Atlas of Clinical Dermatology

"Female pattern hair loss (FPHL) or androgenic alopecia is the most common type of hair loss affecting women with reduced hair density and can have a serious psychological impact. It is characterized by progressive replacement of slow cycling terminal hair follicles by miniaturized, rapidly cycling vellus hair follicles. The frontal hair line may or may not be preserved.
The aim of this review was to assess the evidence for the effectiveness and safety of the treatments available for FPHL.
Searches included: Cochrane Skin Group Specialised Register, Cochrane Central Register of Controlled Clinical Trials in The Cochrane Library, MEDLINE,
EMBASE, AMED, PsycINFO, LILACS and several ongoing trials registries (October 2011).
Randomized controlled trials in women with FPHL were identified.
Twenty-two trials, comprising 2349 participants, were included. A range of
interventions was evaluated, with 10 studies examining varying concentrations of minoxidil. Pooled data from four studies indicated that a greater proportion of participants treated with minoxidil reported a moderate increase in their hair regrowth compared with placebo . There was no difference between the number of adverse events experienced in the twice daily minoxidil and the placebo intervention groups, except for a reported increase with minoxidil 5% twice daily.
Single studies accounted for most of the other comparisons, which were assessed as either having high risk of bias and ⁄or they did not address the prespecified outcomes for this review and provided limited evidence of either the effectiveness or safety of these interventions. Further well-designed, adequately powered randomized controlled trials investigating other treatment options are still required."

Neglected Tropical Diseases cause not only physical and psychological issues but also economic issues in the form of health care cost for both patients and society. This burden is compounded by the existence of disability. Some Neglected Tropical Diseases are existent in Papua including leprosy, yaws, lymphatic  filariaisis  and cysticercosis / worm infection.  Neglected diseases are closely related to poverty, poor sanitation, access to health services, service public  ignorance, lower quality of life due to disability, stigma and discrimination a limited resources, including funds and scarcity of health workers who deal with these diseases.
    Skin diseases and neglectedtropical  diseases have various appearances and are often mixed up. Leprosy often looks similar to other skin diseases (leprosy is a great imitator) therefore necessary skills, experiences  and knowledge  are needed for  the health  workers. With accustomed to seeing cases and pictures we will learn these diseases more easily.
    This book was inspired by Leprosy in Africans by dr.W.K.Jacyk (ILEP Publication) and the book of Common Skin Diseases in Africa: An essay guide Illustrated by Collette van Hees and Ben Naafs. This book was adapted to the circumstances of cases in Papua.
Hopefully, this book will prove to be useful to our health staffs who work in the field, and students in medicine, nursing and public health.

                                                                                                              Author, 2016


"The sole purpose of this illustrative  book (Atlas) is  to train and help field workers and is not meant for commercial purposes”

This paper is based on a Cochrane review (see http://www.CochraneLibrary.net for further information). Cochrane reviews are regularly updated as new evidence emerges and in response to comments and criticisms. The Cochrane Library should be consulted for the most recent version of this review.

Background: Onychomycosis is a common infection of the nail bed that can negatively affect patient quality of life. The complete cure rate for systemic drugs is 2337 % while the complete cure rate for topical drug therapy with efi naconazole is 27.7%. Laser PharmacologyTM presents a promising alternative using a dual-diode laser employing wavelengths of 635 nm and 405 nm to create a drug-like response in living tissue (Erchonia® Lunula Laser®; Erchonia Corporation. Melbourne, FL). The purpose of this clinical study is to assess the safety and effi cacy of mycological and complete cure rates of the dual diode nonthermal laser. Methods: Enrolled subjects (N=20) had onychomycosis affecting the great toenail, confi rmed by a positive mycological culture. Subjects were predominantly female (70%) with a mean (SD) age of 59.9 (9.0) years. Affected toenails were treated with 12-minute laser light sessions, each week for 4 weeks, then one session at 3, 5, 7, 9 and 11 months. Study assessment...

Trichofolliculomas are benign hamartomas of the hair follicles. Usually seen around the nose, they present as small skin-coloured papules or nodules. We present a patient who presented with a cutaneous horn on the pinna developing over a trichofolliculoma, something not described in literature in the past. The growth was excised and the diagnosis was established on histopathological examination.

