Most Effective Hair Loss Home Remedies

Peruvian Hair Loss Treatment

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Peruvian Hair Loss Treatment Summary


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My Peruvian Hair Loss Treatment Review

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Recently several visitors of websites have asked me about this ebook, which is being promoted quite widely across the Internet. So I ordered a copy myself to figure out what all the excitement was about.

All the modules inside this e-book are very detailed and explanatory, there is nothing as comprehensive as this guide.


NETTLE juice combed through the hair to prevent baldness has been a common folk practice (Baker). The Wiltshire cure for dandruff was to massage the scalp with a nettle infusion each day (Wiltshire). PARSLEY was recommended for baldness as far back as Pliny's time (Bazin), repeated a long time afterwards as powder your head with powdered parsley seed three nights every year, and the hair will never fall off (Leyel. 1926). Actually, it really does make a good lotion for getting rid of dandruff, and helps to stave off baldness (A W Hatfield). ROSEMARY, besides providing the base of various hair rinses (see COSMETICS), was also used for the more serious purposes of preventing baldness. A manuscript from 1610 claims that if thou wash thy head with rosemary water and let it drye on agayne by itselfe, it causeth hayre to growe if thou be balde (Gentleman s Magazine Library Popular superstitions p162). Equally optimistic was a wash to prevent the hair from falling off , noted in the...


MAIDENHAIR FERN has been used to stop the hair falling out, a use stemming from the legend that the hair of Venus (capillus-veneris) was dry when the goddess came out of the sea, since when the fern has been used in hair lotions, particularly for lotions to prevent the hair from going out of curl on damp days. From there it is but a short step for the doctrine of signatures to ensure that it should be used for alopecia. It is the ashes of the fern, mixed with olive oil and vinegar, that are used (Leyel. 1937). SOUTHERNWOOD had a similar reputation. See Gerard's prescription the ashes of burnt Southernwood, with some kind of oyle that is of thin parts cure the pilling of the hairs of the head, and make the beard to grow quickly . A cap of IVY-leaves worn on the head was supposed to stop the hair falling out (Leather), or to make it grow again when illness had caused it to fall. Gerard claimed that a gall from a DOG ROSE, stamped with honey and ashes causeth haires to grow which are...

Clinical Description Presentation

Cowden syndrome displays a high level of variability in expression, both between and within families however, it usually presents in the third decade. Hamartomas are derived from all three germ cell layers. Those of the inner organs most commonly involve the breast (70 ) thyroid adenomas and multinodular goitres (40-60 ) gastrointestinal polyps (35-40 ) and can also be seen in the central nervous system and reproductive tract. The gastrointestinal polyps seen in CS are distinct from those seen in other hamartomatous syndromes, as they are more likely to be of ectodermal and or endodermal origin. 5 Dermatological manifestations are the most prevalent findings, with palmoplantar hyperkeratosis in 54 , trichilemmonmas (benign tumors of the hair follicle

Clinical manifestation

Stage 3 streaks and whorls of brown or slate-gray pigmentation along the lines of Blaschko, particularly on the trunk Stage 4 hypopigmented, atrophic, reticulated patches, mostly on the lower extremities lusterless, thin hair nail dystrophy, ranging from mild pitting or ridging to severely thickened, abnormally ridged nails dental abnormalities

Pharmacologic Highlights

Other Therapy Common side effects are alopecia, nausea, vomiting, fatigue, myelo-suppression, and stomatitis. Patients who are receiving chemotherapy are administered antinausea drugs, antiemetics, and pain medicines as needed to help control adverse experiences. Experimental drugs currently in clinical trials include paclitaxel, topoiso-merase-3 inhibitors, nucleoside analogues, monoclonal antibodies, and interferon. During irradiation, the patient may suffer from dry mouth, loss of taste, dysphagia, nausea, and vomiting, which can be managed with frequent mouth care. Explore ways to limit discomfort, such as ice chips. Attempt to provide desired foods to support the patient's nutrition. Keep any foul-smelling odors clear of the patient's environment, particularly during meals. Manage skin irritation and redness by washing the skin gently with mild soap, rinsing with warm water, and patting the skin dry. Encourage the patient to avoid applying lotions, perfumes, deodorants, and...

Levels of testosterone estrogen and progesterone

Testosterone is formed from its precursor androstenedione and to a lesser extent from DHEA. In males, testosterone is produced mainly by Leydig cells of the testes. Testosterone can be converted by peripheral tissues to the more active dihydrotestosterone (DHT) by the enzyme 5a-reductase or it can be converted into estradiol (E2) by an A ring aromatase. In males, the conversion of testosterone to E2 by aromatase achieves masculinization of brain neurons (Wu et al. 2009). In the female ovary, testosterone secreted by thecal cells of the follicles is aromatized by granulosa cells into estradiol.

Eyelid Lesions and Tissues of Origin

Sweat Gland Disease

The dermis also contains epithelial appendages which are the source for many eyelid lesions. The pilosebaceous unit consists of the hair follicle and associated holocrine sebaceous gland and apocrine sweat gland of Moll. All of these structures can be the site of origin for eyelid lesions. The diverse cellular components of this apparatus can give rise to many different lesions that can look similar clinically. Lesions are grouped into four major categories depending upon differentiation towards sebaceous, hair follicle, apocrine, or eccrine tissues. Within these groups lesions are further subdivided into hyperplasias, hamartomas, adenomas, and carcinomas. The hair follicle is a tubule with root cells at the base around the papilla and bulb (Fig. 3). Higher up follicular epithelium lines the follicle, and finally cortical cells lay down the outer keratin layers to the hair. Tumors arising from proliferations of cortical cells are termed piloma-trixomas. Solid proliferations of...

Inverted Follicular Keratosis

Seborrheic Keratosis Eyelid

INTRODUCTION Inverted follicular keratosis is a benign skin lesion that is common on the face and less frequently on the eyelids. It occurs in older individuals from the fifth decade on, and is considerably more common in males. It is frequently mistaken for a malignant tumor. These lesions arise from the infundibular epithelium of the hair follicle and therefore are related to epidermoid cysts. Inverted follicular keratosis may be an irritated form of seborrheic keratosis or verruca vulgaris.

Risk characterization

The lowest observed effect level (LOEL) is that dose of a test agent at which the exposed animals may show some changes associated with the substance but the changes are not considered adverse effects. The no observed adverse effect level (NOAEL) is that dose at which there are no statistically or biologically significant increases in frequency or severity of effects between the exposed and the control groups. For each toxic substance, an adverse effect may be manifested by a separate threshold dose. Figure 6.4 illustrates progressively adverse responses hair loss, reduced fertility, and liver pathology. The risk assessor would judge that hair loss is not an adverse effect and assign a NOEL. The lowest observed adverse effect level (LOAEL) is the dose of the substance at which there are statistically no biologically significant differences in the frequency or severity of adverse health effects between the exposed and the control groups. The lowest observed effect (LOEL) is...

