Gary W. Cole

The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia

BACKGROUND Data suggest that androgenetic alopecia is a process dependent on dihydrotestosterone (DHT) and type 2 5alpha-reductase. Finasteride is a type 2 5alpha-reductase inhibitor that has been shown to slow further hair loss and improve hair growth in men with androgenetic alopecia. OBJECTIVE We attempted to determine the effect of finasteride on scalp skin and serum androgens. METHODS Men with androgenetic alopecia (N = 249) underwent scalp biopsies before and after receiving 0.01, 0.05, 0.2, 1, or 5 mg daily of finasteride or placebo for 42 days. RESULTS Scalp skin DHT levels declined significantly by 13.0% with placebo and by 14.9%, 61.6%, 56. 5%, 64.1%, and 69.4% with 0.01, 0.05, 0.2, 1, and 5 mg doses of finasteride, respectively. Serum DHT levels declined significantly (P <.001) by 49.5%, 68.6%, 71.4%, and 72.2% in the 0.05, 0.2, 1, and 5 mg finasteride treatment groups, respectively. CONCLUSION In this study, doses of finasteride as low as 0.2 mg per day maximally decreased both scalp skin and serum DHT levels. These data support the rationale used to conduct clinical trials in men with male pattern hair loss at doses of finasteride between 0.2 and 5 mg.

The effect of topical cyclosporin A on the elicitation phase of allergic contact dermatitis.

The effect of cyclosporin A (CSA) on the elicitation phase of allergic contact dermatitis was investigated. Initially, the ability of CSA to penetrate normal human cadaver skin was determined using 3 different vehicles. 10% CSA in Labrafil was found to be the must effective combination at achieving skin penetration (0.33%). Patients with known contact sensitivities to a variety of allergens were selected. After a 48‐h pretreatment with 10% CSA in Labrafil, skin sites were exposed to the appropriate contact allergen. 72 h later, the development of an eczemutous patch test reaction was evaluated. Only 1 of 10 patients showed unequivocal signs of suppression of allergic contact dermatitis

Chloracne from pentachlorphenol ‐preserved wood

A patient is presumed who developed chloracne after exposure to lumber which was pressure‐treated with pentachlorophenol (PCP) it was poisoned that his disease arose via percutaneous absorption of polychlorinated aromatic compounds (dioxins and furans) which are known to contaminate technical grade PCP The patients condition improved after treatment with oral isotretinoin.

Mycobacterium marinum infection in a mechanic.

I. Rabeau H, Ukramczyk F Derm1tes des blanchisseuses, role du chrome et du chlore en France. Annates de Dermatolog1e et de Syphiligraph1e !939: 10: 656-680. 2. Lachapelle J M, Lauwerys R, Tennstedt D, Andanson J, Benezra C, Chabeau G, Ducombs G, Foussereau J, Lacroix M, Martm P. Eau de Javel and preventiOn of chromate allergy m France. Contact Dermatitis I 980: 6: I 07I I 0. 3. Spamsh Contact Dermatitis Research Group. First epidemwlogical study of contact dermatitis m Spam. Acta Dermato-venereo!og1ca 1979: 59· Suppl. 85, 33-37 4. Lachapelle J M, Tennstedt D. An epidemwlogIcal survey of occupational contact dermatitis of the hands m Belgmm. Results of the standard patch test senes m 400 patients. Contact Dermatills 1979: 5: 244--248.

THE VERRUCOUS MERMAID

In the United States, it used to be that tattooing of the skin was done mainly to military personnel and persons of lower socioeconomic status. Recently, decorative tattooing has become a popular and permanent form of self-adornment among all economic classes. Because tattooing is becoming more popular, the medical community should become familiar with the complications. We recently diagnosed and treated a patient who developed multiple warts confined to recently tattooed skin.

Hypomelanosis associated with a colonic abnormality. A possible result of defective development of the neural crest.

A neonate born of black parents displayed a congenital, dramatic deficiency of most of his normal pigmentation. This was accompanied by a markedly dilated colon and various other defects. Light- and electron-microscopic examination revealed a deficiency in melanin content in the hypopigmented skin as compared to the normally pigmented areas. No other defects were noted. The possibility exists that a single aberration in neural crest development, a neurocristopathy, might be responsible for our patients multiple congenital defects. Similar conditions in veterinary medicine and human disease are reviewed and compared to this case.