Background: Molluscum Contagiosum is a common viral skin infection, caused by poxvirus, commonly affects young children. Although there is no specific treatment for this infection, many therapeutic modalities has been used with different success rates. Objectives: To evaluate the effectiveness of topical 20% KOH, 20% KOH with pricking and pricking alone as comparative treatments for molluscum contagiosum. Patients and methods: This study was conducted in the Dermatology Clinic of Kufa Medical School Teaching Hospital in Iraq, from August 2011 to January 2013. Ninety patients with Molluscum Contagiosum were recruited. Diagnosis of Molluscum Contagiosum was confirmed on clinical bases. Patients with prior treatment for the last month and patients who had inflamed lesions were excluded. Full history and physical examination were done for all Patients. The patients were divided into three groups: Group 1included 30 patients treated with topical KOH 20% applied by wooden stick daily at bed time. Group 2 included 30 patients treated by pricking the lesions by 27 G needle wet in 20% KOH weekly. Group 3 included 30 patients treated by pricking alone once weekly. Treatment sessions were continued until complete cure or maximum of four sessions was achieved. The patients were followed up for two months period from the last session. Results: Out of the ninety patients, 57 completed the study. There were thirty one (54.3%) males and 26 (45.6%) females with male to female ratio 1.19-. Their ages ranged from 1.5-62 years (mean and standard deviation of 19.4±16.7). The most common age group affected was below 12 years, 29 (50.8%) patients. The most commonly affected body sites were the face and neck, 49 (85.9%) patients. After 4 sessions, the response rate was as follows:-Group 1, 17 (94.4%): patients were cured completely and relapse was not recorded; p-value was highly significant (=0.0019).-Group 2, 20 (86.4%) patients were completely cured and relapse was not recorded; p-value was highly significant (< 0.001).-Group 3, 12 (75%) patients were completely cured and relapse was not recorded; p-value was highly significant (=0.0014). Conclusion: Pricking Molluscum Contagiosum by 27G needle alone, pricking with 20% KOH and topically applied 20% KOH all achieved comparable success rates that were all statistically significant. All three methods represented tolerable and highly effective modes of therapy. Historical review: MC was first described and later assigned its name by Bateman in the beginning of the Nineteenth Century. In 1841, Henderson and Paterson described the intracytoplasmic inclusion bodies now known as Molluscum or Henderson-Paterson bodies. In the early Twentieth Century, Julinsberg, Wile and Kingery were able to extract filterable virus from lesions and show transmissibility. Goodpasture later described the similarities of Molluscum and vaccinia [2].

• Single or multiple filiform lesions of approximately 2 mm in width and 5 mm in length occurring elsewhere on the body. • Large, pedunculated tumor or nevoid, baglike, soft fibromas that occur on the lower part of the trunk [7]. The most common site of skin tag is on the sides of the neck, where they may be mixed with typical small, sessile, seborrheic keratoses [1]. They are also seen frequently in the axillae, eyelids, and less often on the trunk and groins, where the soft pedunculated growths often hang on thin stalks [2], perianal skin are also frequently involved [2,8] and this has now been named infantile perianal pyramidal protrusions. This occurs in young children usually girls, in the midline anterior to the anus. This reduces with time and no treatment is necessary [2]. Skin tag may occur at unusual sites of the body. A huge skin tags have been described on the penis [9]. A lymphedematous skin tag of the glans penis unassociated with condom catheter use also has been described [6]. Skin tags of the oral mucosa, anus, and vulvovaginal areas may be found [7]. Skin tags are usually asymptomatic, but on occasion can become painful secondary to irritation or torsion and infarction [5]. Patients may complain of pruritus or discomfort when an acrochordon is Synonyms: Soft warts, achrochordon[1], cutaneous tag, papilloma colli, fibroma pendulum, cutaneous papilloma, fibroma molluscum, templeton skin tags [2], fibroepithelial polyps, pedunculated soft fibromas, filiform soft fibromas [3]. Definition: Skin tags are common benign connective tissue tumors of the dermis [4], composed of loose fibrous tissue [1], and presents as a soft skin colored to slightly hyperpigmented pedunculated papule [5]. These flesh-colored tumors are often raised from the surface of the skin on a fleshy stalk called a peduncle, and feel like small bags. Skin tags may be single or multiple and are typically the size of a grain of rice [2,6], but they may range in size from 1-2 mm papules on the eyelids to 1-2 cm baggy polyps on the trunk [5]. The surface of a skin tag may be smooth or irregular in appearance [6]. Three types of skin tags have been described: • Small, furrowed papules of approximately 1-2 mm in width and height, located mostly on the neck and the axillae.

Abstract: Palmoplantar lichen planus is an uncommon dermatosis. We present a case of 38-year-old Caucasian
male with a history of pruritic, scaly lesions on the right plantar foot. Physical examination revealed whitish
plaques and numerous spiny hyperkeratotic papules and focal scaling. A biopsy demonstrated orthohyperkeratosis
and acanthosis of the epidermis. Immunohistochemical staining revealed positivity within the epidermis and/
or lichenoid infi ltrate with CD3, CD8, CD45, CD68, myeloid histiod antigen, BCL2, p27, p53, HLA-DPDQDR,
metallothionein and tissue inhibitor of metalloproteinases 1. The diagnosis of PPLP was thus confi rmed; this case
illustrates that PPLP should be considered in the differential diagnosis of uncommon foot dermatoses with a signifi
cant junctional infl ammatory component.