Examination Of Scalp Research Articles

Impact of Persistent Alopecia on Quality of Life in Childhood Cancer and Transplant Survivors.

While alopecia associated with chemotherapy, radiation, or hematopoietic stem-cell transplant (C/R/HSCT) is transient in most children, prior reports indicate nearly one in seven childhood cancer survivors suffer from persistent alopecia after their treatment is completed. The objective of our study was to better characterize the impact of C/R/HSCT-associated persistent alopecia on patient quality of life. A cross-sectional cohort study of patients with a history of C/R/HSCT who were seen at Dana Farber Cancer Institute/Boston Children's Hospital Dermatology from August 2023 to February 2024 for any indication was conducted. Patients who completed their C/R/HSCT treatment regimen >6 months prior to visit were invited to fill out a survey on patient experience with persistent alopecia, including a modified Children's Dermatology Life Quality Index (CDLQI). Participants also underwent a full scalp examination. Twenty one out of 47 (44.7%) patients in our cohort self-reported persistent alopecia. For nine additional patients, alopecia was not self-reported but noted by a dermatologist on exam. Median self-reported alopecia severity was 3 (interquartile range [IQR] 2-5.25) on a visual analog scale of 1-10. The most common pattern of alopecia was diffuse thinning. Median CDLQI score was 5 (IQR 2-7) for those with persistent alopecia, indicating a small negative effect of disease on patient quality of life. Fifteen (31.9%) patients report receiving information about persistent alopecia prior to their C/R/HSCT. Nearly half of childhood cancer and transplant survivors evaluated by dermatology suffered from persistent alopecia, which negatively impacted their quality of life. Better counseling on persistent alopecia should be provided to childhood cancer patients.

Palpable signs of skull fractures on physical examination and depressed skull fractures or traumatic brain injuries on CT in children

To assess the actual presence of underlying depressed skull fractures and traumatic brain injuries (TBI) on computed tomography (CT) in children with and without palpable skull fractures on physical examination following minor head trauma. This was a secondary analysis of a prospective, observational multicenter study enrolling 42,412 children < 18 years old with Glasgow Coma Scale scores ≥ 14 following blunt head trauma. A palpable skull fracture was defined per the treating clinician documentation on the case report form. Skull fractures and TBIs were determined on CT scan by site radiologists. Palpable skull fractures were reported in 368/10,698 (3.4%) children < 2 years old, and in 676/31,613 (2.1%) of older children. Depressed skull fractures on CT were observed in 56/273 (20.5%) of younger children with palpable skull fractures and in 34/3047 (1.1%) of those without (rate difference 19.4%; 95%CI 14.6–24.2%), and in 30/486 (6.2%) vs 63/11,130 (0.6%) of older children (rate difference 5.6%; 95%CI 3.5–7.8%). TBIs on CT were found in 73/273 (26.7%) and 189/3047 (6.2%) of younger children with and without palpable skull fractures (rate difference 20.5%; 95%CI 15.2–25.9), and in 61/486 (12.6%) vs 424/11,130 (3.8%) of older children (rate difference 8.7%; 95%CI 6.1–12.0).Conclusions: Although depressed skull fractures and TBIs on CT are more common in children with palpable fractures than those without, most of these children do not have underlying depressed fractures. The discriminatory ability of the scalp examination could be enhanced by direct bedside visualization of the skull, such as through ultrasound.What is Known:• “Palpable skull fractures” are a high-risk predictor in the PECARN traumatic brain injury (TBI) rule for children younger than 2 years.• The reliability of physical exam findings suggestive of underlying skull fractures is unclear.What is New:• In children younger than 2 years of age, approximately one in five of those with “palpable skull fractures” will actually have a depressed skull fracture on CT, while 60% will have any skull fracture.• The discriminatory ability of the scalp examination could be enhanced by direct bedside visualization of the skull, such as through ultrasound.

