Scalp Infection Research Articles

ETHNOBOTANICAL INVESTIGATION OF INDIGENOUS PLANTS USED IN THE MANAGEMENT OF SOME INFANT ILLNESSES IN IBADAN, SOUTH-WESTERN NIGERIA

Background: Ethnobotanical information on indigenous plants used in the management of infant illnesses was sourced from Bode herbal market in Ibadan South-western Nigeria to preserve indigenous knowledge of medicinal plants, and demonstrate the role of traditional medicine as complementary healthcare system.
 Methods: Information was gathered using periodic open-ended questionnaire and personal interview. The respondents were randomly selected and consist, fifteen (15) women - herb sellers (of between 25-50, age range) who prescribed workable recipes used in the management of scalp infections, abscess, convulsion and cold shivers. The recipes documented are enumerated and served as groundbreaking preparations in infant diseases’ management. 
 Results: The survey yielded 48 plant species belonging to 31 plant families. The family Fabaceae has the highest number of species followed by Combretaceae, Meliaceae, Euphorbiaceae. The leaves and roots constituted the frequency of plant parts used; while the stem has the least frequency. The methods of preparation purposefully cited were decoction, infusion, and soap; others include steeping in cold water and cream whereas the solvent of choice was water. A particular brand of bottle water was preferable for herbal preparation. Other ingredients cited include soft traditional black soap, sulphur, Shea butter, antimony/black lead ore, and local sponge. Method of administration and dosage involves diluting extracts from infusion or decoction in higher parts of water – to be drunk, as well as for bath.
 Conclusion and Application of Results: The study documented indigenous knowledge of plants used in the management of infants’ ailments. Results showed that herbal medicines have played and will continue to play significant roles as alternative or complementary healthcare delivery system. There is need for the sensitization of indigenous people on the conservation of plant resources especially in cases where the root (part) features in prescriptions. A regulatory measure for herbal practitioners as well as public enlightenment is recommended to help sustain and increase the awareness in herbal therapy to different audience. Again, the isolation and identification of active compounds as well as evaluative toxicity test could reveal and confirm indigenous claims by assurring safety in administration.

High dermatophyte contamination levels in hairdressing salons of a West African suburban community.

Tinea capitis is a dermatophyte infection of scalp is commonly spread by currently infected patients, asymptomatic carriers or by fomites, such as hairdressing tools. However, studies on the risk factors of Tinea capitis remain scarce. The aim ofthis study was to evaluate the dermatophytes contamination level of the hairdressing tools to which hairdressing salon customers are exposed in Sirakoro-Méguétana, a suburb of Bamako, the capital city of Mali. A total of 41 hairdressing tools were sampled in five hairdressing salons. Two anthropophilic dermatophytes species, Microsporum audouinii (53.3%) and Trichophyton soudanense (46.7%), were cultured from 30 (73.2%) samples. This first study, addressing hairdressing salons dermatophyte contamination, revealed a strikingly high contamination of hairdressing tools with dermatophyte propagules, which exposes hairdressing salons customers to an important dermatophytosis risk. The sterilisation of hairdressing tools is central to preventing dermatophytoses spreading. Appropriate community information and hairdressers training should be implemented in this view.

PO-0234 Adopted Children And Tinea Capitis: Systematic Screening Needed

<h3>Background/aims</h3> Dermatophytes are keratinophilic fungi responsible for skin, nail and scalp infections. Over the past few years, a rising incidence of dermatophytoses has been reported, particularly due to infected migrants coming from developing countries. In this study, we studied dermatophytes’ prevalence in a cohort of international adopted children. <h3>Methods</h3> This retrospective study has been carried out in the Parasitology – Mycology clinic of La Croix Rousse University Hospital in Lyon, France from 1998 to 2012. Biological samples of scalp or hair have been analysed according to standard mycological procedures. <h3>Results</h3> In total 101 children coming from Africa, and the Caribbean were sampled. 44 children had dermatophytosis (44/101, 43.6%) eg <i>Trichophyton soudanense</i>, <i>Trichophyton violaceum</i>, <i>Trichopyton tonsurans</i>, <i>Trichophyton rubrum</i> and <i>Microsporum audouinii</i>. The clinical presentation of these patients was variable, including squamous scalp lesions without alopecia (n = 20), scalp alopecia-causing lesions (n = 6), squamous lesions scalp associated with tinea corporis (n = 5), tinea corporis (n = 4) and crusty scalp lesions (n = 1). In seven cases we reported completely asymptomatic patients (15.9%, 7/44). Systematic examination of their families led to the discovery of nine cases (20.5%, 9/44) of family contamination. The therapeutic success rate was close to 80% following first line of treatment. <h3>Conclusion</h3> We demonstrated that dermatophytoses often have a silent clinical presentation and, in approximately 20% of cases, cause family contamination. This study highlights the importance of the clinical examination of children and families, as well as systematic sampling of children, to avoid dermatophyte transmission to other family members.

