Hormones are very important in the aging process because some of their levels decrease. Therefore it can be hypothesized that hormone replacement therapy might slow aging. In light of the increasing interest in rejuvenating treatments that can yield good results, hormone replacement therapy has dawned in scientific circles. This review examines the roles of growth hormones melatonin and dehydroepiandrosterone, as well as those of bioidentical hormones in rejuvenation. The authors have also sought to evaluate the results of studies on hormone replacement therapy, considering the risks and benefits of using those hormones, which are seen as the "fountain of youth."

Keywords: HORMONES; REJUVENATION; GROWTH HORMONE; MELATONIN; DEHYDROEPIANDROSTERONE.

Introduction: A poorly described aspect of onychocryptosis – the main cause for nail unit surgeries – is how to perform its surgical closure. The present article describes a new technique denominated alpha stitch that allows the straightening out of the nail fold by positioning it at or below the nail plate’s level.
Objective: To demonstrate the benefits of the alpha stitch surgical closure technique in the surgical matricectomy for onychocryptosis.
Methods: Twenty patients with onychocryptosis grades II and III underwent surgical matricectomy and were followed up for six months. The surgical closure was performed using the alpha stitch technique.
Results: A total of 27 lateral nail folds were operated, with 81.8% yielding the expected result, and 18.1% presenting uncertain outcomes.
Conclusions: The alpha stitch allows the proper healing of the straightened out nail fold, which is positioned at or below the nails plate’s level, with good results, fast recovery, minimal morbidity and a small number of recurrences. The technique can also be used in surgical procedures involving other nail disorders.

Keywords: NAIL DISEASES; AMBULATORY SURGICAL PROCEDURES; SURGICAL PROCEDURES, MINOR; SUTURE TECHNIQUES.

Onychomycosis is a very common condition in Brazil and one whose current treatments yield low cure rates, potential adverse effects, and drug interactions that limit their use. Recent studies have demonstrated laser therapy as a new, safe, and effective treatment option. This treatment was performed in 12 patients (with a total of 20 affected nails), with 3 application sessions of 1,064nm long pulse Nd:YAG laser, in two-week intervals. The results corroborate the current data of good clinical response and safety.

Keywords: ONYCHOMYCOSIS, LASERS, ADVANCED TREATMENT.

Keywords: GLOMUS TUMOR; ULTRASONOGRAPHY, DOPPLER, COLOR; AMBULATORY SURGICAL PROCEDURES.

Introduction: With several treatment options available - including laser - atrophic acne scars are nonetheless difficult to treat. The use of fractional technology results in dermal-epidermal ablation columns, interspersed with intact skin islands, allowing selective thermal damage, effective treatment and faster recovery. The objective of the present study is to demonstrate the efficacy and safety of fractional laser use in the treatment of atrophic acne scars among the Brazilian population. Methods: An open, prospective, interventional study was carried out with patients with acne scars, without restriction regarding the gender and skin phototype. Exclusion criteria were: pregnancy, breast-feeding, presence of infections or blood dyscrasias and the use of anticoagulants. The evaluation was performed by comparing texture, appearance, and relief as observed in digital photographs. Results: Of the 30 selected patients, 24 were included in the study. An improvement was noted in the parameters evaluated in the cases that underwent fractional laser (CO2, Erbium-Glass or both). Individuals who underwent multiple treatments showed better results. All those treated with 4 sessions had improvements greater than 50%. Post-inflammatory hyperpigmentation was detected in 7 of the 24 treated patients. Conclusion: The present study showed that, when using appropriate parameters and adequate care, fractional laser-assisted resurfacing is an effective and safe method for treating atrophic acne scars in the Brazilian population.

Keywords: ACNE VULGARIS; CICATRIX; LASERS; CHEMEXFOLIATION

In dermatology, facial fillers are of great importance in the treatment of wrinkles and expression lines, their use being for aesthetic purposes. Their application is usually carried out with needles, which can lead to complications during the procedure. Among them hematomas, ischemia, necrosis, and even blindness. In recent years however, the application of fillers with microcannulas has revolutionized the techniques of application, in this way avoiding the occurrence of complications during and after the procedure. The present paper is aimed at clarifying the nomenclature, characteristics, and dimensions of the cannulas.

