bromochloroacetic-acid and Scalp-Dermatoses

Topics: Adult; Female; Humans; Keratins; Keratosis; Scalp Dermatoses; Warts

Epidermal inclusion cyst is one of the common benign soft tissue tumors, and it can be easily confirmed and treated by surgical excision. We experienced a patient who had multiple masses on the face and scalp region, and the masses had been misdiagnosed as neurofibromatosis because of accompanying mental retardation. We would like to introduce a case of clinical diagnosis error caused by the lack of radiologic evaluation and pathologic confirmation. A 27-year-old male patient visited with multiple masses, with a length of approximately 1 to 10 cm on the face and scalp region. These mass have developed since childhood without known etiology, and there has been no histologic examination or surgical excision done in the past. The patient's history of seizure disorder and mental retardation led the primary clinician to diagnose it as neurofibromatosis in the initial stage, and therefore, the clinician gave an advice on the possibility of frequent recurrence to the patient. As the masses increased in size, the patient came to our hospital after all. We found that the masses were soft and mobile through the physical examination, and magnetic resonance imaging showed evidence of epidermal inclusion cyst, which is distinguished from neurofibromatosis. Based on physical examination and magnetic resonance imaging, we performed total excision and biopsies. On the histologic examination, it was diagnosed as an epidermal inclusion cyst showing keratotic material internally, and the cyst wall was composed of lamellate keratin. The follow-up period was 12 months, and a recurrence has not occurred. The wound was healed without any specific complication, and both the patient and the guardian were satisfied with the physical enhancement. We have observed a misdiagnosed case that was misconceived by the situation, accompanying mental retardation. Due to this misconception, any surgical treatment was not performed at all, and the symptoms eventually worsened as multiple huge epidermal inclusion cysts. We present this case with a brief review of literature.

Topics: Adult; Biopsy; Diagnosis, Differential; Epidermal Cyst; Epilepsy; Face; Follow-Up Studies; Humans; Intellectual Disability; Keratins; Magnetic Resonance Imaging; Male; Neurofibromatoses; Scalp Dermatoses

Malignant dermal cylindromas are very rare. We present a case of multiple cylindromas of the scalp with metastasis to a cervical lymph node. The morphology of the tumour was unusual in that it contained eccrine spiradenoma-like areas and foci of squamous differentiation with keratin formation. The immunohistochemical phenotype of the eccrine spiradenoma-like areas and the metastatic tumour was similar, but different from the areas of typical cylindroma. Although alleged "malignant" cylindromas have been reported, none have been described to have metastasized, whereas metastatic eccrine spiradenoma is well-documented. We reiterate that overlaps between dermal cylindroma and eccrine spiradenoma are more common than has been documented. In the rare event of metastases, it is the eccrine spiradenomatous component that is metastatic. We contend that there is no evidence that pure dermal cylindromas have metastasized.

Topics: Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Head and Neck Neoplasms; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; S100 Proteins; Scalp Dermatoses; Skin Neoplasms; Staining and Labeling

Cytokeratins are a major component of colloid bodies that are essentially diagnostic of lichen planopilaris (LPP). Here, the authors assess the ability of the cytokeratin 903 antibody (CK-903) to stain colloid bodies and differentiate LPP from other histologically similar appearing primary cicatricial alopecias. A retrospective review of all specimens submitted to the dermatopathology department over a 2-year window identified 18 cases of LPP and 20 cases of histologically similar appearing entities (discoid lupus erythematosus or central centrifugal cicatricial alopecia) through a combination of H&E, elastic van gieson, and periodic acid-schiff stains. All 38 samples were then prospectively stained with CK-903. Colloid bodies were identifiable in 3 of the 18 LPP cases based on H&E alone but were seen in 9 of 18 cases when CK-903 was used. There were no cases where colloid bodies were seen on H&E but not subsequently identified with CK-903. Additionally, there was no CK-903 staining in any of the 20 cases of similar appearing entities except 1 case of discoid lupus erythematosus, which is known to occasionally show colloid bodies. The authors conclude that CK-903 is a useful adjunctive tool that will allow for a quicker, less costly, and more accurate diagnosis of LPP given its ability identify colloid bodies even in the setting of significant inflammation and fibrosis and its advantages over direct immunofluorescence of low cost, short preparation time, and lack of need for a specialized fluorescent microscope.