A Parkinson's disease patient treated with deep brain stimulation, with implantation and reimplantation of the system - an 8 years follow-up

Deep brain stimulation is the most used neurosurgical procedure for advanced Parkinson’s disease. This procedure improves motor symptoms and some non-motor symptoms over a long period of time. In rare cases there are several complications which might lead to system removal. We report here a case were removal of the stimulation system was prompted by a scalp infection which extended to the subcutaneous fatty tissue and subcutaneous wire trajectories and did not resolved with antibiotics. The symptomatology worsened after device removal and reimplantation was decided. We followed this patient for 8 years after the first implant (6 years after the second implant) and he still has a good quality of live, being completely independent in most daily tasks.

Clinical Study of the Prunus dulcis (Almond) Shell Extract on Tinea capitis Infection

Prunus dulcis (Almond) shell extract demonstrated for its biomedical applications. Shell extract prepared by soxhlet method and further characterized by UV-Visible spectrophotometer, Atomic Absorption Spectrophotometer (AAS) and MIC control method. In this study the antifungal activity of almond shell extract was observed against clinically isolated pathogenic fungus by strip method. The antioxidant potential of crude shell extract was also evaluated by using DPPH (2-2-diphenyl-1-picryhydrazyl) and radical scavenging system. The total antioxidant activity varied from 94.38 to 95.49% and total phenolic content was found 4.455 mg/g in almond shell extract. Finally the results provide a great therapeutic potential against infection of scalp caused by Tinea capitis and result can be achieved in 20 days therapy. In this study of shell extract results provide a great therapeutic potential against infection of scalp caused by Tinea capitis and provides scientific evidence for clinical efficacy against dermatologic disorders. The present study is aimed to summarize the therapeutic importance of cheap and discarded coconut shell and the future prospects in order to develop a new generation of modern antimycotic drugs.

Facial trauma: Not a stigma in a newer single stage reconstructive surgery

In trauma surgery, instead of discarding the fractured bone segments as done in earlier days in patients with depressed skull fractures, these fragments can be used to reconstruct the damaged facial architecture.The aim of the study was to test the feasibility of managing comminuted frontal bone depressed fracture by a single stage debridement, reduction and replacement of the bone fragments and soft tissue reconstruction. bone cranioplasty using the native fractured bones was prospectively done in 11 patients over a period of one year from January 2011 to December 2012. We report on our clinical cases and the surgical technique of managing comminuted frontal bone fractures. The posttraumatic frontal bone defect was caused by road traffic accident. There were no deaths due to the minimal complications from the procedure. Two patients (18%) had mild scalp infections, 1 patient (0.9%) had epileptic seizure, which was controlled by medication. It thus concluded that the fractured frontal bone can be reconstructed immediately with debridement in spite of major sinus involvement and underlying brain and dural damage. Factors contributing to success are removal of foreign debris from the fractured bone segments, perfect dural repair with the use of pericranial flaps and bone cover being provided from beneath by the pericranial flap and above the skin. These segments heal excellently with bone remodeling.

A study on tinea capitis in the pre school and school going children

Introduction: Tinea capitis is a superficial fungal infection of scalp and hair caused by various species of dermatophytes. The incidence of Tinea capitis varies from country to country and region to region. Material and Methods: Fifty patients from the preschool going population were selected for the study. Results and Discussion: Clinical presentation of disease revealed that black dot to be the commonest (32%) followed by grey patch (28%), kerion (20%) and favus type was the least (1%). Direct microscopy of hair in KOH preparations revealed that all clinically suspected patients of Tinea capitis had endothrix type in 56% of cases and ectothrix type in 44%.