Keywords: NEEDLES; HYALURONIC ACID; TECHNICAL SPECIFICATIONS

The subungual melanoma is considered a rare subtype of melanoma. It emerges in the ungual matrix, however can involve all components of the nail apparatus. This tumor is often underdiagnosed, which leads to a delay in proper treatment, resulting in a poorer prognosis. The final diagnosis should be confirmed by histology. Conservative surgery in the treatment of subungual melanoma (when in the early stages) is presently recognized by the international literature and offers an effective and curative treatment to the patient, preserving the functional ability. This article describes a case of subungual melanoma successfully treated with conservative surgery, with the preservation of the hallux.

Keywords: MELANOMA; NAIL DISEASES; AMBULATORY SURGICAL PROCEDURES

Subungual squamous cell carcinoma is a rare condition, and its diagnosis is often late. The clinical presentation is atypical and simulates other benign conditions, such as verruca vulgaris, onychomycosis and trauma-induced nail dystrophy. Although it is an unusual entity, we should be attentive to its early diagnosis, considering the biopsy in the chronic nail lesions refractory to treatments. We present five cases of subungual squamous cell carcinoma, in which pain was the most prevalent symptom, and their possible association with trauma and HPV infection should be considered.

Keywords: CARCINOMA, SQUAMOUS CELL; NAILS; NAIL DISEASES

We report a case of pigmented Bowen's disease in the periungual region treated with Mohs micrographic surgery. Bowen's disease is a squamous cell carcinoma in situ. Although it is a common condition, the pigmented form is rarer, with periungual localization being even more uncommon. Pigmented Bowen's disease presents clinically as a non-uniform, desquamous or verrucous brownish lesion, and it is often confused with other diseases (pigmented actinic keratosis, seborrheic keratosis, melanoma, basal cell carcinoma, nevus). Dermoscopy is of great diagnostic and therapeutic value and is important in the evaluation of recurrence.

Keywords: BOWEN'S DISEASE; CARCINOMA, SQUAMOUS CELL; DERMOSCOPY

Alopecia areata is a relatively common autoimmune condition. It has an unpredictable course and its etiology has not yet been fully elucidated. Its treatment must be individualized, and aims at suppressing the phase of activity of the disease. Thus, many alternatives are available; however, none of them have been curative or preventive so far. We report the cases of two patients, aged 18 and 43 years, diagnosed with alopecia areata, who underwent topical immunotherapy with diphencyprone, and obtained different results. The application procedures, the results obtained and the clinical follow-up are described.

Keywords: THERAPEUTICS; IMMUNOTHERAPY; ALOPECIA AREATA; AUTOIMMUNE DISEASES

Alopecia areata can cause significant psychological problems due to the unpredictable nature of the disease, which results in hair loss. We report the case of a patient presenting alopecia areata of difficult treatment, with satisfactory response after intralesional applications of corticosteroid, but that showed recurrence and atrophy; it was then decided to perform intralesional applications of platelet-rich plasma, with improvement of the condition. The technique showed good results in this isolated case, proving to be a potentially useful therapy in the treatment of alopecia areata.

Keywords: ALOPECIA AREATA; ADRENAL CORTEX HORMONES; PLATELET-RICH PLASMA

Case report of a 16-year-old female patient with diagnosis of subungual exostosis in the right hallux with clinical and histopathological diagnosis, submitted to total excision of the lesion and follow-up for five years with excellent aesthetic result.

Keywords: EXOSTOSES; BONE NEOPLASMS; DERMATOLOGIC SURGICAL PROCEDURES

Basal cell carcinoma corresponds to the majority of malignant cutaneous malignancies in Brazil, predominating in middle-aged white individuals, mainly affecting the upper two-thirds of the face and occurring due to several etiological factors. The ideal treatment consists of complete removal with free lesion margins. For better functional and aesthetic results, reconstruction of the surgical wound with flaps or grafts may be necessary. Two types of reconstruction are described in patients with double surgical defects on the face, close to each other: one with a single rotation flap and another with a double rotation flap, also called Yin-Yang.

Keywords: SKIN NEOPLASMS; CARCINOMA, BASAL CELL; SURGICAL FLAPS

INTRODUCTION: Facial aging occurs due to loss of facial volume and altered skin texture. Hyaluronic acid fillers are the main non-surgical tools used to recover the volume loss, since, besides filling, they act as skin remodeling.
OBJECTIVE: To describe a new facial rejuvenation technique with hyaluronic acid: delta V lifting. Through this technique, we seek not only to fill in areas with volume deficits but mainly to stimulate tissue regeneration through the interaction between hyaluronic acid and superficial subcutaneous tissue, the main application plan.
METHODS: A retrospective observational study assessing 200 patients treated with 2 ml of hyaluronic acid at a concentration of 23 mg/ml in a single therapy session with the delta V lifting technique.
RESULTS: 87% of patients rated the result as “great improvement” and 13% as “good improvement” according to the Global Aesthetic Improvement Scale. Also, they all reported progressive improvement of the result until the moment of return within one month after the procedure.
CONCLUSIONS: The delta V lifting technique was effective in bringing satisfactory aesthetic results with a minimal amount of hyaluronic acid. The interaction between hyaluronic acid and adipose tissue is believed to be involved in optimizing results.