P16 Linear bullous aplasia cutis congenita of the scalp: an unusual presentation of a rare condition

Abstract Aplasia cutis congenita (ACC) is a heterogenous group of congenital disorders characterized by focal or widespread absence of skin. Bullous ACC is a rare variant that presents with well-circumscribed oval lesions resembling bullae or vesicles covered with a thin membrane. There have been 20 previously reported cases of bullous ACC. We present a female neonate referred to dermatology at day 2 of life following an IVF-assisted pregnancy and delivery by elective caesarean section for breech presentation. There was no antenatal history of infection, trauma or drugs, and no relevant family history. Clinical examination of the parietal scalp revealed five well-demarcated bullae in a linear distribution along Blaschko lines. The hair collar and ‘golf club set’ signs were absent. Skin swabs for microbiology and viral studies were negative. Ultrasonography showed no associated osseous defect. Clinical examination was otherwise normal. A diagnosis of multibullous ACC was made, and a conservative approach adopted. Clinical follow up at 2 years found resorption of one bulla with flattening of the remainder. Neurodevelopment was normal. On review of the literature, 10/20 (50%) cases of bullous ACC presented with multiple bullae. The hair collar sign was positive in 50%, strengthening theories that bullous ACC may represent a ‘forme fruste’ of a neural tube defect. Four other cases reported distribution along Blashko lines, suggesting possible underlying cutaneous mosaicism. The majority (90%) had no associated cutaneous or extracutaneous findings. Clinical outcomes were good with spontaneous resorption of bullae, suggesting conservative management is appropriate in most cases.

Videodermoscopy Evaluation in Non-scarring Alopecia of Scalp

Introduction: Hair is a versatile structure, and its importance has been linked to it in the beautification of human beings for ages. According to studies on the psychological impacts of androgenetic alopecia (AGA) in men, they are older, weaker, and less appealing. Hair loss in women gives significant stress and lowers self-confidence. Aim: To perform videodermoscopic findings in non-scarring alopecia of scalp versus control volunteers. Material and Methods: Total of 140 patients satisfied the study’s inclusion criteria after a general medical examination, scalp examination (including inspection of the hair shaft and root), and hair anchoring and fragility tests. We examined the lesions with a videodermoscopy, took images, and wrote up our findings. Results: The study found that patients averaged 26.85. Onset averaged 25.15 alopecia averaged 10.3 months. Our sample had 87.7% spotty AA. Conclusion: Videodermoscopy is an effective non-invasive tool of considerable potential in dermatological practice. It is becoming popular as a hair loss differential diagnosis tool.

A Rare Case of Cutis Aplasia Congenita in a Newborn

A Rare Case of Cutis Aplasia Congenita in a Newborn

Pediatric alopecia areata following COVID‐19 infection

Pediatric alopecia areata following <scp>COVID</scp>‐19 infection

Prevalence of Premature Hair Greying, its Associated Factors and Impact on Quality of Life in Medical Students from Rajasthan, India

Background: Considering the paramount significance of hair in life, greying hair at a young age can be extremely distressing. In addition, an incompletely understood aetiology and scarcity of treatment options make premature hair greying (PHG) noteworthy. Aims: We aimed to estimate the prevalence of PHG in medical college students from Rajasthan, India, and any sociodemographic and lifestyle correlates of PHG and to determine its effect on the quality of life (QOL). Patients and Methods: A cross-sectional study was conducted amongst 295 students of a medical college in western Rajasthan, India, under the age of 25 years. A scalp examination was done to count grey hair. All factors were investigated using structured, pre-validated questionnaires. Results: The prevalence of premature greying of hair was 41.4%. Sociodemographic factors such as older age, rural residence and positive family history were significantly associated with PHG. The number of meals, fruit consumption and irregularity of meals were the lifestyle factors associated with PHG. The QoL of 54.1% of students with grey hair was poor; males and rural residents were more affected. Conclusions: Premature greying of hair is a fairly prevalent condition in medical college students affecting their QoL. Factors such as family history, age, residence and eating habits may predispose students to PHG.

