Cutis verticis gyrata associated with congenital heart disease.

Cutis verticis gyrata (CVG) is a very rare benign disorder characterised by convoluted folds and deep furrows of the scalp that mimic cerebral sulci and gyri. Associations with other pathologies as neuropsychiatric and/or ophthalmologic disorders, secondary cases to inflammatory or neoplastic processes, as well as cases associated to genetic disorders as Turner's syndrome have been reported, but there is no literature describing an association with a congenital structural heart defect and no other underlying condition. We report a case of primary CVG in a 3-week-old female infant associated with an echocardiographic diagnosis of cor triatriatum. Other systemic examination findings and investigations were unremarkable, and the patient has normal neurodevelopment at 1 year old. Aside from the neuropsychiatric and ophthalmologic pathologies commonly associated with primary non-essential CVG, it should be noted that isolated congenital cardiac lesions are also possible, so as to increase our index of suspicion in patients with the disorder.

Pediculicide regulations and usage trends in Türkiye in 2015-2022.

BACKGROUND: Over the years, the increasing prevalence of head lice infestation has led to an increase in treatment-related costs and the development of resistance to pediculicides. This study aimed to evaluate pediculicide sales over an 8-year period (2015-2022), including the COVID-19 pandemic. METHODS: Data on products registered in the Turkish Pharmaceutical Index Dataview, Intercontinental Medical Statistics (IMS) database, sold on prescription and approved by the Ministry of Health in Türkiye were formally requested from the research organization IQVIA for pharmacologically active pediculicides (PAP) such as permethrin, pyrethrin, and sumithrin. Data for physically active products containing dimethicone (DMT) were obtained from the relevant pharmaceutical companies. Sale revenues were determined based on sale prices in the aforementioned year. RESULTS: Total sales of pediculicides decreased from 2,452,846 units in 2015 to 2,028,840 units in 2022. While PAP consumption decreased over the years, from 1,832,006 to 518,460 units, DMT consumption increased from 620,840 to 1,510,380 units, from 2015 to 2022. The total price of pediculicides for the consumer increased more than threefold in Turkish currency. In terms of USD, an almost similar amount of money was spent over the years, with the exception of 2022 when the expenditure almost halved mainly due to the high inflation rate in the country. CONCLUSION: The decrease in PAP and the increase in DMT indicate that local lice have developed resistance to the former. Further studies are needed to determine the possible development of resistance in the country.

Ultrasound Pattern of Cutis Verticis Gyrata.

Cutis verticis gyrata (CVG) is a cutaneous benign condition that usually presents symmetric or asymmetric convoluted folds and deep furrows in the scalp, which mimic the disposition of the cerebral sulci and gyri. This scalp deformation may be a worrying situation for the patients and their families. Clinically, its diagnosis may be challenging because it can mimic other cutaneous conditions. So far, the ultrasonographic pattern of CVG has not been reported. Thus, we aim to review the ultrasound findings of this entity. All patients (n = 14) presented zones with dermal and hypodermal thickening that corresponded with the elevated clinical zones, followed by folds with normal cutaneous thicknesses. There was undulation of the cutaneous layers in all cases. The scalp areas involved the frontal, parietal, and occipital regions bilaterally. The mean maximum dermal and hypodermal thicknesses and echogenicities and the color Doppler characteristics are provided. No significant dilation of the hair follicles was detected. In conclusion, CVG presents an ultrasonographic pattern that can support its diagnosis and follow-up. This can help its differential diagnosis with other scalp dermatologic conditions.

The impact of photodynamic therapy on skin homeostasis in patients with actinic keratosis: A prospective observational study.

BACKGROUND: Photodynamic therapy (PDT) is an effective treatment for actinic keratosis (AKs), but there is little information on how PDT affects skin barrier function. The objectives of this study are: To compare skin barrier function between skin with AKs and healthy skin and to evaluate the impact of PDT on skin homeostasis in patients with AKs. METHODS: A prospective observational study was conducted in patients with AKs to evaluate epidermal barrier function and skin homeostasis before and 1 ek after receiving PDT. RESULTS: A total of 21 subjects were included in the study, male/female ratio was 17:4, mean age was 75.86 years. The number of AKS observed before starting treatment was reduced with respect to those diagnosed 1 month after starting PDT (14.83 vs. 1.91, p < 0.0001). Application of PDT for treating AKs modifies epidermal barrier function. Immediately after the first session temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH) and total antioxidant capacity (TAC) increased while pH decreased on lesional skin. After 1-month follow-up, the only remained change was the increased in SCH. Higher increases in temperature were observed when using occlusive PDT compared to mixed modality. 5-ALA and M-ALA seem to have a similar impact on skin barrier. CONCLUSIONS: PDT can improve skin barrier function in patients with AKs. Skin homeostasis parameters can be used to assess efficacy and optimize dosing.

