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Fulltext A Study on Scalp Hair Health and Hair Care Practices among Malaysian Medical Students

Nayak BS, Ann CY, Azhar AB, Ling ECS, Yen WH, Aithal PA

Int J Trichology, 2017 Apr-Jun;9(2):58-62.
PMID: 28839388 DOI: 10.4103/ijt.ijt_76_16

INTRODUCTION: Scalp care is essential because it determines the health and condition of the hair and prevents the diseases of scalp and hair. The objectives of our study were to correlate race and hair types, to determine the awareness of hair care among Malaysian medical students, and to distinguish the factors that affect the health of hair and scalp.

METHODOLOGY: It was a cross-sectional study wherein validated questionnaires were given to 240 medical undergraduate students who belonged to three ethnic races of Malaysia, i.e., Chinese, Malay, and Malaysian Indians after their informed consent. The results were then analyzed using percentage statistics.

RESULTS: Chinese students had comparatively healthier scalp without dandruff. Most Chinese and Indians had silky type of hair while Malay had dry, rough hair. Chinese and Indians colored their hair and used various styling methods; while among the Malays, this percentage was very less. Regarding hair care practices, males used only shampoo and females used shampoo and conditioner for hair wash. Students also faced dietary and examination-related stress.

CONCLUSION: Results indicate that there exist morphological differences in hair among the studied population. Since most students color their hair and employ various hairstyling methods, they should be educated regarding best hair care practices to improve their scalp hair condition and health.

Matched MeSH terms: Scalp
Fulltext Scalp Wound Closure with K wires: An alternative easier method to scalp wound closure

Ramesh S, Ajik S

Med J Malaysia, 2012 Dec;67(6):629-30.
PMID: 23770963 MyJurnal

Scalp defects and lacerations present a reconstructive challenge to plastic surgeons. Many methods have been described from the use of skin grafting to rotation flaps. Here we present a method of closure of a contaminated scalp wound with the use of Kirschner wires. In our case, closure of scalp laceration was made possible with the use of 1.4 Kirschner wires and cable tie/ zip tie fasteners. The duration to closure of wound was 10 days. In reconstructing the scalp defect, this method was found to adhere to principles of scalp reconstruction. There were no post operative complications found from the procedure. On initial application on the edge of the wound, tension applied caused the K wires to cut through the wound edge. On replacement of K wires 1cm away from wound edge the procedure was not plagued by any further complication. In conclusion we find scalp closure with Kirschner wires are a simple and effective method for scalp wound closure.

Matched MeSH terms: Scalp*
Fulltext The efficacy and tolerability of scalp cooling in preventing chemotherapy-induced alopecia in patients with breast cancer receiving anthracycline and taxane-based chemotherapy in an Asian setting

Saad M, Chong FLT, Bustam AZ, Ho GF, Malik RA, Ishak WZW, et al.

Indian J Cancer, 2019 1 4;55(2):157-161.
PMID: 30604728 DOI: 10.4103/ijc.IJC_581_17

BACKGROUND: Scalp cooling has been shown in several studies to be an effective method in preventing chemotherapy-induced alopecia (CIA). Data on the use of scalp cooling in Asian countries are limited, and evidence for its use and efficacy among our patients are not available.
OBJECTIVE: The aim of this study was to assess the effectiveness and tolerability of scalp cooling among breast cancer patients in our study population.
METHODS: Consecutive breast cancer patients receiving FE75C, FE100C, FE100C-D, docetaxel75 or docetaxel, and cyclophosphamide (TC) at our treatment center were recruited and allocated to the treatment (scalp cooling, DigniCapTM system) or control group in this prospective nonrandomized controlled study. The assessment of alopecia was carried out using the World Health Organization grading system and clinical photographs.
RESULTS: Seventy patients were recruited, but only 25 completed the study and were evaluable for analysis. Five of 12 patients (42%) in the scalp cooling group managed to preserve hair. Two of three patients who received FE75C and TC regimens had minimal hair loss. All patients treated with FE100C had severe hair loss. Half of all patients who received scalp cooling throughout chemotherapy rated the treatment as reasonably well tolerated. The most common reason for discontinuing scalp cooling was intolerance to its side effects.
CONCLUSION: Scalp cooling is potentially effective in reducing CIA caused by docetaxel, TC, and FE75C chemotherapy regimen. However, it was not well tolerated by our study population. The dropout rate was high, and this needs to be taken into consideration when pursuing further trials in a similar setting.