Scarring versus Non-Scarring Alopecia: An Interobserver Histopathological Reproducibility Study

Introduction: Distinguishing scarring (SA) versus non-scarring alopecia (NSA) may not be a simple procedure on either clinical or histopathological views. Aims: We sought to study the interobserver variability in the histopathological assessment of SA versus NSA, including clinical-pathological considerations. Methods: Two dermatopathologists independently interpreted the same set of 100 specimens (89 patients). The samples were serial sectioned and stained by hematoxylin and eosin and Verhöeff methods. The patients’ mean age was 46 years, with 13 being males and 76 females. Results: In 16/100 samples, there was no consensus among the two examiners regarding SA versus NSA (weighted kappa = 0.6583; 95% CI); 3/16 patients were re-biopsied, and in the second sample, consensus was reached. In 76/89 patients, the anatomopathological examination was helpful in defining the SA versus NSA subtype. Of the 84 samples in which there was interobserver agreement, 4 which had been considered scarring in the routine pathological report were re-classified as non-scarring, whereas one biopsy, previously diagnosed as non-scarring, was now considered cicatricial due to the newly found areas of lichenoid inflammation in the infundibular epithelium. Discussion: The ideal scalp examination may require deep serial biopsy sectioning, elastic tissue stain, re-biopsy, and strict clinical-evolutive correlation.

Knowledge, Attitudes, Psychosocial Perspectives and Applied Epidemiology in the Control of Head Lice (pediculosis capitis) in Croatian Preschool Children: A Qualitative Study on Childcare Professionals and Health Coordinators.

This study aimed to concurrently determine the perceived knowledge, attitudes and perspectives of childcare professionals working in kindergartens towards pediculosis capitis, a common ectoparasitic disease also known as head lice, as well as gain insights into procedures and control measures that are implemented in an outbreak setting. We used a qualitative approach with a problem-centered, semi-structured and three-part interview technique conducted in selected kindergartens of Varaždin and Međimurje counties of the Republic of Croatia. Based on a purposive (deliberate) sampling method, the study included both childcare professionals and on-site health coordinators aged between 21 and 56 years of age. Five main themes were put forth as a result of the conducted thematic analysis: prevention and control measures for managing head lice, information and knowledge, social issues, psychological issues and disease perception. Each of these themes also had specific emerging categories based on participants’ responses. Even though all respondents confirmed that the disease is continuously monitored only a few of them mentioned that a scalp examination was an inherent part of disease surveillance within the kindergarten community. Moreover, we found that information on pediculosis capitis is available to both parents and childcare professionals, but with a questionable uptake. Additionally, the majority of the respondents reported that parents tend to hide the infestation in their children due to shame and/or to avoid social stigma, and thus often fail to inform kindergarten teachers and health coordinators about the problem. In conclusion, our findings have implications for further practice and the introduction of tailored public health measures for the most vulnerable populations, most notably kindergarten children.