Tinea capitis in schoolchildren in southern Ivory Coast

Fungal infections of the scalp commonly affect the pediatric population. These infections are caused by dermatophytes that are able to invade the keratinized structures of skin, hair, and nails. This study aimed to analyze the epidemiology of fungal scalp infections in southern Ivory Coast during 2008-2009. From October 2008 to July 2009, 17,745 children ranging in age from 4-16years, attending urban and rural primary schools in seven towns in Ivory Coast, were examined clinically for tinea capitis. Hair stumps and scales were collected from children who showed symptoms suggestive of scalp ringworm. Samples were exposed to direct microscopic examination using 30% potassium hydroxide solution and cultivation on Sabouraud's dextrose agar with or without actidione. Of the 17,745 children who were clinically examined, a total of 2645 exhibited symptoms suggestive of scalp ringworm. Positive cultures for fungi were found in 2458, yielding an overall prevalence of tinea capitis of 13.9%. The majority of infections occurred in males (74.0%). The most commonly affected age group involved children ranging from 9-12years (n=1335, 54.3%), followed by those in the range of 4-8years (n=936, 38.1%). Trichophyton soudanense, Microsporum langeronii, and Trichophyton mentagrophytes were the most prevalent etiologic agents (56.7%, 21.4% and 19.7%, respectively). Other species were occasionally isolated, including Trichophyton violaceum (1.4%) and Trichophyton rubrum (0.8%). Epidemiological surveys are an essential tool for developing strategies for infection control.

Alternaria scalp infection in a patient with alopecia areata. Coexistence or causative relationship?

Alopecia areata is an autoimmune disease that is affecting anagen hair follicles. The triggers of autoimmunity in patients with alopecia areata remain unknown. A 13-year-old boy developed multiple hairless patches of focal hair loss with typical clinical and trichoscopy features of alopecia areata. Mycology examination of the scalp hair and epidermal scrapings reveled massive growth of Alternaria chlamydospora. We hypothesize that fungal antigens (e.g. antigens involved in fungal melanin synthesis) may be possible triggers, contributing to autoimmune reactions in patients with alopecia areata. We discuss research data, which may indirectly support this hypothesis, however the concept has yet to be verified.

Dilemmas and challenges in the management of a neonate with Adams–Oliver syndrome with infected giant aplasia cutis lesion and exsanguination: a case-based update

Aplasia cutis is a rare developmental anomaly usually involving the calvarium, associated with a variable extent of defective formation of the scalp. Adams-Oliver syndrome is a condition mainly characterized by the congenital absence of skin, known as "aplasia cutis" which is usually limited to the vertex scalp and transverse limb defects. A 17-day-old term female neonate was referred to us with an infected scalp lesion of the vertex. The lesion which is about 10 × 9 cm had signs of infection with necrotic eschar. We started the neonate on systemic parenteral antibiotics with local dressings. On day 3 of conservative management, the neonate had exsanguination due to bleeding from the midline with severe hemodynamic compromise requiring cardiopulmonary resuscitation. After controlling the bleeding with local tamponade and resuscitating the child, she was taken for early surgery. Debridement and bipedicled rotation flap of the scalp to cover the raw area was performed. On day 18, the flap started showing signs of necrosis. The neonate was taken up for debridement, and subsequently, maternal allograft of split-thickness skin was placed as a temporary wound cover. Meanwhile, the wound showed progressive epithelialization. At 1 year, the patient continued to have a non-healing area, which was later successfully covered with a split-thickness skin graft. We plan to revaluate the need for cranioplasty at around 3-4 years of age. We discuss the dilemmas and challenges involved in the successful management of a neonate with Adams-Oliver syndrome with infected aplasia cutis and an episode of life-threatening exsanguination. Aplasia cutis is a rare developmental anomaly usually involving the calvarium, associated with defective formation of the scalp to a varying extent and severity, requiring various timely strategies.

Cephalhematoma infected by Escherichia coli presenting as an extensive scalp abscess

Cephalhematoma is normally a self-limiting condition affecting 1%–2% of live births, especially following instrumental forceps delivery. The sub-periosteal bleed is characteristically limited by the cranial sutures. Although benign in most instances, this condition may, in a small proportion of cases, be complicated by hyperbilirubinemia or scalp infection. We describe a case of cephalhematoma in a newborn infant infected with Escherichia coli resulting in an extensive deep seated scalp abscess. The infection was also systemic causing E. coli septicemia and initial assessment assumed local extension including bone and meningeal to cause skull osteomyelitis and meningitis respectively. Further investigations and multiple-modality imaging with ultrasound, CT scan and bone scintigraphy outlined the involvement as limited to the scalp, resulting in a shorter antibiotic treatment period and earlier discharge from hospital. The infant recovered well with parenteral antibiotics, saucerization of the abscess and a later skin grafting procedure.