Management of the polycystic ovary syndrome

Trans Vaginal Scan And Polycystic Ovarys

The bioavailability of testosterone is affected by the serum concentration of SHBG. High levels of insulin lower the production of SHBG and so increase the free fraction of androgen. Elevated serum androgen concentrations stimulate peripheral androgen receptors, resulting in an increase in 5alpha reductase activity directly increasing the conversion of testosterone to the more potent metabolite, dihydrotestosterone. Women with PCOS do not become virilized (i.e. do not develop deepening of the voice, increased muscle mass, breast atrophy or clitoromegaly). Drug therapies may take 6-9 months or longer before any improvement of hirsutism is perceived. Physical treatments including electrolysis, waxing and bleaching may be helpful while waiting for medical treatments to work. Electrolysis is time-consuming, painful and expensive and should be performed by an expert practitioner. Regrowth is not uncommon and there is no really permanent cosmetic treatment. Laser and photothermolysis...

Anatomy of the Eyelids

Procerus Muscle

A number of epidermal appendages lined with epithelium lie within the dermis. These include hair follicles associated with an arrectopili muscle attached to the dermal-epidermal junction. Apocrine sweat glands of Moll are coiled glands in the deep dermis that empty via a long ductule into the uppermost portion of the hair follicle. Apocrine glands secrete by cellular decapitation with the apical portion of the secretory cell mixed with sialomucin producing a more viscous secretion with cellular debris. They are concentrated along the eyelid margins. Sebaceous glands contain epithelium that is an outgrowth of the external root sheath of the hair follicle. These are holocrine glands that shed the entire epithelial cell along with secretory products of complex oils, fatty acids, wax, and cholesterol esters called sebum. A large sebaceous gland is associated with each hair follicle and empties its secretions directly into the follicle. The hair follicle along with the sebaceous and Moll...

Examination and investigation of patients with PCOS and secondary amenorrhoea

Signs of hyperandrogenism (acne, hirsutism, balding (alopecia)) are suggestive of the PCOS, although biochemical screening helps to differentiate other causes of androgen excess. It is important to distinguish between hyperandrogenism and virilization, which is additionally associated with high circulating androgen levels and causes deepening of the voice, breast atrophy, increase in muscle bulk and cliteromegaly (see Virilization p. 378). A rapid onset of hirsutism suggests the presence of an androgen secreting tumour of the ovary or adrenal gland. Hirsutism can be graded and given a 'Ferriman-Gallwey Score', by assessing the amount of hair in different parts of the body (e.g. upper lip, chin, breasts, abdomen, arms and legs). It is useful to monitor the progress of hirsutism, or its response to treatment, by making serial records, either using a chart or by taking photographs of affected areas of the body. Dihydrotestosterone

Trichilemmal Sebaceous Cyst

Trichilemmal Cyst Central Punctum

INTRODUCTION The trichilemmal cyst is also referred to as a sebaceous or pilar cyst. It is derived from the outer root sheath of the deeper parts of a hair follicle and consists of a well-keratinized epidermal wall surrounding semi-solid hair keratin and cholesterol-rich debris, rather than just sebaceous material. Trichilemmal cysts are more common in females and most cases occur in the sixth and seventh decades of life. They differ from epidermoid cysts in that they lack a granular layer in the lining epithelium. Foci of proliferating cells and mitoses can occasionally be seen producing the proliferating trichilemmal cyst or pilar tumor. Some authors regard these as malignant tumors.

Spironolactone Induced Gynecomastia

Active androgens and more specifically 5a-dihydrotestosterone (DHT) interact with the androgen receptor (R) in target tissues to form hormone receptor complexes which activate protein synthesis. Low (50-75 mg) or high (200-400) doses of spironolactone interfere with DHT binding with its receptor to form inactive complexes at the nuclear level. From Tremblay.

Adulteration of Hair and Saliva Specimens for Drug Testing

Hair and saliva specimens are alternatives to urine specimens for drug testing (see Chapter 11). Several products available through the Internet claim that washing hair with their shampoos can help pass a drug test. Clear Choice Hair Follicle Shampoo claims to remove all residues and toxins within 10 min of use. One application is sufficient for shoulder-length hair, and the effect can last for 8 h. Root Clean hair-cleansing system shampoo has also been commercially available. However, no systematic study has been reported to investigate the effect of using these products in a drug test. Saliva samples are also used for drug testing. The chances of adulteration of saliva specimen are very low to non-existent. However, the manufacturer of a commercially available mouthwash claims that by rinsing the mouth twice with this product, a person can beat saliva-based drug testing, which is a popular method of testing by insurance companies. The same company claims that its specially...

Asplenium trichomanes Maidenhair spleenwort

Also from Theophrastus, hair madness. Should all else fail, a tea of Asplenium trichomanes (mixed with olive oil) was once reputed to cure baldness.(Drop a sprig or two into your husband's tea.) By all appearances it has not been successful.

Folliculitis decalvans

Inflammatory process caused by obstruction or disruption of individual hair follicles and the associated pilosebaceous units, leading to scarring alopecia because of destruction of the follicular units role of staphylococcal follicular infection uncertain Occurs in women after age 30 and in men from adolescence onward bogginess or induration of affected areas of the scalp or other hair-bearing sites successive crops of pustules late finding of scarring alopecia

Diagnostic categories in infertility

* Clinical indicators of hyperandrogenism are hirsutism, acne and androgenic alopecia. The elevation of free testosterone and or free testosterone (free androgen) index (FAI) are the biochemical indicators of PCOS. Some women with PCOS may have isolated elevations in dehydroepiandrosteronesulphate (DHEAS). The definition of polycystic appearing ovaries on scan includes the presence of 12 or more follicles in each ovary measuring 2-9 mm in diameter, and increased ovarian volume ( 10 ml). The ovarian volume is calculated using the formula (0.5 x length x width x thickness). The distribution of follicles is not included in the definition and only one ovary fitting the description is sufficient for the diagnosis.

Tertiary prevention of hypothyroidism Avoiding Complications

Although autoimmune thyroiditis is not a complication of hypothyroidism per se, patients affected with it are also at risk of developing a relatively small set of associated autoimmune disorders. The polyglandular autoimmune syndrome type II includes hypothyroidism, primary adrenal insufficiency, and type I diabetes (57). Less commonly, hypothyroidism may occur in the autoimmune dystrophy syndrome (or polyglan-dular autoimmune syndrome type I). Autoimmune thyroid disorders are associated with increased risk of developing pernicious anemia and gastric achlorhydria caused by intrinsic factor and parietal cell autoimmunity. Patients with autoimmune thyroiditis should be monitored for vitamin B12 deficiency with periodic complete blood counts and, whenever the disorder is seriously suspected, serum vitamin B12 measurement. Vitiligo, leukotrichia (prematurely gray hair), and alopecia areata have also been associated with autoimmune thyroiditis although these disorders are often...