English

BACKGROUND Cicatricial alopecia is the term used for permanent areas of hair loss due to destruction of hair follicles. It may occur due to a disease that primarily affects hair follicles or due to external causes that damages hair follicle secondarily. The common causes of primary cicatricial alopecia include discoid lupus erythematosus, lichen plano pilaris, pseudopelade of Brocq, folliculitis decalvans and folliculitis keloidalis. Exact diagnosis at an early stage will help to provide disease specific management at the earliest thus, preventing further progression of the disease. We conducted this study to assess the role of clinico-pathological correlation to find out the exact aetiology of primary scarring alopecia in our patients. METHODS We conducted a descriptive cross sectional study to find out aetiology of primary cicatricial alopecia based on clinical and histopathological findings of 50 patients who attended the outpatient department of Dermatology in our hospital. After a detailed history and clinical examination of scalp, biopsy of lesional scalp skin was taken in all patients. In relevant cases direct immunofluorescence study was also done. RESULTS Age of the patients ranged from 16-75 years. M: F ratio was 1:1.5. Hair loss, itching, scaling and scalp pain were the reported symptoms. Commonly affected sites were parietal and temporal areas. 76 % of patients had multiple lesions. Absent follicular ostia, follicular plugging, atrophy, pigmentary changes, scaling and telangiectasias were the commonly observed clinical scalp findings. 88 % of cases showed lymphocytic infiltrate on histopathology. After clinico-pathological correlation, 48% patients had discoid lupus erythematosus followed by follicular lichen planus in 28% and pseudopelade of Brocq in 20 % cases. Folliculitis decalvans and folliculitis keloidalis each were observed in 2 % cases of primary scarring alopecia. CONCLUSIONS Clinicopathological correlation is highly useful to make an early diagnosis in primary cicatricial alopecia. In our patients discoid lupus erythematosus was found to be the predominant cause. KEY WORDS Cicatricial Alopecia, Clinicopathological Correlation, Discoid Lupus Erythematosus, Lichen Planus

Cutaneous T-cell lymphoma in erythrodermic cases may be suspected on the basis of scalp examination with dermoscopy

Erythrodermic variants of cutaneous T-cell lymphoma (CTLC) are one of the case of erythroderma. The aim of the study was to assess the value of scalp dermoscopy in differentiation between erythrodermic CTCL, psoriasis, and atopic dermatitis. A total of 76 patients were included into the study (16 patients with erythrodermic CTCL, 20 patients with psoriatic erythroderma, 20 with erythrodermic atopic dermatitis, and 20 healthy volunteers). The most common trichoscopic features of erythrodermic CTCL were: numerous pili torti, numerous broken hairs, white thick interfollicular bands, and patchy hyperpigmentation of the background. They were observed in 81% (13/16), 75% (12/16), 56% (9/16), and 37.5% (6/16) of patients with CTCL, respectively (p < 0.001). Other specific features of erythrodermic CTCL were 8-shaped hairs (19%; 3/16) and visible anagen bulbs (12.5%; 2/16) (p < 0.05 and p = 0.052, respectively). The most common vascular pattern of erythrodermic CTCL was perifollicular arrangement of glomerular (50%; 8/16; p < 0.001) or linear vessels (31%; 5/16; p < 0.05). Follicular spicules-like scaling was pathognomonic for erythrodermic CTCL (12%, 2/16) although its presence did not reach statistical significance (p = 0.052). In conclusion, the characteristic trichoscopic findings of erythrodermic CTCL are numerous pili torti, eight-shaped hairs, thick white interfollicular bands, color heterogeneity of the background and perifollicular arrangement of vessels.

A clinico-etiological evaluation of hair loss in rural Indian children – A cross sectional study

Introduction: Hair loss in children is relatively less common when compared to adults but is associated with significant psychological stress that may affect the growth and development of the child. The type of alopecia is influenced by the age group, ethnicity, hair type, nutrition, environment and cultural factors also play a significant role in hair loss. This study aims at appraising our knowledge on the clinical presentations and various etiologies of alopecia in children. Materials and Methods: 1574 patients less than 18 years were screened, out of which 75 children fulfilling the criteria were enrolled for the study. A written informed consent was taken from the patient’s parents or guardian. A detailed hair and scalp examination along with necessary investigations to establish the definitive diagnosis was done. The collected data were analyzed by the SPSS 22 version software. Results: In the present study, school going children (6-10 years) and adolescents (10-18 years) were commonly involved, almost equally affecting males and females. Majority of the cases were acquired non- scarring alopecia. Malnutrition, poor grooming habits, associated systemic diseases and stress were common risk factors. The most frequent etiologies were tinea capitis, alopecia areata, telogen effluvium, trichotillomania, nevus sebaceous and scarring following infections. Conclusion: The present study highlights the various acquired and congenital causes of hair loss in children. Early diagnosis and treatment can alleviate the anxiety. The study emphasizes on the importance of addressing underlying malnutrition and poor grooming habits among the patients. Keywords: Hair loss in children, Malnutrition, Tinea capitis, Scalp disorders.