Matched MeSH terms: Scalp/blood supply*
Fetal and maternal lactate increase during active second stage of labour

Nordström L, Achanna S, Naka K, Arulkumaran S

BJOG, 2001 Mar;108(3):263-8.
PMID: 11281466

To determine longitudinally fetal and maternal blood lactate concentrations during the second stage of labour.

Matched MeSH terms: Scalp
The Two-Brains Hypothesis: Towards a guide for brain-brain and brain-machine interfaces

Goodman G, Poznanski RR, Cacha L, Bercovich D

J Integr Neurosci, 2015 Sep;14(3):281-93.
PMID: 26477360 DOI: 10.1142/S0219635215500235

Great advances have been made in signaling information on brain activity in individuals, or passing between an individual and a computer or robot. These include recording of natural activity using implants under the scalp or by external means or the reverse feeding of such data into the brain. In one recent example, noninvasive transcranial magnetic stimulation (TMS) allowed feeding of digitalized information into the central nervous system (CNS). Thus, noninvasive electroencephalography (EEG) recordings of motor signals at the scalp, representing specific motor intention of hand moving in individual humans, were fed as repetitive transcranial magnetic stimulation (rTMS) at a maximum intensity of 2.0[Formula: see text]T through a circular magnetic coil placed flush on each of the heads of subjects present at a different location. The TMS was said to induce an electric current influencing axons of the motor cortex causing the intended hand movement: the first example of the transfer of motor intention and its expression, between the brains of two remote humans. However, to date the mechanisms involved, not least that relating to the participation of magnetic induction, remain unclear. In general, in animal biology, magnetic fields are usually the poor relation of neuronal current: generally "unseen" and if apparent, disregarded or just given a nod. Niels Bohr searched for a biological parallel to complementary phenomena of physics. Pertinently, the two-brains hypothesis (TBH) proposed recently that advanced animals, especially man, have two brains i.e., the animal CNS evolved as two fundamentally different though interdependent, complementary organs: one electro-ionic (tangible, known and accessible), and the other, electromagnetic (intangible and difficult to access) - a stable, structured and functional 3D compendium of variously induced interacting electro-magnetic (EM) fields. Research on the CNS in health and disease progresses including that on brain-brain, brain-computer and brain-robot engineering. As they grow even closer, these disciplines involve their own unique complexities, including direction by the laws of inductive physics. So the novel TBH hypothesis has wide fundamental implications, including those related to TMS. These require rethinking and renewed research engaging the fully complementary equivalence of mutual magnetic and electric field induction in the CNS and, within this context, a new mathematics of the brain to decipher higher cognitive operations not possible with current brain-brain and brain-machine interfaces. Bohr may now rest.

Matched MeSH terms: Scalp
Fulltext Subaponeurotic haemorrhage in Malaysian neonates

Boo NY

Singapore Med J, 1990 Jun;31(3):207-10.
PMID: 2392696

In a 30-month prospective study, between January 1987 and June 1989, 101 of 64,424 Malaysian neonates (1.6 per 1000 livebirths) born in the Maternity Hospital, Kuala Lumpur were found to have subaponeurotic haemorrhage shortly after delivery. The incidence was highest in neonates weighting 4000 gm or more. There was no significant difference in incidence of this condition in neonates of different ethnic origins. Hypoprothrombinemia was present in only 5/101 (5.0%) of the affected neonates. Sixty seven (66.3%) of the neonates with subaponeurotic haemorrhage had history of trial of vacuum extraction. The incidence of subaponeurotic haemorrhage was significantly higher in neonates delivered by vacuum extraction than by other modes of delivery in this hospital (41.4 per 1000 livebirths in neonates delivered by vacuum extraction versus 1.0 per 1000 livebirths in neonates delivered by other modes). Those neonates who developed subaponeurotic haemorrhage without trial of vacuum extraction had a history of either prolonged labour or difficult delivery. Thirty-three (32.7%) of the neonates with subaponeurotic haemorrhage developed anaemia which required blood transfusion and 3/33 (9.1%) were in shock. Fifty seven (56.4%) of the neonates with subaponeurotic haemorrhage developed hyperbilirubinemia due to the haemorrhage. Four (7.0%) of them had severe unconjugated hyperbilirubinemia which required exchange transfusion. The results of this study suggest that subaponeurotic haemorrhage in Malaysian neonates was commonly associated with vacuum extraction and was not a benign condition.

