ABSTRACT
Graham-Little-Piccardi-Lassueur Syndrome is a rare form of Lichen Planus, characterized by the presence of the triad: non-scarring hair loss in the inguinal and axillary regions and follicular spinous or disseminated acuminate papules; typical, cutaneous or mucous LP; and scarring alopecia of the scalp with or without atrophy. These features do not have to be present simultaneously.
Subject(s)
Humans , Female , Middle Aged , Scalp/pathology , Dermatitis/pathology , Lichen Planus/pathology , Scalp/drug effects , Skin/pathology , Syndrome , Treatment Outcome , Adrenal Cortex Hormones/therapeutic use , Dermatitis/drug therapy , Alopecia/pathology , Alopecia/drug therapy , Lichen Planus/drug therapyABSTRACT
Background: Intralesional corticosteroids are the treatment of choice for adults with less than 50% of scalp area involvement with alopecia areata. The sensitivity of picking up clinical response to treatment by clinical examination is very variable and has inter individual variation. Aims: To evaluate the efficacy of intralesional triamcinolone acetonide in the treatment of alopecia areata and to use dermoscopy to identify signs of early clinical response and adverse effects. Methods: Seventy patches in 60 patients were injected with steroid at 4 weeks interval and followed up for 24 weeks. Treatment response was evaluated using regrowth scale (RGS). Heine DELTA 20; dermatoscope was used to assess disease activity, response to treatment and side effects. Results: Twenty eight patients responded early and achieved RGS of 4 within 12 weeks and 29 patients responded late and achieved RGS of 4 within 24 weeks of initiating therapy. There were 3 patients who did not achieve RGS of 4 at 24 weeks. Late and incomplete responders showed statistically significant association with family history of alopecia areata (p < 0.0001), presence of recurrent disease (p = 0.0147) and presence of nail changes (p = 0.0007). Dermoscopically, 60 patches demonstrated regrowth of new vellus hair at 4 weeks. Tapering hair disappeared maximally at 4 weeks. At 12 weeks, complete disappearance was seen in tapering hairs, broken hairs and black dots whereas for yellow dots to disappear completely in all patches it took 16 weeks. The adverse effects were observed at an earlier stage using dermoscopy than clinically. Conclusion: Intralesional triamcinolone acetonide is efficacious for treatment of localized patchy alopecia areata. Dermoscopy is very useful to identify signs of early clinical response, adverse effects and markers of disease activity.
Subject(s)
Adolescent , Adult , Alopecia Areata/drug therapy , Alopecia Areata/pathology , Dermoscopy , Drug Monitoring/methods , Female , Follow-Up Studies , Glucocorticoids/administration & dosage , Glucocorticoids/adverse effects , Hair/drug effects , Hair/pathology , Humans , Injections, Intralesional , Male , Scalp/drug effects , Scalp/pathology , Treatment Outcome , Triamcinolone Acetonide/administration & dosage , Triamcinolone Acetonide/adverse effects , Young AdultABSTRACT
OBJECTIVE: Determine the effect of scalp infiltration on postoperative craniotomy pain with 0.5% bupivacaine with adrenaline 1:400,000. MATERIAL AND METHOD: A prospective randomized double blind control trial was conducted on 50 patients (18-65 years), who were ASA physical status I to III, and scheduled for elective intracranial surgery at Maharaj Nakorn Chiang Mai Hospital, Thailand between October 2006 and December 2007. The patients received wound infiltration before skin closure by either 0.5% bupivacaine with adrenaline 1.:400,000 (group B), or normal saline with adrenaline 1:400,000 (group S). RESULTS: The median pain score in the first 12 hours trended to be lower in the bupivacaine group than in the control, but the differences were not statistically significant apart from the score in the first hour (median pain score = 2, IQR = 3; p = 0.031). There were more pain-free patients in the bupivacaine group than in the control group at all time intervals during the first 12 hours. However, the difference was significant in the first hour (7 vs. 1; p = 0.034). Although the median (range) time interval between the end of surgery and first administration of tramadol was longer in the bupivacaine group, when compared to the control group, it was not statistically significant. CONCLUSION: Surgical wound infiltration, before skin closure, with 0.5% bupivacaine with adrenaline decreased the incidence and severity of postoperative pain in patients undergoing supratentorial craniotomy, but only for the first hour after surgery.