Topics: Adult; Aged; Aged, 80 and over; Alopecia; Antibodies; Antibodies, Monoclonal, Murine-Derived; Biomarkers; Biopsy; Diagnosis, Differential; Female; Hair Follicle; Humans; Immunohistochemistry; Keratins; Lichen Planus; Male; Middle Aged; New York City; Predictive Value of Tests; Retrospective Studies; Scalp; Scalp Dermatoses; Workflow; Young Adult

The aim of this study was to determine if there were characteristic trichogram changes in scalp psoriasis in patients without clinically evident effluvium or alopecia. A total of 45 patients (17 men and 28 women, aged from 15 to 73 years) with clinically and histologically confirmed psoriasis vulgaris with scalp involvement were included. The control group consisted of 60 volunteers (23 males and 37 females aged from 15 to 74 years) with no scalp involvement. Our results from the psoriatic group showed highly increased proportions of dysplastic hair roots. Median proportion was 50% with 95% confidence interval (CI) for median 30-60%, whereas telogen hair ratio was slightly increased-median proportion was 16% with 95% CI for median 15-20%. Within the psoriasis patients' group no statistically significant correlations were found between the proportion of dysplastic hairs and the patients' age, sex, and the intensity and duration of disease. According to the results of this study, the dysplastic hairs in scalp psoriasis are statistically significant much more frequently compared with the control group. Thus, the increased proportion of dysplastic hairs in scalp psoriasis without effluvium or alopecia might be its characteristic trichogram sign.

Topics: Adolescent; Adult; Aged; Female; Humans; Keratins; Male; Middle Aged; Psoriasis; Scalp Dermatoses

Several clinical syndromes are characterized by ectodermal dysplasia (ED) in association with clefting of the lip and/or palate. In these syndromes, alopecia is primarily due to abnormalities of the hair shaft associated with increased hair fragility. Scalp dermatitis is yet another peculiar finding, primarily seen in the ankyloblepharon-ED-clefting (AEC) syndrome. We report on a 16-year-old patient with ectrodactyly-ED-clefting (EEC) syndrome, who exhibited a scarring alopecia due to deep folliculitis. On scanning electron microscopy, irregular torsion and longitudinal grooving of the hair shaft (pili torti et canaliculi) were observed. Quantitative determinations of the elastic and viscous parameters of hair demonstrated a normal viscosity but a significantly reduced hair elasticity, indicating either an abnormal composition or a disordered arrangement of microfibrils within the apparently normal keratin matrix. In contrast to the erosive scalp dermatitis of early onset in the AEC syndrome, alopecia in this case of EEC syndrome demonstrated follicular scarring with onset during puberty. We question a possible role of the anatomical hair abnormality in the pathogenesis of chronic deep folliculitis in this and clinically related syndromes.

Topics: Adolescent; Alopecia; Biophysical Phenomena; Biophysics; Cicatrix; Cleft Lip; Cleft Palate; Dermatomycoses; Ectodermal Dysplasia; Elasticity; Fingers; Folliculitis; Hair; Humans; Keratins; Malassezia; Male; Microscopy, Electron, Scanning; Puberty; Scalp Dermatoses; Staphylococcal Skin Infections; Syndrome; Viscosity

Two patients presented with the unusual condition of multiple warty dyskeratomas on the scalp. Biopsies of affected skin stained positive with human keratin monoclonal antibodies HKN-6 and -7, specific for cortex and inner root sheath of normal human hair, respectively. Multiple warty dyskeratomas are a rare occurrence and their aetiopathogenesis remains elusive. Positive immunohistochemical staining of a lesion with antikeratin antibodies HKN-6 and -7, specific for human hair keratin, suggests a follicular origin for warty dyskeratoma.

Topics: Aged; Aged, 80 and over; Female; Humans; Keratins; Scalp Dermatoses; Warts

The characteristic MRI of scalp trichilemmal cysts is reported. The feature of an iso-intense area on T1-weighted images is unique to trichilemmal cysts. MRI is helpful in diagnosing the trichilemmal cyst and useful in distinguishing cystic tumors on the median scalp from a cranial malformation, meningo- or encephalocele.

Topics: Adult; Aged; Diagnosis, Differential; Encephalocele; Epidermal Cyst; Epithelium; Female; Humans; Keratins; Magnetic Resonance Imaging; Meningocele; Scalp Dermatoses; Skull; Tomography, X-Ray Computed

Topics: Aged; Diagnosis, Differential; Epidermal Cyst; Female; Hair; Humans; Keratins; Magnetic Resonance Imaging; Scalp Dermatoses

The cutaneous ciliated cyst (CCC) is an unusual lesion found in young women that typically occurs on the lower extremities. This report describes a case of CCC arising in the scalp, a previously undescribed anatomic location for this lesion. In addition, positive nuclear staining for estrogen and progesterone receptors is demonstrated by immunohistochemical methods. Possible pathogenetic mechanisms are discussed.