Effects on Particular Organs or Organ Systems

The skin suffers toxic effects itself, including cancer, primary irritation, allergic reactions, hair loss, pigment disturbances, ulceration, and chloracne. Dermatitis is an inflammation of the dermis. Irritant contact dermatitis and allergic dermatitis can both be caused by exposure to chemicals and produce similar symptoms, including hives, rashes, blistering, eczema, or skin thickening. The difference between them is that a true allergy takes time to develop, typically at least two weeks whereas irritation does not require a previous exposure. For example, no one reacts to poison ivy when first exposed. Only after a second or subsequent exposure does the itchy rash develop.

See Risk For Impaired Skin Integrity

Defining Characteristics (Specify radiation effects erythema, dryness, itching, increased pigmentation, dry desquamation, necrotic tissue chemotherapy and antibiotic induced side effects local phlebitis, stomatitis, mucositis, maculopapular rash, hyperpigmentation, nail changes, pruritus, dermatitis, alopecia, photosensitivity, acne, erythema, poor wound healing.)

Women Not Interested in Fertility

Spironolactone, an aldosterone antagonist and antidiuretic, is the next most commonly used drug. It competes for androgen receptors in the hair follicle, inhibits the enzyme 5a-reductase, and may have a direct effect on inhibiting ovarian steroid synthesis. The recommended doses are 50-200 mg daily, but the response to this agent is also slow (6 mo). Spironolactone can cause irregular menses and is teratogenic hence it is usually prescribed in combination with OCPs, although this may not significantly improve the outcome (55). Flutamide inhibits the androgen receptor directly but has limited use because of the severe hepatotoxicity reported in a small number of cases (56). Finasteride inhibits 5a-reductase activity, hence decreasing the conversion of testosterone to dihydrotestosterone, and has fewer side effects. A prospective randomized trial compared the efficacy of flutamide, finasteride, ketoconazole, and ethinyl-estra-diol-cyproterone acetate over a period of 360 d. Although an...

Conditions That May Simulate Tinea

Tinea of the scalp may be confused with any scalp disorder that causes patchy alopecia, inflammation, or scale. The presence of hairs broken off a short distance above or right at the scalp surface should cause immediate suspicion. Occasionally TCa does not produce hair breakage. Alopecia areata causes patchy hair loss and may show erythema of the scalp. Scale is absent, however, and the presence of exclamation-point and dystrophic anagen hairs should differentiate it. In older patients with alopecia areata, gray hairs continue to grow within the patches of alopecia. An active impetigo of the scalp, on rare occasions, can produce enough inflammation to cause hair loss and may simulate a kerion. Hairs can be readily epilated but come out by the root rather than by breakage. Whenever there is a question, hair KOH exam and fungal culture are indicated.

Dissecting cellulitis of scalp

Chronic inflammatory disease characterized by painful suppurating lesions of the scalp, leading to scarring alopecia Associated with acne conglobata, hidraden-itis suppurativa, and pilonidal cysts, all of which have follicular blockage as the common mechanism retained material dilates and causes follicular rupture keratin and organisms from the damaged hair follicles initiate neutrophilic and granulomatous response bacterial infection secondary event Perifollicular pustules tender nodules (some discharging pus or gelatinous material) intercommunicating sinuses between nodules patchy alopecia with scarring frequent recurrences over many years

Chloro13Dinitrobenzene 6Chloro13Dinitrobenzene

This substance is one of the strongest primary skin irritant known, and a universal contact allergen. Occupational dermatitis has been reported, but current use is decreasing or performed with completely closed systems. DNCB is sometimes used for topical treatment of alopecia areata, severe warts, and cutaneous metastasis of malignant melanoma.

Primary Nursing Diagnosis

Topical fluorouracil may be used to manage some SCC skin lesions. During treatment, the patient's skin is more sensitive than usual to the sun. Healing generally occurs in 1 to 2 months. With metastatic SCC, radiation, chemotherapy, and surgery may be combined. The chemother-apeutic agent commonly used is cisplatin or doxorubicin, or both. External beam radiation therapy may be used in cases where a tumor is difficult to remove surgically because of its size or location and in situations in which the patient's health precludes surgery. As an adjuvant therapy after surgery, radiation can be used to kill small deposits of cancer cells that were not visible during surgery. Radiation may also be used when NMSC has spread to other organs or to lymph nodes. If the patient undergoes radiation therapy, prepare the patient for common side effects such as nausea, vomiting, diarrhea, hair loss, and malaise.

Description Medical Other Infectious and

Begins with the penetration of the infecting organism, the spirochete Treponema pallidum, into the skin or mucosa of the body. Within 10 to 90 days after the initial infection, the primary stage begins with the appearance of a firm, painless lesion called a chancre at the site of entry. In women, the chancre often forms in the vagina or on the cervix and therefore goes unnoticed. If it is left untreated, the chancre heals spontaneously in 1 to 5 weeks. As this primary stage resolves, systemic symptoms appear, thus signaling the start of the secondary stage. Secondary stage symptoms include malaise, headache, nausea, fever, loss of appetite, sore throat, stomatitis, alopecia, condylomata lata (reddish-brown lesions that ulcerate and have a foul discharge), local or generalized rash, and silver-gray eroded patches on the mucous membranes. These symptoms subside in 1 week to 6 months, and the infected person enters a latent stage, which may last from 1 to 40 years. During latency,...

Ethical issues from genome to therapy

The most pressing short-term problems arise out of the fact that the most immediate impact of finished sequence data on the human genome is likely to be in diagnostics, with the primary therapies being prenatal diagnosis and abortion. There are a large number of important issues that have been raised with regard to genetic testing. These include worries about the quality of informed consent when dealing with complicated statistical and probabilistic information and limited access to genetic counselling worries about genetic privacy and confidentiality and genetic discrimination and concerns about a new eugenics as testing slides from cystic fibrosis to baldness, a tendency toward obesity, homosexuality, and other value-laden traits (for example, Andrews et al 1994, Kevles & Hood 1992, McGee 1997).

Dermatologic Physical Exam

Microdistribution Follicular distribution is encountered on rare occasions. The disease may attack any hair bearing area. Follicular LP may be seen with other typical skin and mucous membrane lesions or may occur alone. It presents as pin-head-sized conical, rough red papules pierced by a hair. Permanent hair loss may occur.

