A rare complication of follicular hair unit extraction: Kaposi's varicelliform eruption.

Follicular hair unit extraction (FUE) is becoming a popular type of hair transplantation recently. Kaposi's varicelliform eruption (KVE) is an uncommon skin emergency due to cutaneous dissemination of several types of viruses, most notably herpes virus, over the lesions of preexisting skin disorders. A 34-year-old man visited our dermatology outpatient clinic with a blistering, itchy and tender eruption on his head and body. He had undergone follicular FUE for androgenic alopecia 12 days previously, and 5 days after the procedure, umbilicated and/or hemorrhagic vesiculopustules appeared firstly on the occipital scalp skin where the hair units were taken. The lesions had rapidly spread over the upper chest and back. After the operation, he had taken oral methylprednisolone, amoxicillin clavulanate and had used fusidic acid ointment without any benefit. Bacterial culture of the pustules yielded no microorganism, while Tzanck smear from the vesicles revealed multinuclear giant cell groups. Based on a diagnosis of KVE, we treated the patient with oral valacyclovir hydrochloride 1000 mg 3 times a day for 14 days. Symptoms cleared rapidly, pustules and vesicles dried in a few days, and re-epithelialization of the eroded areas started at the end of the first week. The reported complications of FUE include necrosis of the donor site, postoperative hyperesthesia, recipient area folliculitis, keloids, bleeding, infection and pyogenic granuloma. Up to this date there are only three reports of KVE developing just after dermatological surgery, including dermabrasion, laser resurfacing, and skin grafting. According to our knowledge, this is the first case of KVE occurring after the FUE procedure. We think that the traumatic effects and skin barrier disruption due to operation and immune alteration due to postsurgical steroid treatment might have precipitated the activation and dissemination of latent herpesvirus infection.

Autologous fascia graft as a biological barrier to silicone application in rabbits.

OBJECTIVE: To determine the cellular effects of providing a fascial interface around subcutaneously-placed silicone implants, in terms of capsule thickness, myofibroblast/fibroblast cell count and inflammatory cell count. STUDY DESIGN: Interventional, comparative study. PLACE AND DURATION OF STUDY: Istanbul University Cerrahpasa Medical Faculty, Laboratory of Experimental Animals, Istanbul, Turkey, from May to September 2008. METHODOLOGY: A total of 16 adult New Zealand male rabbits with mean weight of 2508 ± 360 g were used in the study. Animals were divided into two groups as experiment and control groups with equal number of rabbits in each. Fascia injection was applied on silicone implant in the experiment group and compared with the control group in terms of capsule thickness, myofibroblast/fibroblast cell count and inflammatory cell count. At the end of the experiment, tissue samples were examined macroscopically and microscopically for the above. Statistical analysis of data was performed using student's t-test. RESULTS: A statistically significant difference was found between experiment group and control group in terms of mean capsule thickness, mean myofibroblast and fibroblast cell counts and cell density (p < 0.05, each). CONCLUSION: Fascia tissue barrier prevent silicone rod reaction and foreign body reaction developing against silicone prosthesis in the studied animal model.