Keywords: Hyaluronic acid; Rejuvenation; Techniques

This review article reports the scientific data available on La Roche-Posay thermal water and clarifies its mechanisms of action, indications, and clinical benefits. Clinical studies and genomic evaluation of the skin microbiome have shown that La Roche-Posay thermal water improves the skin microbiome’s diversity and reduces the severity of skin lesions in inflammatory dermatoses, such as atopic dermatitis and psoriasis. Therefore, it justifies the use of selenium-rich water in topical formulations to prevent or treat skin diseases and as an adjunct to increase dermatological patients’ quality of life.

Keywords: Balneology; Cosmetics; Mineral Waters; Selenium; Skin; Thermal Water

The recurrent squamous cell carcinoma (SCC) needs an appropriate approach to decrease the risk of recurrences. We report the case of a man diagnosed with SCC on the left temporal region treated by conventional surgery, with infiltration and erythema in the scar area. Reflectance confocal microscopy suggested the diagnosis of recurrent SCC confirmed by histopathology. New surgery and traditional intraoperative frozen section were performed. After two months, the patient had a new relapse, finally treated with Micrographic surgery without new involvement. This article highlights the importance of micrographic surgery in treating SCC, aiming to decrease new recurrences.

Keywords: Skin Neoplasms; Mohs Surgery; Carcinoma, Squamous Cell

We present a case of delayed-type hypersensitivity to hyaluronic acid (HA)-based filler on the face following the Pfizer booster in a Moderna-vaccinated individual. It is the first known case of treatment of the delayed-type hypersensitivity reaction with hyaluronidase following Covid vaccination. Hyaluronidase is a viable option to treat this reaction, particularly for patients who may not benefit from systemic treatment options. With an anticipated fourth round of vaccine boosters on the horizon, there may be an increased incidence of cutaneous adverse events, including the reaction discussed.

Keywords: COVID-19; SARS-CoV-2; Inflammation; Dermal fillers; Hypersensitivity, Delayed; Hyaluronic acid

Cutaneous angiosarcoma is a rare cancer with a poor prognosis that affects mainly elderly men. It is related to chronic exposure to sunlight, chronic lymphedema, and procedures using radiation. We report a case of a 62-year-old man with a progressively growing violaceous tumor in the left temporal region. Dermoscopy showed erythematous areas of different shades, pseudo-follicular openings structures, and rosettes. The biopsy and the immunohistochemical study confirmed the diagnosis of cutaneous angiosarcoma. The patient is currently undergoing chemotherapy treatment in the oncology service with significant improvement of the lesion.

Keywords: Dermoscopy; Hemangiosarcoma; Skin neoplasms

Damage caused by chemical, physical, and thermal procedures can disrupt the natural morphological characteristics of the hair, causing the strands to become dry, dull, weak, and brittle. The objective of this article was to update dermatologists on the methods available for assessing hair shaft damage. The main laboratory (microscopy, tensile strength, structural assessment, physical and mechanical properties) and outpatient (diagnostic tests and patient history) diagnostic methods for evaluating the quality of the hair shaft are presented.

Keywords: Hair; Dermatology; Keratins.

The 1064-nm Nd:YAG laser in Q-switched and micropulsed modes has been used in rejuvenation, pore reduction, skin texture improvement, and wrinkle reduction. The aim of this study is to evaluate the combination of 1064-nm Nd:YAG laser in micropulsed and Q-switched modes in the same session for global facial treatment. Thirty female patients underwent six treatment sessions every two weeks. Three blinded dermatologists evaluated the results through clinical photographs and Visia^® or Focco^® images obtained before and 30 days after the last treatment session. The parameters of interest were solar melanosis, telangiectasias, wrinkles, dilated pores, melasma and skin texture. Three patients had face biopsies before and 30 days after the end of treatment. Most patients showed improvement in all evaluated parameters, except for two patients who had worsening of melasma. An increase in collagen was observed in two of the three histological examinations performed after treatment. The combination of laser modes studied herein offers a safe treatment that can improve wrinkles, skin texture, and laxity with minimal downtime.

Keywords: Lasers; Skin Aging; Rejuvenation