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P137 Erosive pustular dermatosis of the scalp: A case report
Posters
IPi 34
Onychomycosis
treated by Lamisil
S. Konstantinovic. Institute Medicine,
University
- Hair
of Dermatovenerology, Faculty of Belgrade, Belgrade, Yugoslavia
of
Total of 20 onychomycosis patients were treated by orally administered Lamisil, at least 3 months after completing previous therapy. Ten of them were not previously treated for onychomycosis. Three of them were treated with Griseofulvin, and the others were treated topically. Patients were selected in two groups. In the first group 8 had onychomycosis of the fingernails. In the second group 12 had onychomycosis of the toenails. The duration of active treatment (250 mg per day) in the patients in the first group was 6 weeks, and 12 weeks in the second group. Parameters investigated were clinical and mycological. Hyperkeratosis and onycholysis disappeared 6 months after therapy in 95% (19/20). KOH preparation was negative after 4 weeks 10 patients, and after 8 weeks in all 20 patients. Mycological culture revealed negative after 4 weeks in 16 patients, and after 8 weeks in all of them. Follow up after 12 months showed no recurrences. No side effects were recorded. I P135 Influence of systemic treatment on hair roots I. Jazienicka, G. Chodorowska, B. Lecewicz-Torun. Department
of Dermatology,
Medical
School
in Lublin,
Poland
Many agents administered systemically in skin diseases are capable of causing the loss of hair as a side effect we studied 80 patients (45 male, 35 female age 20-75 different skin diseases). 30 patients were given Tigason, 15 -Roaccutane, 15-cytostoxits, IO-Cyclosporin A and 10 -fraxiparin. All the patients had trichograms performed before treatment, after 2, 4, 6, 8, 12 weeks of their therapy and finally after another 3 months. There were no trichogram abnormalities observed in any patient before treatment. The earliest and most marked effluvium changes were noticed after 2 weeks of treatment with cytostatics (MTX, Endoxan). Cyclospirin A induced less intense effuvium alterations after 4 weeks of treatment. Latest effluvium changes detected in trichograms followed the 8-l 2 weeks treatment with aromatic retinoids and anticoagulant agents. The hair loss was observed to continue for about 3 months but proved to be entirely reversible. I PI 36 Monilethrix: Case report G. Lo Scocco, G. Pasquinelli ’ , E. Caprari, V. Di Lemia. Depts. of Dermatology, Arcispedale S. Maria Nuova, ‘Electron Microscopy, University of Bologna,
Reggio Italy
Emilia;
Monilethrix is a hereditary structural defect of the hair associated with increased fragility, which shows an autosomal dominant pattern inheritance. The hair is characterized by the presence of knots and narrowings along the shaft, similar to a rosary or pearl necklace. We report a 4-year old female, who since the first year of life presented short hair that did not grow long in the occiput and nape. No familial cases of hypotrichosis were reported, but hair of both parents could not be examined. Clinical examination revealed short and broken hair in the occipital area, where a follicular keratosis was also present. Eyebrows and eyelashes were otherwise normal; the remainder of skin examination, including
S185
and Nails
nail and teeth, was negative. Ocular examination was normal, as well as physical and mental development. A clinical diagnosis of monilethrix was made. Light microscopy showed elliptical nodes occurring along the shaft with periodic variation of hair shaft diameter. SEM revealed typical findings of monilethrix, consisting of nodes and internodes alternated along hair. Urine and serum aminoacid analysis did not disclose abnormalities. Avoiding of brushing was suggested. I P137
Erosive pustular dermatosis of the scalp: A case report
V. Simonetti, A. Conti, C. Lasagni, G. Giusti, A. Cimitan. Department ltaly
of Dermatology,
University
of Modena,
Modena,
Erosive Pustular Dermatosis of the scalp (EPD) is defined as a chronic extensive pustulation confined to the scalp of an elderly person, and leading to erosion and scarring alopecia. No recognized cause of pustulation is present, and the histology is non-specific, showing ATROPHY and chronic inflammation. We report a case of a 80-year-old man with erosive pustular scalp lesions leading to extensive ulceration. Laboratory investigations were within normal limits. Bacteriological and mycological cultures were negative. Biopsy showed non specific histological changes with acute and chronic inflammation and eosinophils granulocytes in the papillary dermis. Topical and systemic antibiotics had little effect. I P138
Hormonal parameters in androgenetic alopecia of the male
T.O. Giilec, T. Akan, A. Karaduman. University Faculty Turkey
of Medicine,
Department
of Dermatology,
of Hacettepe, Ankara,
Androgenetic Alopecia (AGA), the most common cause of balding in human, occurs through the combined effect of a genetic predisposition and the action of androgens on hair follicules of the scalp. Increased local androgen metabolism and androgen receptor binding in the balding areas confirm the importance of the target organ hair follicule as regulator of androgen influences. In our study hormonal parameters of 20 male patients with AGA with a mean age of 20.9 years were compared with those of 16 age-matched controls. Determinations of androgens, sex-hormone- binding globulin, the hypophyseal hormones as luteinizing hormone, follicle-stimulating hormone and prolactin, 17-B estradiol and cortisol were performed by standard radioimmunoassay. Significant differences in serum levels of androstenedione (p < O.Ol), 17-OH progesterone (p = O.OOl), cortisol (p = O.OOl), 17-B estradiol (p < 0.05) and luteinizing hormone (p < 0.01) were noted between hair loss patients and control subjects. Therefore, adrenal stimulation as well as hypophyseal feedback mechanisms seem to be involved in male pattern alopecia.
