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Br J Plast Surg. 2002 Jun;55(4):324-9.
New treatment of a visible linear scar in the scalp: multiple hair-bearing flap technique.

Yotsuyanagi T, Watanabe Y, Yamashita K, Urushidate S, Yokoi K, Sawada Y.

Department of Plastic and Reconstructive Surgery, Hirosaki University School of Medicine, Hirosaki, Japan.

Scars on the scalp have no hair, and can be conspicuous even when narrow. Alopecia, especially in the whorl of hair at the back of the parietal region, is very difficult to camouflage. We present a new technique using multiple hair-bearing flaps harvested from near the area of alopecia, each flap including 10-15 hairs. We treated 24 patients who were suffering from alopecia, with scar sizes ranging from 2 cm to 17 cm in length and from 0.5 cm to 2 cm in width. Between three and 12 flaps per patient were used to complete the treatment. All wounds healed without complications, and satisfactory results were achieved in 20 patients. Hair loss from the flap was rare. The scar could be hidden by the hair immediately after the operation. In four patients, a visible scar remained or was created at the donor site. These patients required a secondary repair. The major advantages of this technique are that the dense hair bundles in the flap are studded here and there in the scar, the scar can be reduced and the residual scar can be hidden by the flap hair. This technique is most useful for the parietal and occipital areas, especially near the whorl of hair.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12160539&dopt=Abstract

Presse Med. 2002 Jul 13;31(24):1126-8.
[Acquired ichthyosis disclosing Hodgkin's disease. Simultaneous recurrence]

[Article in French]

Ghislain PD, Roussel S, Marot L, Tennstedt D, Michaux L, Lachapelle JM.

Service de dermatologie, Cliniques universitaires Saint-Luc, Universite catholique de Louvain, 10 avenue Hippocrate B-1200 Bruxelles. PierreDominique.Ghislaidvalvas.be

INTRODUCTION: Hodgkin's lymphoma is rarely evidenced by dermatological signs or symptoms. OBSERVATION: A 37 year-old man progressively developed widespread cutaneous roughness, with small parallel lines producing fish-like scales. A skin biopsy confirmed the diagnosis of acquired ichthyosis, as evidenced by the absence of the epidermal granular layer. The patient's condition was assessed to be satisfactory. However, two months later, his general condition had gradually deteriorated (night sweats, weight loss, axillary and scalp alopecia, and adenopathies). Hodgkin's lymphoma was diagnosed. After treatment with adriamycin, bleomycin, vincristine and dacarbazine, complete remission of the lymphoma was obtained, and concomitantly, the symptoms of acquired ichthyosis resolved; this was confirmed by serial skin biopsies that evidenced the progressive complete restoration of the granular layer. The level of plasmatic vitamin A and carotene, which had decreased before the treatment, returned to normal values. A subsequent relapse of Hodgkin's lymphoma was preceded by the recurrence of ichthyosis; this time vitamin A and carotene levels were not decreased. DISCUSSION: As a paraneoplastic syndrome, acquired ichthyosis as a first sign of Hodgkin's lymphoma is discussed. In the presence of acquired ichthyosis, repeated monitoring of the patient is required since clinical symptoms of Hodgkin lymphoma are often delayed. Acquired ichthyosis is also an early marker of lymphoma recurrence.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12162096&dopt=Abstract

Am J Pathol. 2002 Aug;161(2):693-703.
Impaired hair follicle morphogenesis and cycling with abnormal epidermal differentiation in nackt mice, a cathepsin L-deficient mutation.

Benavides F, Starost MF, Flores M, Gimenez-Conti IB, Guenet JL, Conti CJ.

Science Park-Research Division, The University of Texas M. D. Anderson Cancer Center, Smithville, Texas 78957, USA. fbenavideprd1.mdacc.tmc.edu

We previously described an autosomal-recessive mutation named nackt (nkt) exhibiting partial alopecia associated with CD4(+) T-cell deficiency. Also, we recently reported that nkt (now Ctsl(nkt)) comprises a deletion in the cathepsin L (Ctsl) gene. Another recent study reported that Ctsl knockout mice have CD4(+) T-cell deficiency and periodic shedding of hair, which recapitulate the nkt mutation and the old furless (fs) mutation. The current study focuses on the dermatological aspects of the nkt mutation. Careful histological analysis of skin development of homozygous nkt mice revealed a delayed hair follicle morphogenesis and late onset of the first catagen stage. The skin of Ctsl(nkt)/Ctsl(nkt) mice showed mild epidermal hyperplasia and hyperkeratosis, severe hyperplasia of the sebaceous glands, and structural alterations of hair follicles. Epidermal differentiation seems to be affected in nkt skin, with overexpression of involucrin and profilaggrin/filaggrin along with focal areas of keratin 6 expression in the interfollicular epidermis. Severe epidermal hyperplasia, acanthosis, orthokeratosis, and hyperkeratosis were only observed in mice maintained in nonpathogen-free environments. The analysis of Rag2-/- Ctsl(nkt)/Ctsl(nkt) double-mutant mice indicates that the skin defect remains under the absence of T and B cells. This animal model provides in vivo evidence that cysteine protease cathepsin L plays a critical role in hair follicle morphogenesis and cycling, as well as epidermal differentiation.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12163394&dopt=Abstract

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