Staphylococcus lugdunensis and Trichophyton tonsurans Infection in Synthetic Hair Implants

A new easy technique to identify the correct artificial hair implantation site: A case series and preliminary results

BACKGROUND

The implantation of artificial hair is a successful standardized procedure to restore bald areas or scarred alopecic surfaces of the scalp in both sexes.

MATERIALS AND METHODS

Sebometric measurements were taken, pre, 1, 3, and 6 months postimplant in two symmetric frontotemporal areas of the scalp of seven volunteers to be implanted with 50 units of artificial hair. The artificial hair used in this study are Biofibre 4.0 produced by Medicap srl, Italy.

RESULTS

The dermaroller assisted procedure was performed only on one side, and the plain random implant contralaterally for comparison. A marked downregulation of the sebum concentration was observed in the dermaroller treated area 1, 3, and 6 months later in respect to the control side.

CONCLUSION

The dermaroller assisted procedure is safe and effective in reducing the foreign body reaction by the sebaceous glands and the vascular axis injured by the implanting needle; a longer standing success of the implanted hair can thus be achieved reducing the burden of inflammatory reaction.

Trichophyton as a Rare Cause of Postoperative Wound Infection Resistant to Standard Empiric Antimicrobial Therapy

Fungal infections are rare causes of acute surgical wound infections, but Candida is not an infrequent etiology in chronic wound infections. Trichophyton species is a common cause of tinea capitis but has not been reported as a cause of neurosurgical wound infection. We report a case of Trichophyton tonsurans causing a nonhealing surgical wound infection in a 14-year-old male after hemicraniectomy. His wound infection was notable for production of purulent exudate from the wound and lack of clinical improvement despite empiric treatment with multiple broad-spectrum antibiotics targeting typical bacterial causes of wound infection. Multiple wound cultures consistently grew Trichophyton fungus, and his wound infection clinically improved rapidly after starting terbinafine and discontinuing antibiotics.

Linear Circumscribed Scleroderma-Like Folliculitis Decalvans: Yet Another Face of a Protean Condition

Since Quinquaud's original report of folliculitis decalvans (FD), further clinical variants have been described on the basis of common histopathological and microbiological findings. Histopathology reveals a neutrophilic primary scarring alopecia, and microbiological studies invariably reveal pathogenic strains of Staphylococcus aureus. The presence of thickening of lesional skin in FD has been previously described. We report a new presentation of FD, clinically mimicking linear circumscribed scleroderma of the scalp. Overlapping features of the scarring alopecias may blur the distinction between different conditions that ultimately share the common final pathway of replacement of follicle by fibrous tissue. Therefore, a careful patient history, clinical examination including dermoscopy, microbiological studies, and a scalp biopsy for histopathology, and immunofluorescence studies are prerequisites to an accurate diagnosis and appropriate treatment of the respective condition. The case is presented to illustrate the clinical variability in presentation of FD and to underline the necessity of performing a biopsy for an accurate diagnosis in the scarring alopecias.