with the keratinocytes surrounding the hair matrix. The extracellular matrix of the dermal papilla differs markedly from the interfollicular matrix and plays a key role in the maintenance of hair growth. In this study we investigated the expression pattern and activity of matrix metalloproteinases (MMP) and their tissue inhibitor in in vitro cultures of cells derived from scalp dermal papilla and fibrous sheath. Expression and activity of MMP-1, MMP-2, MMP-3, MMP-9, TIMP-1, TIMP-2 and MT1-MMP were analysed in those cells cultured in contact with one of the relevant protein component of the dermal matrix, collagen type I as well as in monolayer. Zymographic analysis showed activation of MMP-2 in all cells grown in three-dimensional collagen lattices whereas MMP-9 was activated only in three-dimensional collagen cultures of dermal fibroblasts and weakly in follicular cells. Expression of MMP-1, TIMP-1, TIMP-2 and MT1-MMP was similar in all cells, in both culture conditions, whereas expression of MMP-3 was absent in dermal papilla cells. In addition to a series of reported morphological and functional differences between dermal fibroblasts and the dermal mesenchyme-derived cells of the hair follicle, we reported differences in MMP expression in dermal papilla and fibrous sheath cells within the mesenchymal population of the hair follicle.

Cells, Cultured↗
PubMed1984

Halo scalp ring: a form of localized scalp injury associated with caput succedaneum.

Caput succedaneum is a common birth injury attributed to cervical, uterine, or vaginal pressure on the fetal presenting part. It usually consists of diffuse soft tissue swelling and bruising, which resolve in a few days without sequelae. We have seen two patients who had an unusual alopecic "halo" ring on the scalp associated with a caput succedaneum.

Alopecia↗