An overview of scalp dermatoses in a tertiary care institute

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The scalp is unique among skin areas in humans, with high follicular density and high rate of sebum production which though providing thermal insulation also creates an environment conducive to superficial mycotic infections and parasitic infestations. As there is a paucity of studies on scalp dermatoses in the Indian and Western literature, a clinical study of these scalp dermatoses can unravel the common clinico-epidemiological manifestations in our population.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This is a prospective observational study conducted for a period of 6 months. All the patients reporting to our department were evaluated for entry into the study and patients having scalp lesions were enrolled. A detailed clinical history and a thorough scalp examination were performed.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The incidence of scalp dermatoses is more among adolescents and early adulthood with a male to female ratio 1.8:1. 57% of patients had lesions exclusive to scalp. Scalp was the initial site of presentation in 54.6% of cases who had generalized lesions. Itching (n=107; 53.5%) is the commonest presenting complaint. Among the scalp sites, parietal area was involved the most (73%). The most common dermatoses were psoriasis (21.5%) followed by alopecia areata (11.5%).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The scalp dermatoses have significant psychological impact affecting the social profile of the patients. To the best of our knowledge, this is the first Indian study on scalp dermatoses involving all age groups which gives a precise clinical insight into scalp dermatoses.&lt;/p&gt;

Prevalence of Pediculosis and Its Predictors among Urban Primary School Children in Kuantan, Pahang

Introduction: Pediculosis capitis among primary school children is always known as the problem of the lower socio-economic class and rural communities. It carries significant consequences to the school children and caregivers. Limited studies have been conducted among the urban populations. Thus, this study aims to investigate the prevalence and predictors of Pediculosis capitis among Urban primary school children in Kuantan. Materials and method: An analytical cross-sectional study using cluster random sampling was carried out in Kuantan, Pahang, Malaysia. A selfadministered validated questionnaire was issued to the participants with purpose to collect socio-demographic data related to age, gender and factors that associated with head lice infestations among primary school children from standard one to six. It was then followed by hair and scalp examination by a well-trained examiners to check the infestation status. The results were analyzed using the chi-squared test and logistic regression analysis. Results: A total of 1347 students from 5 schools were included in this study. Majority of them were males (53.6%), Malays (61.0%), household income between RM1000-RM2999 (32.1%). The overall prevalence was 9.1% (n=122). Multivariate analysis showed that predictors for pediculosis capitis were female gender (OR= 6.02, 95% CI= 2.97-12.21), Indian ethnicity (OR= 5.55 , 95% CI=3.26-9.45), sibling of more than 5 (OR= 2.72 , 95% CI=1.04-7.12) and contact with infested person (OR=2.42, 95% CI=1.58-3.71). Conclusion: The prevalence of Pediculosis capitis among urban primary school children in Kuantan, Pahang is endemic (9.1%) and predictors are female genders, Indian ethnicity, having siblings of more than 5 and contact with infested person. Hence, preventive measures are necessary to reduce the transmission of head lice among school children.

Predictors of Pediculosis Capitis among Primary School Children in Kuantan, Pahang

Introduction: Pediculosis capitis is a worldwide problem which carries significant consequences among the school children and caregivers. This study aims to investigate the prevalence and predictors of Pediculosis capitis among primary school children in Kuantan, Pahang. Materials and method: An analytical crosssectional study using two-stage cluster random sampling was carried out among 1,365 primary school children in seven schools in Kuantan, Pahang. A selfadministered validated questionnaire was used followed by hair and scalp examination. Results: The median age of the respondents was 8.0 years. Majority of them were males (53.41%), Malays (60.29%), household income between RM1000RM2999 (31.87%) and from urban school location (98.68%). The overall prevalence of Pediculosis capitis was 9.6% (n=131). Multivariate logistic regression analysis showed that predictors for Pediculosis capitis were female (Odds ratio (OR)=8.571, 95% Confidence interval (CI)=5.024-14.620), Indian (OR=5.560, 95% CI=3.384-9.136), those with siblings more than five (OR=2.644, 95% CI=1.044-6.700), history of contact with infested person (OR=2.445, 95% CI=1.619-3.691) and urban school location (OR=0.030, 95% CI=0.284-0.091). Conclusion: Pediculosis capitis is a common public health problem affecting primary schoolchildren in Kuantan, Pahang and those levels are of epidemic importance. Hence, preventive measures are necessary to reduce the transmission of head lice among school children.