IPi 34
Onychomycosis
treated by Lamisil
S. Konstantinovic. Institute Medicine,
University
- Hair
of Dermatovenerology, Faculty of Belgrade, Belgrade, Yugoslavia
of
Total of 20 onychomycosis patients were treated by orally administered Lamisil, at least 3 months after completing previous therapy. Ten of them were not previously treated for onychomycosis. Three of them were treated with Griseofulvin, and the others were treated topically. Patients were selected in two groups. In the first group 8 had onychomycosis of the fingernails. In the second group 12 had onychomycosis of the toenails. The duration of active treatment (250 mg per day) in the patients in the first group was 6 weeks, and 12 weeks in the second group. Parameters investigated were clinical and mycological. Hyperkeratosis and onycholysis disappeared 6 months after therapy in 95% (19/20). KOH preparation was negative after 4 weeks 10 patients, and after 8 weeks in all 20 patients. Mycological culture revealed negative after 4 weeks in 16 patients, and after 8 weeks in all of them. Follow up after 12 months showed no recurrences. No side effects were recorded. I P135 Influence of systemic treatment on hair roots I. Jazienicka, G. Chodorowska, B. Lecewicz-Torun. Department
of Dermatology,
Medical
School
in Lublin,
Poland
Many agents administered systemically in skin diseases are capable of causing the loss of hair as a side effect we studied 80 patients (45 male, 35 female age 20-75 different skin diseases). 30 patients were given Tigason, 15 -Roaccutane, 15-cytostoxits, IO-Cyclosporin A and 10 -fraxiparin. All the patients had trichograms performed before treatment, after 2, 4, 6, 8, 12 weeks of their therapy and finally after another 3 months. There were no trichogram abnormalities observed in any patient before treatment. The earliest and most marked effluvium changes were noticed after 2 weeks of treatment with cytostatics (MTX, Endoxan). Cyclospirin A induced less intense effuvium alterations after 4 weeks of treatment. Latest effluvium changes detected in trichograms followed the 8-l 2 weeks treatment with aromatic retinoids and anticoagulant agents. The hair loss was observed to continue for about 3 months but proved to be entirely reversible. I PI 36 Monilethrix: Case report G. Lo Scocco, G. Pasquinelli ’ , E. Caprari, V. Di Lemia. Depts. of Dermatology, Arcispedale S. Maria Nuova, ‘Electron Microscopy, University of Bologna,
Reggio Italy
Emilia;
Monilethrix is a hereditary structural defect of the hair associated with increased fragility, which shows an autosomal dominant pattern inheritance. The hair is characterized by the presence of knots and narrowings along the shaft, similar to a rosary or pearl necklace. We report a 4-year old female, who since the first year of life presented short hair that did not grow long in the occiput and nape. No familial cases of hypotrichosis were reported, but hair of both parents could not be examined. Clinical examination revealed short and broken hair in the occipital area, where a follicular keratosis was also present. Eyebrows and eyelashes were otherwise normal; the remainder of skin examination, including
S185
and Nails
nail and teeth, was negative. Ocular examination was normal, as well as physical and mental development. A clinical diagnosis of monilethrix was made. Light microscopy showed elliptical nodes occurring along the shaft with periodic variation of hair shaft diameter. SEM revealed typical findings of monilethrix, consisting of nodes and internodes alternated along hair. Urine and serum aminoacid analysis did not disclose abnormalities. Avoiding of brushing was suggested. I P137
Erosive pustular dermatosis of the scalp: A case report
V. Simonetti, A. Conti, C. Lasagni, G. Giusti, A. Cimitan. Department ltaly
of Dermatology,
University
of Modena,
Modena,
Erosive Pustular Dermatosis of the scalp (EPD) is defined as a chronic extensive pustulation confined to the scalp of an elderly person, and leading to erosion and scarring alopecia. No recognized cause of pustulation is present, and the histology is non-specific, showing ATROPHY and chronic inflammation. We report a case of a 80-year-old man with erosive pustular scalp lesions leading to extensive ulceration. Laboratory investigations were within normal limits. Bacteriological and mycological cultures were negative. Biopsy showed non specific histological changes with acute and chronic inflammation and eosinophils granulocytes in the papillary dermis. Topical and systemic antibiotics had little effect. I P138
Hormonal parameters in androgenetic alopecia of the male
T.O. Giilec, T. Akan, A. Karaduman. University Faculty Turkey
of Medicine,
Department
of Dermatology,
of Hacettepe, Ankara,
Androgenetic Alopecia (AGA), the most common cause of balding in human, occurs through the combined effect of a genetic predisposition and the action of androgens on hair follicules of the scalp. Increased local androgen metabolism and androgen receptor binding in the balding areas confirm the importance of the target organ hair follicule as regulator of androgen influences. In our study hormonal parameters of 20 male patients with AGA with a mean age of 20.9 years were compared with those of 16 age-matched controls. Determinations of androgens, sex-hormone- binding globulin, the hypophyseal hormones as luteinizing hormone, follicle-stimulating hormone and prolactin, 17-B estradiol and cortisol were performed by standard radioimmunoassay. Significant differences in serum levels of androstenedione (p < O.Ol), 17-OH progesterone (p = O.OOl), cortisol (p = O.OOl), 17-B estradiol (p < 0.05) and luteinizing hormone (p < 0.01) were noted between hair loss patients and control subjects. Therefore, adrenal stimulation as well as hypophyseal feedback mechanisms seem to be involved in male pattern alopecia.