Matched MeSH terms: Scalp*
The findings of 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan in patients with hidradenitis suppurativa in Malaysia: A multicenter study

Loo CH, Khoo ACH, Tan WC, Khor YH, Tang JJ, Tang MM, et al.

World J Nucl Med, 2020 08 22;20(1):32-37.
PMID: 33850487 DOI: 10.4103/wjnm.WJNM_33_20

Hidradenitis suppurativa (HS) is known to have association with systemic diseases with chronic inflammation such as psoriasis. We aim to describe the concomitant systemic inflammation in patients with HS using 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) scan. This was a case-control study conducted in three tertiary hospitals in Northern Malaysia from January to December 2017, involving HS patients aged 18 years and above. Thirty-two HS patients with age- and sex-matched controls were recruited with a mean age of 31.4 years (range: 18-56). Numerous cutaneous inflammatory foci were detected on FDG-PET/CT scan in clinically unapparent sites (27/32, 84.4%). Approximately 90.6%, 93.8%, and 50.0% of the patients had significantly higher cutaneous uptake over nasal, mandibular, and scalp regions, respectively (P < 0.0001). PET/CT scan did not detect any systemic inflammation unlike those found in psoriasis. Three (9.4%) patients had thyroid nodules with high uptake (maximum standard uptake values ranging from 2.9 to 11.3). Two of them were confirmed to have papillary thyroid carcinoma, while the third patient has inconclusive finding. 18F-FDG PET/CT scan may be useful to map disease burden of HS. Nonlesional inflammatory foci on the skin of the nose, mandibular, and scalp are probably significant. The association of thyroid carcinoma in HS warrants further evaluation.

Matched MeSH terms: Scalp
Cephalhematoma infected by Escherichia coli presenting as an extensive scalp abscess

Wong CS, Cheah FC

J Pediatr Surg, 2012 Dec;47(12):2336-40.
PMID: 23217901 DOI: 10.1016/j.jpedsurg.2012.09.029

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.

Matched MeSH terms: Scalp*
Successful free omental flap and skin graft reconstruction of scalp avulsion injury

Ramzisham AR, Somasundaram S, Nasir ZM, Ali F, Das S

Clin Ter, 2010;161(5):453-5.
PMID: 20949243

For the management of a full-thickness scalp avulsion injury, thorough wound debridement and immediate primary revascularization or a split-thickness skin graft may be necessary. Graft failure may be common situation thereby predisposing the individuals to unnecessary multiple operations. In the recent times, the use of omental graft has gained much popularity. In the present study, we describe an interesting case of chronic non healing scalp ulcer in a young woman who eventually underwent a free omental flap reconstruction with split-thickness skin graft and had satisfactory outcome.

Matched MeSH terms: Scalp/injuries*; Scalp/surgery*
Fulltext Selection of Mother Wavelet Functions for Multi-Channel EEG Signal Analysis during a Working Memory Task

Al-Qazzaz NK, Bin Mohd Ali SH, Ahmad SA, Islam MS, Escudero J

Sensors (Basel), 2015;15(11):29015-35.
PMID: 26593918 DOI: 10.3390/s151129015

We performed a comparative study to select the efficient mother wavelet (MWT) basis functions that optimally represent the signal characteristics of the electrical activity of the human brain during a working memory (WM) task recorded through electro-encephalography (EEG). Nineteen EEG electrodes were placed on the scalp following the 10-20 system. These electrodes were then grouped into five recording regions corresponding to the scalp area of the cerebral cortex. Sixty-second WM task data were recorded from ten control subjects. Forty-five MWT basis functions from orthogonal families were investigated. These functions included Daubechies (db1-db20), Symlets (sym1-sym20), and Coiflets (coif1-coif5). Using ANOVA, we determined the MWT basis functions with the most significant differences in the ability of the five scalp regions to maximize their cross-correlation with the EEG signals. The best results were obtained using "sym9" across the five scalp regions. Therefore, the most compatible MWT with the EEG signals should be selected to achieve wavelet denoising, decomposition, reconstruction, and sub-band feature extraction. This study provides a reference of the selection of efficient MWT basis functions.