Factors Associated with Pediculosis Capitis among Primary School Children in Kuantan, Pahang

Introduction: Pediculosis capitis among primary school children is a worldwide problem which carries significant consequences among the school children and caregivers. Despite causing significant health problem which needs to be intervened, only few studies were conducted in Malaysia and there is no previous study conducted in Pahang. Thus, this study aims to investigate the determinants of prevalence of Pediculosis capitis among primary school children in Kuantan, Pahang, Malaysia. Materials and method: An analytical cross-sectional study using cluster random sampling of primary schools was carried out in Kuantan. Selfadministered validated questionnaire was used followed by hair and scalp examination. Multivariate logistics was done to determine the predictors and to control for confounding effect. Results: The overall median age of the 1,365 respondents was 8.0 years. Majority of them were males (53.41%), Malays (60.29%), household income between RM1000-RM2999 (31.87%) and from urban school location (98.68%). The overall prevalence of Pediculosis capitis was 9.6% (n=131). Multivariate logistic regression analysis showed that female (Odds ratio (OR)=8.571, 95% Confidence interval (CI)=5.024-14.620), Indian (OR = 5.560, 95% CI=3.3849.136), those who had number of siblings more than five (OR = 2.644, 95% CI=1.0446.700), history of contact with infested person (OR=2.445, 95% CI=1.619-3.691) and urban school location (OR=0.030, 95% CI=0.284-0.091) were predictors for Pediculosis capitis. Conclusion: The prevalence of Pediculosis capitis among primary school children in Kuantan, Pahang is endemic(9.6%) and predictors are female, Indian, having siblings of more than 5 and contact with infested person. Hence, preventive measures are necessary to reduce the transmission of head lice among school children.

Prevalence and Predictors of Pediculosis Capitis among Female Primary School Children in Kuantan, Pahang

Introduction: Pediculosis capitis has been a worldwide concern among the vulnerable population of primary school children due to the physical, economical and psychological consequences that it brings to both the children and their caretakers. It is observed that there were only limited studies conducted in Malaysia and no previous study was done in Kuantan despite the health concern that it bears. Since both local and worldwide studies show that Pediculosis capitis is more prevalent among female as compared to male school children, thus, this study aims to investigate the prevalence and predictors of Pediculosis capitis among female primary school children in Kuantan. Materials and method: An analytical crosssectional study using cluster random sampling was carried out in Kuantan, Pahang, Malaysia. A self-administered validated questionnaire was used to collect the data among female primary school children from standard one to six. Hair and scalp examination was performed to identify presence of Pediculosis capitis infestation. Multivariate logistic regression was used to control for potential confounding and determine the predictors Results: 10 schools participated in the study with total number of 636 female students as respondents. The overall prevalence of Pediculosis capitis among female primary school children was 17.6% (n=112). Multivariate logistic regression analysis showed that Indian (OR=5.634, 95% CI= 3.157-10.055), history of contact with infested person (OR=2.822, 95% CI=1.6193.691) and those who had number of family members more than four (OR=0.065, 95% CI=0.008-0.550) were predictors for Pediculosis capitis Conclusion: The prevalence of Pediculosis capitis among female primary school children in Kuantan, Pahang is endemic (17.6%) and predictors are Indian, history of contact with infested person and having family members of more than 4. Hence, there is a need for health intervention to reduce the burden of Pediculosis capitis infestation.