Lowrisk disease management

The low-risk chemotherapy treatment is usually well tolerated without much major toxicity. Methotrexate does not cause alopecia or significant nausea and myelosup-pression is extremely rare. Of the side effects that do occur, the most frequent problems are from pleural inflammation, mucositis and mild elevation of liver function tests. For the low-risk patients with lung metastases visible on their chest X-rays, our policy is to add CNS prophylaxis with intrathecal methotrexate administration to minimize the risk of development of CNS disease.

Description Of Lesion

If a chancre exists, palpate the surrounding lymph nodes for hard, painless nodules. Also inspect the scalp, skin, and mucous membranes for hair loss, rashes, or mucoid lesions, which are characteristic of the secondary stage. Inspect the fingernails for signs of pitting.

Standard Firstline Therapy For Metastatic Disease

Tournigand et al. conducted an innovative randomized phase III trial of irinotecan plus infusional 5-FU leucovorin (FOLFIRI) followed by FOLFOX at disease progression vs the reverse sequence. The most impressive result of this study was an overall survival exceeding 20 mo in both arms, which had not been previously reached in any randomized study of metastatic colorectal cancer therapy. Neither arm was superior, though toxicity profiles were different. In first-line therapy, grade 3 4 mucositis, nausea vomiting, and grade 2 alopecia were more frequent with FOLFIRI, and grade 3 4 neutropenia and neurosensory toxicity were more frequent with FOLFOX. Interestingly, second-line response rate data was higher with FOLFOX (15 ) than with FOLFIRI (4 ) (84). This trial suggests that the inferiority of IFL to FOLFOX in N9741 was not owing to the irinotecan, and that FOLFIRI represents a reasonable first-line choice for patients with metastatic disease.

Cronkhitecanada Syndrome

With an average age of onset during the sixth to seventh decade of life (105,109). The syndrome has a worldwide distribution, and has no known cause. It is more common in men (60 ) than women, and is characterized by the onset of generalized GI polyposis, with esophageal sparing, in association with cutaneous hyperpigmentation, hair loss, nail atrophy, and hypogeu-sia (105). The polyps are sessile and innumerable, and they range in size from several millimeters to several centimeters. On histological examination the polyps resemble juvenile polyps, although dysplastic changes do rarely occur (110).

Discharge And Home Healthcare Guidelines

Discuss with the woman helpful coping mechanisms. Encourage her to be open with her partner, her family, and her friends about her concerns. Help the patient cope with hair loss. Teach her cosmetic techniques to deal with hair and body changes. Explore alternative methods to medication to manage nausea and vomiting.

Drug interactions

Alopecia areata Hypersensitivity to drug class or compo- Pressure alopecia nent systemic fungal infection caution in patients with congestive heart failure, seizure disorder, hypertension, diabetes melli- Traction alopecia tus, tuberculosis osteoporosis impaired liver function

Dyskeratosis congenita

Cutaneous manifestations developing between 5 and 15 years of age tan-to-gray, hyperpigmented or hypopigmented macules and patches in a mottled, or reticulated pattern, sometimes with poikilo-derma located on the upper trunk, neck, and face, often with involvement of sun-exposed areas scalp alopecia mucosal leu-koplakia on the buccal mucosa, tongue, oropharynx, esophagus, urethral meatus, glans penis, lacrimal duct, conjunctiva, vagina, anus dental caries progressive nail dystrophy increased incidence of malignant neoplasms, particularly squamous cell carcinoma of the skin, mouth, nasopharynx, esophagus, rectum, vagina, and cer

Hamartomatous Polyposis Syndromes

Unlike the syndromes discussed earlier, Cronkhite-Canada syndrome is an acquired, nonfamilial syndrome of diffuse gastrointestinal juvenile polyposis. The extraintestinal manifestations include onycholysis, alopecia and skin hyperpigmention. Patients typically present in middle age or older (average 62 yr) with rapid onset of progressive diarrhea, protein-losing

Vitamin DRelated Disorders

This disorder typically responds to physiologic replacement doses of calcitriol (54,55). Vitamin D-dependent rickets type II (vitamin D-resistant rickets) is a rare autosomal recessive disorder characterized by hypocalcemia, hypophosphatemia, elevated PTH concentration, and elevated levels of 1,25(OH)2D. This disorder results from mutation of the vitamin D receptor gene (56). Presentation is similar to that of vitamin D-dependent rickets alopecia has been described in some kindreds (57). Treatment of vitamin D-dependent rickets type II is challenging, with variable response to pharmacologic doses of vitamin D or calcitriol (58).

Breast and ovarian cancer in other hereditary colorectal cancer syndromes

Cowden syndrome is a rare autosomal predisposition characterized by multiple hamartomas and a high risk of breast, thyroid and, perhaps, other cancers (Eng, 2000). These hamartomas can arise in tissues derived from all three embryogenic germ-cell layers. The cardinal features of this syndrome include trichilemmomas, which are hamartomas of the infundibulum of the hair follicle, and mu-cocutaneous papillomatous papules. Breast cancer develops in 20-30 of female carriers. Other tumours seen among patients with Cowden syndrome include adenomas and follicular cell carcinomas of the thyroid polyps and adenocar-cinomas of the gastrointestinal tract and ovarian cysts and carcinoma. Cowden syndrome is caused by germline mutations in the PTEN gene.

Gardner Syndrome

Cutaneous manifestations of FAP help to define Gardner syndrome. These include epidermoid cysts and fibromas (Figure 17.1). Cutaneous cysts are usually multiple, and most occur on the scalp and face. Many begin to develop before puberty. While some cysts have no distinctive features, a study of cysts from a large kindred of Gardner syndrome patients revealed foci of pilomatrical differentiation in 63 of lesions (Figure 17.2A and 17.2B). Pilo-matrical cells are those cells of the hair follicle that differentiate into the keratinizing cells that form the hair shaft. While the finding is of unknown specificity, such differentiation was not found in any of 100 randomly selected cysts (11). Multiple pilomatricomas may also be a cutaneous marker of Gardner syndrome (12). Nuchal-type fibroma is a deep-seated fibrous tumor, usually of the posterior neck, which may be associated with Gardner syndrome or, more commonly, diabetes mellitus. Tumors are composed of thick bundles of hypocellular...


Clusively in the transitional zone of the prostate gland. The growth and development of the prostate is under the influence of testosterone, specifically its active metabolite dihydrotestosterone (DHT). After conversion by the enzyme 5-a reductase, DHT stimulates androgen receptors in the prostate, which results in the production of growth factors such as epidermal growth factor (EGF). These factors then promote the hyperplasia seen in BPH. It has been postulated that a reduction in apoptosis is also involved in the development of BPH, by causing an imbalance in the ratio of proliferation and apoptosis and hence leading to glandular hy-perplasia. The process also involves an increase in the amount of stromal and smooth muscle tissue of the transitional zone. Histologically, initially small stromal nodules are seen in the transitional zone around the urethra, followed by hyperplasia of the glandular structures. These changes are seen in prostates of men as young as 40, and are...