Matched MeSH terms: Scalp
Fulltext Classification of Visual and Non-visual Learners Using Electroencephalographic Alpha and Gamma Activities

Jawed S, Amin HU, Malik AS, Faye I

Front Behav Neurosci, 2019;13:86.
PMID: 31133829 DOI: 10.3389/fnbeh.2019.00086

This study analyzes the learning styles of subjects based on their electroencephalo-graphy (EEG) signals. The goal is to identify how the EEG features of a visual learner differ from those of a non-visual learner. The idea is to measure the students' EEGs during the resting states (eyes open and eyes closed conditions) and when performing learning tasks. For this purpose, 34 healthy subjects are recruited. The subjects have no background knowledge of the animated learning content. The subjects are shown the animated learning content in a video format. The experiment consists of two sessions and each session comprises two parts: (1) Learning task: the subjects are shown the animated learning content for an 8-10 min duration. (2) Memory retrieval task The EEG signals are measured during the leaning task and memory retrieval task in two sessions. The retention time for the first session was 30 min, and 2 months for the second session. The analysis is performed for the EEG measured during the memory retrieval tasks. The study characterizes and differentiates the visual learners from the non-visual learners considering the extracted EEG features, such as the power spectral density (PSD), power spectral entropy (PSE), and discrete wavelet transform (DWT). The PSD and DWT features are analyzed. The EEG PSD and DWT features are computed for the recorded EEG in the alpha and gamma frequency bands over 128 scalp sites. The alpha and gamma frequency band for frontal, occipital, and parietal regions are analyzed as these regions are activated during learning. The extracted PSD and DWT features are then reduced to 8 and 15 optimum features using principal component analysis (PCA). The optimum features are then used as an input to the k-nearest neighbor (k-NN) classifier using the Mahalanobis distance metric, with 10-fold cross validation and support vector machine (SVM) classifier using linear kernel, with 10-fold cross validation. The classification results showed 97% and 94% accuracies rate for the first session and 96% and 93% accuracies for the second session in the alpha and gamma bands for the visual learners and non-visual learners, respectively, for k-NN classifier for PSD features and 68% and 100% accuracies rate for first session and 100% accuracies rate for second session for DWT features using k-NN classifier for the second session in the alpha and gamma band. For PSD features 97% and 96% accuracies rate for the first session, 100% and 95% accuracies rate for second session using SVM classifier and 79% and 82% accuracy for first session and 56% and 74% accuracy for second session for DWT features using SVM classifier. The results showed that the PSDs in the alpha and gamma bands represent distinct and stable EEG signatures for visual learners and non-visual learners during the retrieval of the learned contents.

Matched MeSH terms: Scalp
Comparison of the effect of scalp block analgesia bupivacaine 0.25% and clonidine 2 μg/kg with bupivacaine 0.25% and dexamethasone 8 mg on cortisol levels and Numeric Rating Scale in craniotomy tumour

Maharani ND, Fuadi A, Halimi RA

Med J Malaysia, 2023 Nov;78(6):808-814.
PMID: 38031225

INTRODUCTION: Craniotomy tumour is brain surgery that can induce a stress response. The stress response can be measured using haemodynamic parameters and plasma cortisol concentration. The stress response that occurs can affect an increase in sympathetic response, such as blood pressure and heart rate, which can lead to an increase in intracranial pressure. Scalp block can reduce the stress response to surgery and post-operative craniotomy tumour pain. The local anaesthetic drug bupivacaine 0.25% is effective in reducing post-operative pain and stress in the form of reducing plasma cortisol levels. The adjuvant addition of clonidine 2 μg/kg or dexamethasone may be beneficial.
MATERIALS AND METHODS: A randomised control clinical trial was conducted at the Central Surgery Installation and Hasan Sadikin General Hospital Bandung and Dr. Mohammad Husein Hospital Palembang from December 2022 to June 2023. A total of 40 participants were divided into two groups using block randomisation. Group I receives bupivacaine 0.25% and clonidine 2 μg/kg, and group II receives bupivacaine 0.25% and dexamethasone 8 mg. The plasma cortisol levels of the patient will be assessed at (T0, T1 and T2). All the patient were intubated under general anesthaesia and received the drug for scalp block based on the group being randomised. Haemodynamic monitoring was carried out.
RESULTS: There was a significant difference in administering bupivacaine 0.25% and clonidine 2μg/kg compared to administering bupivacaine 0.25% and dexamethasone 8 mg/kg as analgesia for scalp block in tumour craniotomy patients on cortisol levels at 12 hours post-operatively (T1) (p=0.048) and 24 hours post-surgery (T2) (p=0.027), while post-intubation cortisol levels (T0) found no significant difference (p=0.756). There is a significant difference in Numeric Rating Scale (NRS) at post-intubation (T0) (p=0.003), 12 hours post-operatively (T1) (p=0.002) and 24 hours post-surgery (T2) (p=0.004), There were no postprocedure scalp block side effects in both groups.
CONCLUSION: The study found that scalp block with 0.25% bupivacaine and 2μg/kg clonidine is more effective in reducing NRS scores and cortisol levels compared bupivacaine 0.25% and dexamethasone 8mg in tumour craniotomy patients.