Reconstruction of Postinfected Scalp Defects Using Latissimus Dorsi Perforator and Myocutaneous Free Flaps

In severe, infected scalp defects, locally available tissues are not sufficient for reconstruction and are often unhealthy. In this situation, healthy free tissue transfer offers abundant vascularity of uncompromised tissue that can control infections and a single-stage reconstruction. Between March 2002 and May 2010, 18 patients (20 cases) underwent traumatic scalp defect reconstruction with coincident infections as follows: 16 cases of postcranioplasty infections with previous traumatic open skull fractures and 4 cases of traumatic defects with infections without cranioplasties. Eighteen patients underwent 20 latissimus dorsi free flaps: 8 cases were latissimus dorsi perforator flaps without muscle and 12 cases were latissimus dorsi myocutaneous flaps. The mean flap size was 214 cm. All patients healed well during the follow-up period. A latissimus dorsi flap in the supine position is an alternative for reconstruction of scalp defects with postcranioplasty or traumatic infections.

Comparison of manually shaped and computer-shaped titanium mesh for repairing large frontotemporoparietal skull defects after traumatic brain injury

The object of this study was to compare the effects and complications of manual and computer-aided shaping of titanium meshes for repairing large frontotemporoparietal skull defects following traumatic brain injury. From March 2005 to June 2011, 161 patients with frontotemporoparietal skull defects were observed. Patients were divided into 2 groups according to the repair materials used for cranioplasty: 83 cases used computer-aided shaping for the titanium mesh, whereas the remaining 78 cases used a manually shaped titanium mesh. The advantages and disadvantages of the 2 methods were compared. No case of titanium mesh loosening occurred in either group. Subcutaneous fluid collection, titanium mesh tilt, and temporal muscle pain were the most common complications. In the manually shaped group, there were 14 cases of effusion, 10 cases of titanium mesh tilt, and 15 cases of temporal muscle pain. In the computer-aided group, there were 6 cases of effusion, 3 cases of titanium mesh tilt, and 6 cases of temporal muscle pain. The differences were significant between the 2 groups (p < 0.05). Other common complications were scalp infection, exposure of titanium mesh, epidural hematoma, and seizures. In the computer-aided group, the operative time decreased (p < 0.01), the number of screws used was reduced (p < 0.01), and the satisfaction of patients was significantly increased (p < 0.05). Computer-aided shaping of titanium mesh for repairing large frontotemporoparietal skull defects decreases postoperative complications and the operative duration, reduces the number of screws used, increases the satisfaction of patients, and restores the appearance of the patient's head, making it an ideal choice for cranioplasty.

Head-to-Head Head Trial

Fungal infections of the scalp and hair are common, especially in children. Systemic treatments include griseofulvin, terbinafine, and fluconazole, but

Saethre–Chotzen phenotype with learning disability and hyper IgE phenotype in a patient due to complex chromosomal rearrangement involving chromosomes 3 and 7

The authors describe on a Brazilian girl with coronal synostosis, facial asymmetry, ptosis, brachydactyly, significant learning difficulties, recurrent scalp infections with marked hair loss, and elevated serum immunoglobulin E. Standard lymphocyte karyotype showed a small additional segment in 7p21[46,XX,add(7)(p21)]. Deletion of the TWIST1 gene, detected by Multiplex Ligation Probe-dependent Amplification (MPLA) and array-CGH, was consistent with phenotype of Saethre-Chotzen syndrome. Array CGH also showed deletion of four other genes at 7p21.1 (SNX13, PRPS1L1, HD9C9, and FERD3L) and the deletion of six genes (CACNA2D2, C3orf18, HEMK1, CISH, MAPKAPK3, and DOCK3) at 3p21.31. Our case reinforces FERD3L as candidate gene for intellectual disability and suggested that genes located in 3p21.3 can be related to hyper IgE phenotype.

Scalp Abscess Due to Streptomyces cacaoi subsp. cacaoi , First Report in a Human Infection

Streptomyces cacaoi subsp. cacaoi, a Gram-positive, branching filamentous bacteria, was isolated from a scalp infection in a patient from Pondicherry, India. Phenotypic tests identified the isolate as a Streptomyces species, but 16S rRNA sequence analysis provided the species identification required for tracking of this emerging pathogen.