Subject(s)
Adolescent , Adult , Aged , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Craniotomy/adverse effects , Double-Blind Method , Epinephrine/administration & dosage , Female , Humans , Male , Middle Aged , Narcotics/administration & dosage , Pain Measurement , Pain, Postoperative/drug therapy , Prospective Studies , Scalp/drug effects , Tramadol/administration & dosage , Young AdultSubject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Alopecia Areata/drug therapy , Alopecia Areata/therapy , Alopecia/diagnosis , Anthralin/therapeutic use , Minoxidil/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Allergens/therapeutic use , Alopecia/drug therapy , Cyclosporine/therapeutic use , Inosine/therapeutic use , Lichen Planus/complications , Lupus Erythematosus, Cutaneous/complications , Practice Guidelines as Topic , Scalp/drug effects , Trichotillomania/therapyABSTRACT
La dermatitis seborreica de piel cabelluda (caspa) es un padecimiento crónico, recidivante y frecuente que se presenta entre los 18 y 40 años de edad y es más común en hombres adultos que en mujeres. Para tratar este padecimiento se ha empleado ketoconazol al 1 por ciento en champú y actualmente se ha propuesto climbazole champú. Por lo anterior, los objetivos del estudio fueron conocer la eficacia de climbazole y compararla con ketoconazol. El diseño del estudio fue doble ciego, comparativo, prospectivo y longitudinal, con una duración de seis semanas de tratamiento por pacientes. Se estudiaron 60 pacientes con diagnóstico clínico de dermatitis seborreica en piel cabelluda, edades entre 16 y 45 años, y que otorgaron su consentimiento para participar en el protocolo. A los pacientes se les asignó en forma aleatoria a una de las dos pociones de tratamiento, realizándose una valoración inicial del padecimiento, y posteriormente se les citó para revisión al final de la primera, tercera y sexta semanas de tratamiento. Se encontró que ambos medicamentos fueron efectivos en el tratamiento de los síntomas como prurito, descamación, piel reseca o grasosa, pero ketoconazol al 1 por ciento champú mostró una eficacia superior, con una diferencia estadísticamente significativa en todos los síntomas. El 80 por ciento de los pacientes del grupo ketoconazol y el 13 por ciento de los del grupo climbazole se calificaron como curación clínica al final del tratamiento (p=0.0001)
Subject(s)
Humans , Male , Female , Adult , Antifungal Agents/administration & dosage , Imidazoles/administration & dosage , Ketoconazole/administration & dosage , Scalp Dermatoses/therapy , Scalp/drug effectsABSTRACT
Os autores fazem uma revisäo do tratamento da alopécia areata durante um período de 10 anos e concluem pela näo existência ainda de um medicamento eficaz para curar esta afecçäo
Subject(s)
Humans , Male , Female , Alopecia Areata/drug therapy , Anthralin/pharmacology , Beclomethasone/pharmacology , Cyclosporine/pharmacology , Minoxidil/pharmacology , Scalp/drug effectsABSTRACT
Os autores realizaram estudo retrospectivo, a partir da análise do prontuário de 291 mulheres com diagnóstico de Alopecia Difusa, de um total de 3.103 pacientes do sexo feminino, atendidas em clínica privada, no período de janeiro a outubro de 1991. Foram analisados dados epidemiológicos e prováveis fatores associados. A incidência de alopecia na mulher foi maior na clínica privada (11,4%) do que no Serviço de Dermatologia do HEC (2,6%). A Alopecia Difusa ocorreu como forma clínica mais comum, tanto em consultório privado (84,1%) como no HEC (71,4%). A faixa etária predominante foi dos 21 aos 40 anos (73,6%). Das causas prováveis relacionadas as mais freqüentes foram: stress/depressäo 76(26.1%); drogas 37(12,7%); dieta 33(11,3%); hiperfluxo menstrual 27(9,3%); pós parto 27(9,3%); anemia 18(6,2%)