Trichoscopic Patterns of Nonscarring Alopecia's.

Background:Hair loss (alopecia) is a common problem and is a major cause of psychological stress and anxiety among affected individuals. It is of utmost importance to diagnose these cases at the earliest and treat them accordingly. Trichoscopy provides a noninvasive option that can be used for early diagnosis and monitoring the progression of the hair disorders.Aims and Objectives:To perform trichoscopy and document the findings in patients with nonscarring alopecia's.Materials and Methods:A total of 100 cases satisfying the inclusion criteria were screened for general physical examination and scalp examination including hair shaft and root, and tests for hair anchorage and fragility were also done. The lesions were examined through dermoscope, photographs were taken, and findings were documented.Results:Among the total of 100 cases screened, 57 were female and 43 were male. The mean age of the study group was 26 ± 14.8 years. Females were affected by alopecia areata (AA) and female pattern hair loss (29.8%) equally, whereas males were most commonly affected by AA (41.8%). The common trichoscopic follicular features noted were broken hair (48%), black dots (48%), single hair follicle unit (45%), short vellus hair (44%), upright hair (41%), and yellow dots (40%). The common interfollicular features seen were honeycomb pigmentation (26%) and arborizing red lines (12%).Conclusion:The emergence of newer hair signs on trichoscopic studies aids in identification and has a definitive role in the diagnosis of clinically difficult cases, so it is recommended to use trichoscopy in the routine examination of nonscarring alopecia's.

Bold to do — bald to be? Outcomes decades after harvesting the scalp in burned children

BackgroundThe scalp is the only hidden donor site for split thickness skin grafts. Nevertheless, it is underappreciated due to fear of iatrogenic scarring alopecia. Long-term data showing whether androgenetic hair loss can reveal previously hidden scarring alopecia is unavailable. We aimed to evaluate results and patient satisfaction up to 30years after skin harvest from the scalp. MethodsBurn patients, hospitalized between 1977 and 1987 at the University Children’s Hospital Zurich with scalp skin harvest and currently over 30years old, were studied. Medical records and patient satisfaction were analyzed, and a clinical scalp examination was performed. ResultsThirty-two patients (18 males, 14 females) with a current age of 34.13±3.42years participated. Mean follow-up time was 27.09±3.04years. Fifty-four scalp harvests were performed with 1.69±0.96 sequential harvests. Hair growth was considered normal in 97% patients. Androgenetic alopecia (AGA) type Norwood II–VI was seen in 11 patients. Scalp examination revealed 11 unknown likely harvest-related alopecias with a mean size of 0.7cm2. ConclusionsLong-term morbidity of scalp skin harvest and the risk of clinically significant alopecia is very low while patient satisfaction is high. AGA is unlikely to reveal harvest damage previously hidden by regrown hair.

Fluctuant Mass on an Infant’s Scalp

A term infant has the following scalp examination [click on the video]. Of the options shown in Fig 1A (A, B, C, or D) of the top of an infant’s head, what is the most likely location of the involved area in this infant? Video. Click here to view the video. Figure 1A. Locations for potential collections that are exterior and interior to an infant’s skull. The video of this newborn shows a moderate-to-large fluctuant mass gathered in the dependent portion of the neonate’s scalp. Upon gentle tapping of the boggy collection, there is a clearly visible fluid wave. This finding is most consistent with a subgaleal hemorrhage. Subgaleal hemorrhage is a serious, potentially fatal event in a newborn. It is caused by the rupture of large, bridging, emissary veins that connect the scalp veins to the intracranial dural sinuses. When these veins rupture, blood accumulates between the periosteum and the galeal aponeurotica, a large potential space composed of loose connective tissue. This space extends without restriction across the cranium and can hold as much as 260 mL of blood. (1) (Note: The average total blood volume in a term infant is 80–90 mL/kg.) A hemorrhage of …