Outcome Criteria

Teach parents and child about the disease process, surgical procedure, what to expect preoperatively and postoperatively including chemotherapy and its benefits and side effects (nausea, vomiting, diarrhea, stomatitis, alopecia, and others are possibilities but are temporary phantom pain).


Considered to be a prohormone, because it is converted in extratesticular tissues to other biologically active steroids. Testosterone may be reduced to the more potent androgen, 5a-dihydrotestosterone, in the liver in a reaction catalyzed by the enzyme 5a-reductase type I and returned to the blood. This enzyme is a component of the steroid hormone degradative pathway and also reduces 21-carbon adrenal steroids. Testosterone is also reduced to dihydrotestosterone in the cytoplasm of its target cells mainly through the catalytic activity of 5a-reductase type II, whose abundance in these cells is increased by the actions of testosterone. Dihydrotestosterone is only about 5 as abundant in blood as testosterone and is derived primarily from extratesticular metabolism. Some testosterone is also metabolized to estradiol (Fig. 7) in both androgen target and nontarget tissues. A variety of cells, including some in brain, breast, and adipose tissue, can convert testosterone and androstenedione...

Touch Receptors

The five major classes of touch receptors illustrated in Fig. 1 include three (Pacinian corpuscles, Merkel's disks, and Ruffini's corpuscles) that are common to both hairy and glabrous (nonhairy) skin. Hair follicle receptors are unique to hairy skin, and Meissner's corpuscles are found primarily in glabrous skin. All of these types of somato-sensory mechanoreceptors have fibers designated as type II, indicating that they have a similar diameter, a similar degree of myelination, and a similar conduction rate. Hair follicle receptor Hair follicle receptor Pacinian corpuscle Hair follicle Merkel's disk Ruffini's corpuscle


INTRODUCTION Trichofolliculoma is an uncommon hamartoma of hair follicle tissue typically occurring on the face of adults. They are not associated with systemic disease or with other skin disorders. Trichofolliculomas are believed to represent abortive differentiation of pluripotent skin cells on their way to develop into hair follicles. They are associated with minimal clinical morbidity. There is no sexual or racial predilection. HISTOPATHOLOGY Trichofolliculomas have a dilated hair follicle, containing keratinous debris and hair shaft fragments, from which radiate numerous small follicles that exhibit variable degrees of maturation (shown below). The follicles that radiate from the central follicle may branch further to give rise to secondary or tertiary follicles. The radiating follicles may contain hair shafts, rudimentary pilar structures, or there may be only cords of epithelial cells.

Intersex disorders

Intersex Genitalia Images

The manner in which testosterone, produced by developing testes, is utilized to bring about masculinization of the cloaca is through conversion of testosterone to dihydrotestosterone through the action of the enzyme 5a-reductase. Wolffian structures, however, are capable of utilizing testosterone directly and are therefore independent of 5a-reductase activity. Thus, in those patients with 5a-reductase deficiency abnormal development of the external genitalia will occur and an intersex state results. For effective utilization of both testosterone and 5a-reductase it is necessary for the testosterone to be bound to the receptors on the cell membranes and ineffective binding of testosterone leads to abnormal sexual differentiation in disorders known as androgen insensitivity. As described above, normal masculinization of the external genitalia requires the conversion of testosterone to dihydrotestosterone by 5a-reductase. Although the Wolf-fian structures respond directly to...

Sebaceous Adenoma

Sebaceous Cell Carcinoma Upper Eyelid

INTRODUCTION Cutaneous adnexal neoplasms showing sebaceous differentiation are difficult to classify. Because of the intimate relationship of sebaceous glands with other adnexal structures associated with the pilosebaceous unit these lesions often display complex histologic features combining sebaceous, hair follicle, and sweat gland tissues. Sebaceous neoplasms run the gamut from benign to malignant lesions. These include sebaceous gland proliferation (sebaceous hyperplasia), congenital sebaceous hamartomas (nevus sebaceum), sebaceous adenoma, and sebaceous carcinoma. Sebaceous adenoma is an uncommon, often solitary lesion usually seen in patients over 40 years of age, with a predilection for the eyelid and brow, occurring in elderly patients.



INTRODUCTION Trichoepithelioma is a benign adnexal tumor of hair follicle origin that may occur as a solitary lesion or as an inherited form with multiple lesions, each with a predilection for the face. They can occur at any age, but the mean age is 45 years. Solitary lesions tend to present in older patients. These lesions are nonaggressive and assymptomatic, but may cause significant cosmetic disfigurement. Multiple lesions may occur in an inherited, autosomal dominant pattern called epithelioma adenoids cysticum of Brooke. This syndrome begins in the second decade of life with the appearance of multiple lesions that tend to involve the face, particularly in the region of the nasolabial folds, lips, nose, and eyelids. The scalp, neck, and trunk may also be involved. HISTOPATHOLOGY Trichoepitheliomas are dermal tumors composed of islands of basaloid cells that may exhibit peripheral palisading. Trichoepitheliomas often have small keratinous cysts lined by stratified squamous...


Collodion Baby Syndrome

CLINICAL PRESENTATION In lamellar ichthyosis the skin shows, course, yellow scales with raised corners which range is size from fine to large and plate-like. These scales are arranged in a mosaic pattern resembling fish skin and are easily shed. Fine, light to dark thick scales are present on the eyelid skin and at the base of the eyelashes. Alopecia of the scalp and loss of eyelashes is common. Often there is keratinization of the lid margin and palpebral conjunctiva, accompanied by a papillary reaction. With time the skin tightens resulting in ectropion which may be very severe. Corneal exposure with secondary scarring and vascularization is a constant threat. HISTOPATHOLOGY A moderate degree of hyperkeratosis and a thin or absent granular cell layer are the usual findings in ichthyosis vulgaris. Keratotic follicular plugs may result from extension of hyper-keratosis into hair follicles.