Matched MeSH terms: Scalp/surgery
Fulltext Giant epidermoid cyst of the thigh

Mohamed Haflah N, Mohd Kassim A, Hassan Shukur M

Malays Orthop J, 2011 Nov;5(3):17-9.
PMID: 25279030 MyJurnal DOI: 10.5704/MOJ.1111.001

Epidermoid cyst is a common benign cutaneous swelling frequently encountered in surgical practice. It usually presents as a painless lump frequently occurring in hairbearing areas of the body particularly the scalp, scrotum, neck, shoulder and back. Giant epidermoid cysts commonly occur in hairy areas such as the scalp. We present here the case of a rare occurrence of a giant epidermoid cyst in the less hairy area of the right upper thigh mimicking a soft tissue sarcoma. Steps are highlighted for the management of this unusual cyst.

Matched MeSH terms: Scalp
Fulltext Effects of tocotrienol supplementation on hair growth in human volunteers

Beoy LA, Woei WJ, Hay YK

Trop Life Sci Res, 2010 Dec;21(2):91-9.
PMID: 24575202 MyJurnal

Studies have shown an association between oxidative stress and alopecia. Patients with alopecia generally exhibit lower levels of antioxidants in their scalp area as well as a higher lipid peroxidation index. Tocotrienols belong to the vitamin E family and are known to be potent antioxidants. Hence, a study was conducted to investigate the effect of tocotrienol supplementation on hair growth in volunteers suffering from hair loss. Twenty one volunteers were randomly assigned to orally receive 100 mg of mixed tocotrienols daily while 17 volunteers were assigned to receive placebo capsule orally. The volunteers were monitored for the number of hairs in a pre-determined scalp area as well as the weight of 20 strands of 1 cm length hair clippings at 0 (before supplementation), 4 and 8 months. The number of hairs of the volunteers in the tocotrienol supplementation group increased significantly as compared to the placebo group, with the former recording a 34.5% increase at the end of the 8-month supplementation as compared to a 0.1% decrease for the latter. Nevertheless, the cumulative weight of 20 strands of hair clippings did not differ much from the baseline for both supplementation groups at the end of the study period. In conclusion, this trial demonstrated that supplementation with tocotrienol capsules increases hair number in volunteers suffering from hair loss as compared to the placebo group. This observed effect was most likely to be due to the antioxidant activity of tocotrienols that helped to reduce lipid peroxidation and oxidative stress in the scalp, which are reported to be associated with alopecia.

Matched MeSH terms: Scalp
Fulltext Infantile Myofibromatosis: A Case Report

Hasniah, A.L., Rohana, J., Boo, N.Y., Thambidorai, C.R., Isa, M.R.

International Medical Journal Malaysia, 2007;6(1):1-6.
MyJurnal

Case: A male infant was born at 36th week period of gestation with a birth weight of 1.99kg following an uneventful intrauterine period. At birth, he was noted to have multiple skin nodules. The largest nodule measuring 4.0 x 2.0 x 1.5 cm was at his pre-auricular area. It was initially fleshy and reddish in color. A few days later, it turned black and subsequently the black skin overlying the mass fell off, leaving a firm underlying mass with the appearance of a cauliflower. Other skin lesions, which were firm in consistency, were found on the medial aspect of his right supraorbital ridge, right mid-arm, right mid-thigh, plantar surface of his right big toe and his scalp. They were either skin-colored or reddish in colour, measuring between 1.0 and 2.0 cm in diameter. He also had hepatomegaly and splenomegaly palpable at 5 cm and 3 cm below the subcostal margins, respectively

Matched MeSH terms: Scalp
Risk factors associated with subaponeurotic haemorrhage in full-term infants exposed to vacuum extraction

Boo NY, Foong KW, Mahdy ZA, Yong SC, Jaafar R

BJOG, 2005 Nov;112(11):1516-21.
PMID: 16225572

To determine obstetric and neonatal risk factors associated with subaponeurotic haemorrhage (SAH) in infants exposed to vacuum extraction.