Erosive pustular dermatosis of the scalp secondary to Erlotinib: A rare occurrence with trichoscopic perspective.

Epidermal growth factor receptor inhibitors are anti-tumour agents that are frequently used for the treatment of neoplastic disorders. In addition to their cutaneous adverse effects, these drugs can rarely lead to erosive pustular dermatosis of the scalp. We report a case of a 67-year-old female who developed erosive pustular dermatosis of the scalp after being started on erlotinib from a trichoscopic perspective, which has been described in literature only once till now.

Clinical efficacy of a gentle anti-dandruff itch-relieving shampoo formulation.

Dandruff is a common scalp condition affecting almost half of the world's population. Despite its high prevalence, the exact pathophysiology is not well established and is understood to be multifactorial, with factors such as fungal colonization, sebaceous gland activity and individual factors being implicated. There is a need for an effective and safe shampoo that can target the above factors. Hence, we have developed a shampoo formulation with properties of oil control, moisturizing, non-irritative, anti-fungal, anti-microbial and itch-relieving. In this interventional, open-label study, we evaluated the efficacy and safety of this shampoo in reducing the clinical signs of dandruff and pruritus in patients with pre-existing mild-to-moderate dandruff over a course of 21-day treatment duration through self-assessment and objective clinical evaluations. After continued use of the shampoo, there was a significant decrease in the adherent and loose scalp flaking scores. Mean pruritus scores also decreased significantly across the 21-day time points. There were also no adverse events or skin intolerances reported. This study showed that our shampoo formulation has led to a significant reduction in both adherent and loose scalp flaking and pruritus when used in individuals suffering from mild to moderate dandruff. As such, it is an ideal shampoo, which can be used to effectively control dandruff.

Les pellicules sont une affection courante du cuir chevelu qui touche près de la moitié de la population mondiale. Malgré sa prévalence élevée, la physiopathologie exacte n'est pas bien établie et est comprise comme étant multifactorielle, avec des facteurs impliqués tels que la colonisation fongique, l'activité des glandes sébacées et des facteurs individuels. Un shampooing sûr et efficace pouvant cibler les facteurs évoqués ci-dessus est nécessaire. Par conséquent, nous avons développé une formulation de shampooing présentant des propriétés de contrôle du sébum, d'hydratation, non irritante, antifongique, antimicrobienne et de soulagement des démangeaisons. Dans cette essaie interventionnelle ouvert, nous avons évalué l'efficacité et la sécurité d'emploi de ce shampooing dans la réduction des signes cliniques de pellicules et de prurit chez des patients présentant des pellicules préexistantes légères à modérées sur une durée de traitement de 21 jours par le biais d'auto-évaluations et d'évaluations cliniques objectives. Après une utilisation continue du shampooing, une diminution significative des scores de squames adhérents et d'excoriation du cuir chevelu a été observée. Les scores de prurit moyens ont également significativement diminué tout au long de la période de 21 jours. De même, aucun événement indésirable ou intolérance cutanée n'a été rapporté. Cette étude a montré que notre formulation de shampooing a entraîné une réduction significative des squames adhérents, de l'excoriation du cuir chevelu et du prurit lorsqu'elle est utilisée chez des personnes souffrant de pellicules légères ou modérées. Il s'agit donc d'un shampooing idéal qui peut être utilisé pour contrôler efficacement les pellicules.

Rare Congenital Frontal Hairline Deformity with Temporo-Parieto-Occipital Multiple Folds of Scalp.

Two cases of congenital hairline deformity are reported. Both cases exhibited multiple wrinkled areas in the lower occipital region, with hair that punctured and irritated the adjacent skin as it grew, creating ulcerated lesions. Both patients had a unilateral folded and raised wrinkled and twisted region stretching from the temporal area to the parietal and occipital areas. There was also a defect in the frontotemporal hairline of the affected side that was not present on the contralateral side. The skin of the forehead was also thinner on the affected side. Both patients were in good physical health and had no other congenital abnormalities or pertinent family history. There were no other skin, neurological, or physical abnormalities. In each case, the excessive skin was excised from the temporo-occipital region and microscopically dissected into follicular units, which were transplanted into the temporal area and the frontal hairline. Histologic examination did not reveal any specific abnormal findings. The transplanted hairs were well engrafted and showed natural results. Congenital anomalies of the hairline or hair-bearing scalp tissue are rare. Cutis verticis gyrata is a rare disease that causes multiple furrows and folds of the scalp. However, the cases reported here exhibited a somewhat different appearance from that of cutis verticis gyrata, as multiple folds were present in the scalp in each case, along with an alopecic lesion. This author has successfully treated 2 cases of this rare form of congenital hair loss that has not yet been reported to our knowledge.