Diphencyprone is a potent contact allergen used in topical immunotherapy, to treat some severe alopecia areata. It is responsible for occupational contact dermatitis in chemists and dermatology department staff. diphencyprone in a chemist. Contact Dermatitis 32 363 Temesv ri E, Gonz lez R, Marschalk M, Horv th A (2004) Age dependence of diphenylcyclopropenone sensitization in patients with alopecia areata. Contact Dermatitis 50 381-382


Lupus Eyelid

INTRODUCTION Madarosis refers to the loss of eyelashes. It may result from trauma, rubbing the eyelids, or it can follow eyelid surgery with injury to the lash follicles. Madarosis is also associated with systemic diseases such as alopecia areata, but here hair loss is usually seen in other parts of the body as well. Discoid lupus erythematosis involving the eyelids presents with erythema, scarring, and madarosis, but the latter can be the only presenting finding before any other

Lupus Erythematosus

Eye Lid Disorders

Common nonscarring eyelid lesions include a pruritic eruption of the lower eyelids. Scarring lesions often present as sharply demarcated purple-red, slightly raised, circumscribed plaques covered with thin adherent whitish scales and telangiectasias. Often such lesions are localized to the lateral aspect of the lower eyelids. Such lesions may enlarge to reach a size of about 5 to 10 mm. The major disfigurement of discoid lupus occurs as the lesions involute where atrophic scarring may lead to trichiasis and entropion. Often, pronounced hypopigmentation or hyper-pigmentation occurs. Other common skin manifestations include the classic butterfly rash, cutaneous vasculitic foci, urticaria, vesiculobullous lesions, and nonscarring alopecia. Ocular manifestations include retinal hemorrhages, cotton wool spots, retinal vasculitis, papillitis, diffuse retinal edema, keratoconjunctivitis sicca, and band keratopathy. Associated systemic findings in lupus erythematosus include arthralgia,...

Leukemia Cutis

Leonine Facies Differential Diagnosis

Associated orbital disease is not uncommon and presents with pain, lid edema, and exophthalmos. Systemic manifestations include purpura due to thrombocytopenia, urticaria, pruritis, erythema multiforme, leonine facies, alopecia, exfoliative dermatitis, and infection with opportunistic organisms may be seen. Death may result from infection or hemorrhage.


Acanthosis Nigrigans Vulva

Thyroid disease is common and the thyroid gland should be palpated and signs of hypothyroidism (dry thin hair, proximal myopathy, myotonia, slow-relaxing reflexes, mental slowness, bradycardia, etc.) or hyper-thyroidism (goitre with bruit, tremor, weight loss, tachycardia, hyperreflexia, exopthalmos, conjunctival oedema, ophthalmoplegia, etc.) elicited.


Insulin Pump Overweight Women

Anti-oestrogenic effects include thickening of cervical mucus and hot flushes in 10 of women. Other side effects include abdominal distension (2 ), abdominal pain, nausea, vomiting, headache, breast tenderness and reversible hair loss. Clomifene has a mydriatic action that can result in blurred vision and scotomas in 1.5 of women. These changes are reversible. Significant ovarian enlargement


Distichiasis Eyelashes Humans

Distichiasis is a congenital or acquired condition in which there is an accessory row of eyelash cilia behind the normal row. The disorder may be familial with an autosomal dominant pattern of inheritance, but may also follow severe inflammatory or traumatic injury. It is believed that these abnormal lashes develop as a result of metadifferentiation of primary epithelial germ cells originally intent upon meibomian gland development. The meibomian glands are modified sebaceous glands that are not associated with the eyelashes or other hairs. In the skin sebaceous glands are usually associated with a hair follicle and an apocrine sweat gland to form a pilosebaceous unit. Under some circumstances it is believed that the meibomian gland can undergo differentiation into a primitive pilosebaceous unit producing an abnormal distichitic eyelash.

Epidermoid Cyst


INTRODUCTION The epidermoid cyst is also referred to as infundibular cyst, epidermal inclusion cyst, keratinous cyst, or frequently and erroneously sebaceous cyst. The sebaceous cyst is similar clinically but arises from obstruction in the hair follicle and is referred to as a pilar or trichilemmal cyst. The epidermoid cyst is a very common skin lesion that arises from traumatic entrapment of surface epithelium or from aberrant healing of the infundibular epithelium of the hair follicle following episodes of follicular inflammation. They can also be seen following any injury to the skin, including surgery. When congenital, they likely arise from sequestration of epidermal rests along embryonic fusion planes. Epidermoid cysts are not of sebaceous origin, but rather produce normal keratin rather than sebum. These cysts may present anytime from adolescence through adulthood, but commonly in the third and fourth decades.

Genetics of PCOS

The PCOS has long been noted to have a familial component 11 . Genetic analysis has been hampered by the lack of a universal definition for PCOS. Most of the criteria used for diagnosing PCOS are continuous traits, such as, degree of hirsutism, level of circulating andro-gens, extent of menstrual irregularity, and ovarian volume and morphology. To perform genetic analyses these continuous variables have to be transformed into nominal variables. Family studies have revealed that about 50 of first-degree relatives have PCOS suggesting a dominant mode of inheritance 12 . Commonly first-degree male relatives appear more likely to have premature baldness and metabolic syndrome. As hyperandrogenism is a key feature of PCOS it is logical to explore the critical steps in steroidogenesis and potential enzyme dysfunction. Some studies have found an abnormality with the cholesterol side chain cleavage gene (CYP11a), which is the rate limiting step in steroidogenesis.

Castor Oil Plant

The plant's dissemination must have taken place very early, for it was cultivated as a drug plant by the ancient Egyptians. It was sacred enough to have been put in sarcophagi by 4000BC, so that the dead would have use for the bean in the other world. There is a whole list of medicinal uses in the Ebers Papyrus and other lesser known ones. They used the seeds as a purge, taken with beer, or as a painkiller, particularly for sores, in the form of an ointment, which was also used for a disease tentatively identified as alopecia. Again, the seeds, mixed with beans, were used as a fumigant, and employed to drive away the influence of a god or goddess, a male poison or a female poison, a dead man or a dead woman (Dawson. 1929).

Parkinsons Disease

Treating kidney and liver trouble, and for dropsy and jaundice (Vesey-Fitzgerald). Parsley tea used to be a rheumatism remedy (Rohde). Even chewing the leaves is still thought of as a means of warding off rheumatism (Camp). Actually, parsley for rheumatism is a very ancient medicine there is a leechdom in the Anglo-Saxon version of Apuleius for sore of sinews. (Cockayne). Chapped hands were cured in the Fens by rubbing on a salve made from finely-chopped parsley mixed with the fat of a roasted hen (Porter. 1969). It seems, too, that parsley was used for snakebite in the past (Cockayne). Indeed, it once enjoyed the reputation of being able to destroy poison, probably, as one suggestion has it (C P Johnson), because it can overcome strong smells. The crushed leaves make an antiseptic dressing for insect bites, scratches and bruises, or boils (V G Hatfield). It was even recommended for baldness as far back as Pliny's time (Bazin), repeated a long time afterwards as powder your head with...