Topics: Adult; Antigens; Cilia; Cysts; Cytoplasm; Female; Humans; Immunohistochemistry; Keratins; Membrane Glycoproteins; Mucin-1; Receptors, Estrogen; Receptors, Progesterone; Scalp Dermatoses

The morphology of hair follicles was examined in psoriatic scalp biopsies and compared with normal scalp. In scalp psoriasis the lower outer root sheath and hair matrix were not affected by the psoriatic changes, although there was an irregular expansion in the proximal lower outer root sheath. This area has been characterized, by the presence of keratin K19-containing cells, as the putative stem cell region. In addition, marked shrinkage of the sebaceous glands was seen in the psoriatic scalp, as previously reported. A panel of monospecific monoclonal antibodies to individual epithelial keratins was used to analyse scalp specimens immunohistochemically. Keratin expression in scalp was generally unaffected by psoriasis, except for widespread expression of suprabasal keratins K16 and K17 in suprabasal interfollicular psoriatic scalp epidermis. Simple epithelial keratins K8 and K18 were not found in follicular epithelium from either normal or psoriatic scalp, using multiple monospecific antibodies. This study shows that keratin K17 is induced suprabasally during epidermal hyperproliferation, and cannot therefore be considered a hair follicle-specific keratin.

Topics: Adolescent; Adult; Cell Differentiation; Child; Child, Preschool; Epithelium; Female; Humans; Immunohistochemistry; Infant; Keratinocytes; Keratins; Male; Middle Aged; Psoriasis; Scalp; Scalp Dermatoses; Sebaceous Glands

There are two types of hair cast. The common type is found frequently in association with parakeratotic scalp disorders. They have features allowing specific identification. They occur in children and adults of either sex. It is suggested they be called parakeratotic hair casts, as this name reflects the cause and composition of the casts. The uncommon type has specific features that are different from the common type. They are not usually associated with diseases of the scalp and have only been reported in female subjects. It is suggested they be called peripilar keratin casts, as this is the name frequently used for them. The proposed nomenclature should avoid confusion between two distinct types of hair casts that have often inappropriately been regarded as the same disorder, and which have not been previously differentiated by specific names.

Topics: Female; Hair Diseases; Humans; Keratins; Male; Parakeratosis; Scalp Dermatoses; Terminology as Topic

Topics: Epidermal Cyst; Female; Fluorescent Antibody Technique; Hair Diseases; Humans; Keratins; Middle Aged; Scalp Dermatoses

Topics: Electrophoresis, Polyacrylamide Gel; Epidermal Cyst; Female; Humans; Immunodiffusion; Keratins; Middle Aged; Scalp Dermatoses

The ichthyotic skin in X-linked dominant chondrodysplasia punctata was investigated in a four-week-old baby and a fourteen-year-old girl. Histologically, the ichthyosiform erythroderma of the newborn and the ichthyosis of the older child presented as a retention hyperkeratosis with several distinctive features such as calcification of the keratotic follicular plugs, atrophy of the hair follicles and focal hyperpigmentation of the basal keratinocytes. On ultrastructural examination, small to medium sized vacuoles were regularly seen in the thinned granular layer. Some of these vacuoles contained needle-like calcium inclusions. The histologic and ultrastructural findings are therefore characteristic for this rare type of ichthyosis.

Topics: Adolescent; Chondrodysplasia Punctata; Female; Hair; Humans; Ichthyosis; Infant, Newborn; Keratins; Scalp Dermatoses; Skin; Vacuoles; X Chromosome

Topics: Alopecia; Brain Neoplasms; Cobalt Radioisotopes; Facial Dermatoses; Forehead; Glioma; Hair Diseases; Humans; Keratins; Male; Middle Aged; Scalp Dermatoses; Skin Pigmentation

Topics: Cell Membrane; Child; Child, Preschool; Cytoplasmic Granules; Desmosomes; Ectodermal Dysplasia; Female; Hair; Humans; Ichthyosis; Keratins; Microscopy, Electron; Scalp Dermatoses; Skin; Syndrome

Topics: Adolescent; Child; Child, Preschool; Ectodermal Dysplasia; Female; Hair; Humans; Ichthyosis; Infant; Keratins; Male; Microscopy, Electron; Scalp; Scalp Dermatoses

Topics: Blister; Dermatitis, Atopic; Dermatitis, Exfoliative; Extremities; Facial Dermatoses; Foot Dermatoses; Genes, Dominant; Genes, Recessive; Hand Dermatoses; Humans; Ichthyosis; Keratins; Keratosis; Microscopy, Electron; Ribosomes; Scalp Dermatoses; Sex Chromosomes; Skin; Thorax