Prevalence of Tinea capitis in school going children in Kolkata, West Bengal

Background:In recent years the incidence of Tinea capitis, infection of scalp by dermatophytes, has increased in United Kingdom and North America. The trend may be similar in India. The objective of this study is to find the prevalence of Tinea capitis in school going urban children in Kolkata, West Bengal state.Materials and Methods:The present study is a cross-sectional study conducted in a government higher primary school in Kolkata.Results:Totally 505 students were screened and 52 were diagnosed to have Tinea capitis by clinical examination, giving a prevalence rate of 10% among school children. Prevalence rates among the age groups of 6–8, 9–11 and 12–14 years were almost the same, ranging from 9 to 11%. The prevalence rate was significantly high among the boys (14%). There was no significant difference in prevalence of infection among coconut oil users and castor oil users. Measures of general hygiene were similar among those who were infected with Tinea capitis and those who were not. The commonest clinical type of infection found was dull grey patches. Itching with hair loss was the major symptom and most of the infected children had cervical lymphadenopathy. The potassium hydroxide studies revealed endothrix spores in majority of samples.Conclusion:Tinea capitis in prevalent in school going urban children in Kolkata, West Bengal state and necessary measures must be undertaken to curtail this incidence.

Familial mucocutaneous candidiasis - a case report

Chronic mucocutaneous candidiasis is an immune-deficiency disorder primarily due to T- cell dysfunction characterized by persistent candidal infection of mucous membrane, skin, scalp and nails. A familial occurrence has been reported in some instances suggesting a genetic predisposition. Chronic mucous membrane candidiasis has an onset in infancy or childhood; the primary affected site is the oral cavity; however, lesions may occur on trunk, hands, feet and scalp. This paper describes two siblings with candidial infection of the oral mucosa associated with cutaneous bacterial infection.

Medical and Environmental Risk Factors for the Development of Central Centrifugal Cicatricial Alopecia

To investigate medical and environmental risk factors for central centrifugal cicatricial alopecia (CCCA), the most common type of scarring alopecia in African American women. A population study involving a quantitative cross-sectional survey of risk factors for CCCA. Survey results are then correlated with a clinical evaluation for CCCA using a standardized, previously published central scalp alopecia photographic scale. Two African American churches and a health fair for African American women in Cleveland, Ohio. A total of 326 African American women who participated in the hair study. Prevalence of CCCA in the general African American population and risk factors associated with CCCA. Of the 326 responders, 28% received a grade of 2 or higher using a standardized, previously published central scalp alopecia photographic scale, a score consistent with clinically evident central hair loss. Advanced central hair loss with clinical signs of scarring (grade ≥ 3) was seen in 59% of these respondents and was interpreted as clinically consistent with CCCA. Diabetes mellitus type 2 was significantly higher in those with CCCA (P = . 01), as were bacterial scalp infections (P = .045) and hair styles associated with traction (eg, from braids and weaves) (P = .02). Our survey results suggest that there is a high prevalence of central hair loss among African American women. Hair styles causing traction as well as inflammation in the form of bacterial infection may be contributing to the development of CCCA. The increase in diabetes mellitus type 2 among those with CCCA is in line with the recent theory that cicatricial alopecia may be a manifestation of metabolic dysregulation.

Trichophyton tonsurans scalp carriage among wrestlers in a national competition in Turkey

Trichophyton tonsurans tinea gladiatorum is an emerging epidemic among combat-sport athletes across the globe. In the present study, we investigated the prevalence of symptomatic and asymptomatic dermatophytic infections among wrestlers in the National Greco-Roman Championship in Turkey. In total, 194 wrestlers from 32 provinces and 72 clubs were examined for scalp, trunk, groin, and toe web dermatophytic infections. We also administered a questionnaire to obtain information on the participants' lifestyles, wrestling characteristics, and risk factors for dermatophytic infections. The hairbrush method was used for scalp and trunk sampling, whereas a cotton swab was used for groin, toe web, and mat sampling. Three wrestling mats in the gymnasium were surveyed for dermatophytes using the touch preparation method. A total of 17 (8.8%) wrestlers harbored dermatophytes, and 22 strains were isolated: 13 (59.1%) T. tonsurans and 9 (40.9%) T. rubrum. These isolates were found on the scalp (8), trunk (2), forearm (1), hand (1), groin (3), and feet (7). In addition, we recovered 8 dermatophyte strains from the 150 mat samples (5.3%): T. rubrum in 6 samples (75%) and T. tonsurans in two samples (25%). T. tonsurans was only recovered from 11 out of 194 (5.7%) wrestlers. Scalp carriage represents the predominant (72.7%) clinical picture of a T. tonsurans infection in these Greco-Roman wrestlers in Turkey.