It was also said in Gloucestershire that if Lad's Love were put in the shoe, you would come across our lover by chance (J Lewis). Another explanation of the origin of the name Lad's Love, is that the name comes from its use in an ointment that young men used to promote the growth of a beard (Leyel. 1937). Gerard among others, had something to say about southernwood's anti-baldness properties the ashes of burnt Southernwood, with some of oyle that is of thin parts cure the pilling of the hairs of the head, and make the beard to grow quickly . That is to be found too in the Gentleman's Magazine, where the correspondent is quoting a 1610 manuscript. To remedye baldnes of the heade . After burning and powdering the herb, mix it with oile of radishes and anoynte the balde place, and you shall see great experiences .


ACE, angiotension converting enzyme AGE, advanced glycation end-products AR, androgen receptor Akt, serine threonine protein kinase CNV, choroidal neovascularization COX, cyclooxygenase CVD, cardiovascular disease DHEA, dehydroepiandrosterone DHT, dihydrotestosterone DIEP, Diabetes in Early Pregnancy Study E, estrogens E2, 17p-estradiol EDRF, endothelium-derived relaxing factor ETDRS, Early Treatment of Diabetic Retinopathy Study eNOS, endothelial nitric oxide synthase ER, estrogen receptor ERa, estrogen receptor alpha ERp, estrogen receptor beta ERE, estrogen-response element ERK, extracellular signal-regulated kinases FGF, fibroblast growth factor HAM, hypoandrogen metabolic syndrome HDL, high-density lipoprotein HLA, human leukocyte antigen HRT, hormone replacement therapy HSP, heat-shock protein HUVEC, human umbilical endothelial cells IDDM, insulin-dependent diabetes mellitus, type 1 ICAM, inter-cellular adhesion molecule LDL, low-density lipoprotein LH, luteinizing hormone MAPK,...

Chondroid Syringoma

INTRODUCTION Chondroid syringoma is also known as pleomorphic adenoma or mixed tumor of the skin. These benign lesions are of possible eccrine gland or hair follicle origin, although several reports showed apocrine differentiation. They usually occur on the head and neck. They only occasionally involve the eyelid. Rarely, malignant variants have been reported.

Brow Ptosis

TREATMENT Several procedures are available for the correction of brow ptosis. The choice depends upon a number of factors (i) the sex of the patient and, therefore, the desired brow contour (ii) the relative position of the brows (iii) the density of the brow cilia (iv) the presence of associated deformities such as crow's feet and prominent transverse glabellar folds and (v) the height of the scalp hair line or presence of male-pattern baldness. Each procedure has its advantages and disadvantages, and selecting the most appropriate operation must be individualized for each patient. The brow pexy is the simplest technique where the deep fascia of the frontalis muscle is fixed to periosteum to prevent the action of gravity from pulling the brows downward. More recently the trans-blepharoplasty Endotine (Coapt) has made this procedure more effective. In the direct brow lift an ellipse of skin is removed from above the brow, leaving a fine scar just above the brow hairs. However, this...

Scarlet Pimpernel

Country people used it medicinally, too, notably for complaints of the eyes. Perhaps the pimpernel's habit of closing its petals at dusk suggested a connection with the eyes (Conway). Anyway, the use is quoted from ancient Greece onwards. 15th century leechdoms have examples for the web in the eyes . One prescription required the patient to take pimpernel a good quantity and stamp it, and wring the juice through a cloth and take swine's grease, and as much of hen's grease and melt together and put the juice thereto, and keep it in boxes and anoint the eyes therewith when thou goest to bed (Dawson. 1934). Something similar to this preparation, i.e., a lotion made from the plant with hog's lard, has been used as a cure for baldness (Page. 1978).

Specific History

Tinea capitis Tinea of the scalp (TCa) is most common in preschool children and pre-teens and is uncommon in adults. It should be part of the differential of any scalp condition that presents with patchy hair loss, inflammation, scaling, a localized inflammatory lesion, or follicular pustules. In children, the onset is usually abrupt and parents usually recount symptoms of redness, scaling, or hair loss of only a few weeks' duration. Discrete, demarcated, pruritic, circular areas of partial alopecia with scale and broken hairs are the most common initial signs. Adults with chronic pustular or less inflammatory infections may describe symptoms of months' or years' duration. The course of TCa is variable. Changes may continue to consist only of broken hairs with minimal scale, erythema, and pruritus in noninflammatory cases. Some patients will develop thick scale, obscuring the underlying scalp, while in other cases deep follicular pustules occur. A common scenario in children is the...

Whats in a Name

In addition to its myeloablative effects, HDC is extremely toxic to other tissues with dividing cells, such as the gastrointestinal tract, the skin, and the hair follicles. Acute toxicities include cramping and dysfunction in the gastrointestinal tract, mouth sores, nausea, diarrhea, rashes, and fatigue. Total hair loss is very common but varies with the type of chemotherapy used. Severe organ toxicity is less common but can be fatal. The lungs are particularly sensitive to some drugs (e.g., vincristine in the Solid Tumor Autologous Marrow Program I regimen), and life-threatening interstitial pneumonitis can occur, resulting in fluid accumulation and reduced blood oxygen. Other severe adverse effects may include liver damage and inflammation of the bladder. Cardiac events occur more often with HDC. For these reasons, patients who underwent HDC ABMT were usually hospitalized for several weeks and sometimes for months if complications occurred. During hospitalization, patients were at...

Beyond the cell wall

Perhaps the most obvious extracellular structures are flagella (sing flagellum), thin hair-like structures often much longer than the cell itself, and used for locomotion in many bacteria. There may be a single flagellum, one at each end, or many, depending on the bacteria concerned (Figure 3.10). Each flagellum is a hollow but rigid cylindrical filament made of the protein flagellin, attached via a hook to a basal body, which secures it to the cell wall and plasma membrane (Figure 3.11). The basal body comprises a series of rings, and is more complex in Gram-negative than Gram-positive bacteria. Rotation of the flagellum is an energy-dependent process driven by the basal body, and the direction of rotation determines the nature of the resulting cellular movement. Clockwise rotation of a single flagellum results in a directionless 'tumbling',

Beet Root

Medicinal uses for beech are few, in fact the only recipe involving the leaves dates from the 15th century, and is for deafness take the juice of leaves of a beech-tree, and good vinegar, even portions, and put thereto powder of quick-lime and then clear it through a cloth and of this, when it is cleansed, put hot into the sick ear (Dawson). More attention was paid to the water that collected in hollow parts of the tree. It cures, according to Evelyn, the most obsinate tetters, scabs, and scurfs, in man or beast, fomenting the part with it , and it also prevents baldness, according to a report from Devonshire (Devonshire Association. Transactions. vol 103 1971 p103).