Matched MeSH terms: Scalp/injuries*
Recurrent occipital dermatofibrosarcoma protuberans tackled with wide local excision: A case report and current management

Kho JPY, Ng BHK, John R

Med J Malaysia, 2019 02;74(1):82-84.
PMID: 30846668

Dermatofibrosarcoma protuberans (DFSP) is a slowgrowing, locally invasive tumour of the dermis. It commonly presents in the trunks and proximal extremities but is seen to a lesser extent in the head and neck regions. We present a case report of a recurrent DFSP in a 48-year-old Iban woman at the occipital region. The patient underwent wide local excision and removal of outer table of cranium, dressing followed by split thickness skin graft. Histopathological examination confirmed dermatofibrosarcoma protuberans with clear lateral surgical margins and a deep margin of 0.5mm. She is currently undergoing radiotherapy and is planned for 50Grey 25cycles.

Matched MeSH terms: Scalp/surgery*
Correlation of Arsenic Levels in Smokeless Tobacco Products and Biological Samples of Oral Cancer Patients and Control Consumers

Arain SS, Kazi TG, Afridi HI, Talpur FN, Kazi AG, Brahman KD, et al.

Biol Trace Elem Res, 2015 Dec;168(2):287-95.
PMID: 25975948 DOI: 10.1007/s12011-015-0355-y

It has been extensively reported that chewing of smokeless tobacco (SLT) can lead to cancers of oral cavity. In present study, the relationship between arsenic (As) exposure via chewing/inhaling different SLT products in oral cancer patients have or/not consumed SLT products was studied. The As in different types of SLT products (gutkha, mainpuri, and snuff) and biological (scalp hair and blood) samples of different types of oral cancer patients and controls were analyzed. Both controls and oral cancer patients have same age group (ranged 30-60 years), socio-economic status, localities, and dietary habits. The concentrations of As in SLT products and biological samples were measured by electrothermal atomic absorption spectrophotometer after microwave-assisted acid digestion. The validity and accuracy of the methodology were checked by certified reference materials. The resulted data of present study indicates that the concentration of As was significantly higher in scalp hair and blood samples of oral cancer patients than those of controls (p<0.001). It was also observed that the values of As were two- to threefolds higher in biological samples of controls subjects, consuming SLT products as compared to those have none of these habits (p>0.01). The intake of As via consuming different SLT may have synergistic effects, in addition to other risk factors associated with oral cancer.

Matched MeSH terms: Scalp/drug effects
Dermatofibrosarcoma protuberans of the scalp: therapeutic challenges

Kanesen D, Zakaria Z, Ch'ng ES, Nandrajog P, Kandasamy R

ANZ J Surg, 2019 03;89(3):261-264.
PMID: 28513108 DOI: 10.1111/ans.14040
Matched MeSH terms: Scalp*
Fulltext Aggressive scalp and sternal lesion: A presentation of rare case of metastatic eccrine carcinoma

Rownose CS, Mohamad Saupi MS, Sharif SZ, Lah NASN

Ann Med Surg (Lond), 2021 May;65:102322.
PMID: 33996055 DOI: 10.1016/j.amsu.2021.102322

Introduction: Ductal Eccrine carcinoma (DEC) is a rare primary cutaneous tumor that exhibits both squamous and adnexal ductal differentiation. Due to its rarity in clinical practice we present as case of DEC and a literature review on the latest management of this rare disease.
Case presentation: We report a case 41 years old female presented with lesion on the scalp and sternal mass, increasing in size with itchiness and erythematous for 6 months duration. Further CECT scan of brain and neck shows features of malignant left frontal scalp lesion with poor plane with overlying skin and underlying skull bone and CECT of thorax shows a large, irregular heterogeneously enhancing mass with necrotic center noted at right hilar within superior segment of right lower lobe, encasing right middle and lower lobe bronchi. Wedge biopsy of scalp lesion showed an intradermal lesion extensively infiltrating by malignant gland accompanied by desmoplasia and the tumor cells are seen extending into the surgical margins suggestive of ductal eccrine carcinoma.Clinical Discussion:This case highlights the importance and challenges in achieving early diagnosis coupled with the scarcity of information on these leads to difficulty in managing this patient.
Conclusion: In managing Ductal Eccrine Carcinoma tumor, standard method of treatment for has not been established. However, wide surgical excision is the treatment of choice for localized lesions. Regarding prognosis, there is conflicting data published which we describe in this article.

Matched MeSH terms: Scalp

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