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Hair repigmentation in lentigo maligna
ARTICLES
25 Falutz J, Turcot D. Considerations in the development of a case definition for HIV/HAART-associated lipodystrophy syndrome. San Diego: First International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, 1999: (abstr 21). 26 Muurahainen N, Falutz J, Santos G, et al. The SALSA (selfascertained lipodystrophy syndrome assessment) cohort abnormalities in cases compared to controls. San Diego: First International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, 1999 (abstr 22). 27 Muurahainen N, Pettit R, Kotler D, et al. Abnormalities in HIVassociated lipodystrophy syndrome that vary by weight status. San Diego: First International Workshop on Adverse drug Reactions and Lipodystrophy in HIV, 1999: (abstr 63). 28 Flynn MA, Nolph GB, Baker AS, et al. Total body potassium in aging humans: a longitudinal study. Am J Clin Nutr 1989; 50: 713–17.
29 Shimokata H, Tobin JD, Muller DC, et al. Studies in the distribution of body fat: effects of the age, sex and obesity. J Gerontol 1989; 44: 66–73. 30 Schwartz RS, Shuman WP, Bradbury VL, et al. Body fat distribution in healthy young and older men. J Gerontol 1990; 45: 181–85. 31 Safrin S, Grunfeld C. Fat distribution and metabolic changes in patients with HIV infection. AIDS 1999; 13: 2493–505. 32 Silva M, Skolnik P, Gorbach S, et al. The effect of protease inhibitors on weight and body composition in HIV-infected patients. AIDS 1998; 12: 1645–51. 33 Carbonnel F, Maslo C, Beaugerie L, et al. Effect of indinavir on HIVrelated wasting. AIDS 1998; 12: 1777–84. 34 Pernerstorfer-Schoen H, Schindler K, Parschalk B, et al. Beneficial effects of protease inhibitors on body composition and energy expenditure: a comparison between HIV-infected and AIDS patients. AIDS 1999; 13: 2389–96.
Clinical picture: Hair repigmentation in lentigo maligna Reinhard Dummer
A 76-year-old, grey-haired patient was informed by her hairdresser that she had a patch of repigmented hairs at the left side of the scalp. Clinical examination showed an area of heavily pigmented hair with irregular macular hyperpigmentation on the scalp (figure, top). A biopsy sample was taken. It showed an atrophic epidermis with pronounced elastosis and large melanocytic cells in the basal layer of the epidermis invading the upper parts of a hair follicle accompanied by lymphocytic inflammation (figure, bottom). There was striking hyperpigmentation in the hair roots without evidence of melanocytic invasion (inset). Lentigo maligna was diagnosed and treated by radiotherapy. The hair grew back grey. Department of Dermatology, University Hospital Zürich, Gloriastrasse 31, CH-8091 Zürich, Switzerland (Reinhard Dummer MD)
598
THE LANCET • Vol 357 • February 24, 2001
For personal use only. Reproduce with permission from The Lancet Publishing Group.
25 Falutz J, Turcot D. Considerations in the development of a case definition for HIV/HAART-associated lipodystrophy syndrome. San Diego: First International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, 1999: (abstr 21). 26 Muurahainen N, Falutz J, Santos G, et al. The SALSA (selfascertained lipodystrophy syndrome assessment) cohort abnormalities in cases compared to controls. San Diego: First International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, 1999 (abstr 22). 27 Muurahainen N, Pettit R, Kotler D, et al. Abnormalities in HIVassociated lipodystrophy syndrome that vary by weight status. San Diego: First International Workshop on Adverse drug Reactions and Lipodystrophy in HIV, 1999: (abstr 63). 28 Flynn MA, Nolph GB, Baker AS, et al. Total body potassium in aging humans: a longitudinal study. Am J Clin Nutr 1989; 50: 713–17.
29 Shimokata H, Tobin JD, Muller DC, et al. Studies in the distribution of body fat: effects of the age, sex and obesity. J Gerontol 1989; 44: 66–73. 30 Schwartz RS, Shuman WP, Bradbury VL, et al. Body fat distribution in healthy young and older men. J Gerontol 1990; 45: 181–85. 31 Safrin S, Grunfeld C. Fat distribution and metabolic changes in patients with HIV infection. AIDS 1999; 13: 2493–505. 32 Silva M, Skolnik P, Gorbach S, et al. The effect of protease inhibitors on weight and body composition in HIV-infected patients. AIDS 1998; 12: 1645–51. 33 Carbonnel F, Maslo C, Beaugerie L, et al. Effect of indinavir on HIVrelated wasting. AIDS 1998; 12: 1777–84. 34 Pernerstorfer-Schoen H, Schindler K, Parschalk B, et al. Beneficial effects of protease inhibitors on body composition and energy expenditure: a comparison between HIV-infected and AIDS patients. AIDS 1999; 13: 2389–96.
Clinical picture: Hair repigmentation in lentigo maligna Reinhard Dummer
A 76-year-old, grey-haired patient was informed by her hairdresser that she had a patch of repigmented hairs at the left side of the scalp. Clinical examination showed an area of heavily pigmented hair with irregular macular hyperpigmentation on the scalp (figure, top). A biopsy sample was taken. It showed an atrophic epidermis with pronounced elastosis and large melanocytic cells in the basal layer of the epidermis invading the upper parts of a hair follicle accompanied by lymphocytic inflammation (figure, bottom). There was striking hyperpigmentation in the hair roots without evidence of melanocytic invasion (inset). Lentigo maligna was diagnosed and treated by radiotherapy. The hair grew back grey. Department of Dermatology, University Hospital Zürich, Gloriastrasse 31, CH-8091 Zürich, Switzerland (Reinhard Dummer MD)
598
THE LANCET • Vol 357 • February 24, 2001
For personal use only. Reproduce with permission from The Lancet Publishing Group.