Headaches can be cured with it, by bruising a leaf, wetting it and tying it to the head (Thomas & Thomas). That is the American way, but the cure is simpler in Britain. All you need do is smell it, so they claim in Norfolk (V G Hatfield), or in Sussex, just holding the scrapings tight would do the trick (J Simpson). The cure in Gloucestershire was also to smell it, better put as inhaling the vapour from the grated root (Vickery. 1995). It is even said that sniffing the juice will cure baldness (Page. 1978). It will relieve toothache, too, if bound on (Newman & Wilson). That was in Essex, but in Norfolk the grated root had to be put on the opposite wrist for twenty minutes (V G Hatfield). Horseradish figures quite a lot in Fenland medicine. Wearing a bag filled with the grated root round the neck was a Cambridge ague preventive, and Fen people claimed that a slice applied to a cut stopped the bleeding and drew the edges of the skin together quickly so that the minimum of scarring...

Dog Rose

The galls made by the gall wasp on the dog-rose enjoyed a great reputation at one time. These Briar balls , also known by more picturesque names like Robin Redbreast's Cushions in Sussex (Latham), used to be sold by apothecaries to be powdered and taken to cure the stone, as a diuretic, and also for colic. Boiled up with black sugar (the sugar used for curing ham), the result would be drunk for whooping cough (Page. 1978). That is a gypsy remedy, but country people generally used to hang them round their necks as an amulet against whooping cough (Grigson. 1955), or just hanging them in the house (Rolleston), not only for whooping cough, but for rheumatism, too (Bloom), or for piles (Savage). Putting one under the pillow was a Norfolk way of curing cramp (Taylor). In Hereford and Worcester the gall was carried round in the pocket to prevent toothache (Leather), while Yorkshire schoolboys wore them as a charm against flogging (Gutch) that is why they were known as Savelick there. Gerard...

Follicular mucinosis

Alopecia mucinosa Pruritic, pink to yellow-white, follicular papules and plaques may be solitary or multiple face and scalp most common sites non-scarring alopecia Alopecia areata telogen effluvium andro-genetic alopecia keratosis pilaris lichen spinulosus lichen planopilaris


PARSLEY makes a good lotion for getting rid of dandruff, and helps to stave off baldness (A W Hatfield). The Wiltshire remedy was to massage the scalp with a NETTLE infusion each day (Wiltshire) (see also Baldness). An American domestic remedy for the condition is to use a lotion made of one part APPLE juice to three parts of water (H M Hyatt). Evelyn favoured a MYRTLE decoction for dandruff, and also for dyeing the hair black. Not only that, but it keepeth them from shedding . Gerard reported thet the juyce of the decoction (of FENUGREEK) pressed forth doth clense the haire, taketh away dandruffe , and the meale , presumably the paste or porridge made from the seeds, he reports as being good to wash the head ., for it taketh away the scarfe, scales, nits, and all other imperfections . substitute, but as a ritual hair shampoo in initiation ceremonies, but the Kiowa claimed it was an effective cure for dandruff and baldness (Vestal & Schultes).

Maidenhair Fern

(Adiantum capillus-veneris) Adiantum is from a Greek word meaning unmoistened, because the fern has the property of repelling moisture, a peculiarity that was attributed to the hair of Venus (capillus-veneris), who when she rose from the sea came out with dry hair. So, ever since these legends arose, it has been used in hair lotions, and particularly in lotions to prevent the hair going out of curl on damp days. The doctrine of signatures ensured that it should be used for alopecia it is the ashes of the fern, mixed with olive oil and vinegar, that are used (Leyel. 1937). It was used too for lung complaints, like coughs and breathing difficulties, and it was also recommended for jaundice and swollen joints (Addison. 1985).


(Yucca glauca) As with other members of the genus, the root was used like soap by the native Americans. Once the root bark is stripped off, the root can be pounded in cold water to make a lather. Blankets were washed in this way (Stevenson) in fact, the Navajo, in washing wool, prefer to use Yucca roots, because there is no grease or fatty substance in it, and they also say that they have a greater cleansing power than soap (Elmore). As with Datil (Yucca baccata) the special, ceremonial use is for hair shampoo - the Pueblo Indians used it as part of the ritual in initiation ceremonies (La Fontaine), though people like the Kiowa claimed it was an effective cure for dandruff and baldness (Vestal & Schultes).


Hormones are known to act as promoters. For example, estrogen administered to menopausal females increases the risk of endometrial cancer. The synthetic hormone diethylstilbestrol (DES) used to be given to pregnant women with high miscarriage risk to improve their chances of carrying the pregnancy to full term. Tragically, it has been found that daughters produced by those pregnancies are at a high risk of contracting cervical cancer in their late teens or early 20s. Testosterone, or more precisely its metabolite (dihydrotestosterone), promotes prostate cancer in men.

Radiation Treatment

Of patients who undergo conventional radiation therapy, 1-2 experience hair loss, cranial nerve palsies, tumor necrosis with hemorrhage, and optic nerve damage or pituitary apoplexy with visual loss (65-69). Lethargy, memory loss, and altered personality are also reported (70). Half of patients treated with radiation therapy develop hypopituitarism within 10 yr of receiving radiation treatment (58,71), with an increased incidence annually thereafter (65), requiring permanent replacement with gonadal steroids, thyroid hormone, and cortisone. Secondary brain neoplasms arising in the radiation field have been rarely reported (72,73). Radiation therapy is highly effective in shrinking GH-secreting adenomas, but it takes 15-20 yr to control GH IGF-1 levels in 90 of patients. Radiation therapy is recommended for patients not cured by surgical or medical


(Cinnamonium cassia) In Palestine, cassia oil was mixed with olive oil, and this was used to rub on the feet, and also to massage into the scalp, as it kept hair dark and greasy, and prevented baldness (Genders. 1972). The twigs are used in China to improve blood circulation, and also to treat angina (Geng Junying). But Cassia oil was one of the precious perfumes, an ingredient of the holy oil of the Old Testament. It was also used as part of the incense burnt in the Temple (Zohary). In much the same way as the oak in European mythology, some of the earlier peoples of India regarded the Cassia as the origin of human life (Porteous. 1928).

Medical management

Selection criteria for treatment with methotrexate are usually strict and they are listed in Table 14.3. Two randomized trials which compared methotrexate to surgery showed that only one third of all tubal ectopics satisfied these criteria and were suitable for medical treatment with the success rates between 65 and 82 35,36 . The overall contribution of methotrexate to successful treatment of tubal ectopic was between 23 and 30 while all other women required surgery. The other problem with methotrexate is the risk of tubal rupture and blood transfusion, which occurred significantly more often in women receiving methotrexate compared to those who had surgery, this emphasizes the need for a very close follow up 35 . There is also a risk of side effects such as gastritis, stomatitis, alopecia, headaches, nausea and vomiting. Disturbances in hepatic and renal function and leukopenia or thrombocytopaenia may also occur.

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