Conventional Photodynamic Therapy (c-PDT), approved in Brazil since 2006 for non-melanoma skin cancer, is a well-established treatment worldwide. The evolution of PDT, in the last 10 years, includes its use in other indications, its association with techniques that promote increased photosensitizer permeation and use of daylight instead of artificial light. This new method, which uses daylight, was approved in Brazil in 2014 for the treatment of actinic keratosis and field cancerization, with the benefit of maintaining c-PDT's efficacy without adverse events.

Keywords: PHOTOCHEMOTHERAPY; LIGHT; SKIN NEOPLASMS; KERATOSIS, ACTINIC

Introduction: Daylight photodynamic therapy (PDT) is a recent therapeutic modality for actinic keratoses and field cancerization. The association of techniques to PDT for transepidermal delivery of the photosensitizer is a new option for the treatment of photodamaged skin with actinic keratosis.
Objective: To evaluate the clinical efficacy and the adverse events of photodamaged skin treatment through the transepidermal drug delivery and daylight-PDT.
Methods: Seven patients with phototype II and III, aged 60-73 years, with photodamaged skin, with and without actinic keratoses, were submitted to the association of methods (CO₂ laser, micro-abrasion or microneedling) and daylight-PDT. Two sessions were performed with two weeks intervals. MAL was applied after micro-abrasion and after CO₂ laser, but before the micro-needling. All patients were exposed to daylight for a period of 2 hours. Clinical evaluations were performed before, 15 days and three months after treatment.
Results: CO₂ laser associated with daylight-PDT was more effective in overall improvement of the skin (texture, pigmentation and wrinkles). Microneedling associated with daylight-PDT was effective in improving texture and pigmentation. Micro-abrasion proved to be effective when combined with microneedling. Excellent improvement of actinic keratosis lesions was achieved with all associations of techniques. Adverse events were transient and more intense with the association of CO₂ Laser.
Conclusion: Association of TDD with daylight-PDT was effective in the treatment of photodamaged skin and safe in all protocols.

Keywords: PHOTODYNAMIC THERAPY, PHOTOSENSITIZER, LIGHT, ACTINIC KERATOSIS, PHOTOAGING.

Nevus lipomatosus cutaneous superficialis is an uncommon dermatosis in which the adipose tissue is present ectopically in the dermis.This condition is clinically divided into two variants: classical and solitary.The first is characterized by soft, pedunculated, cerebriform, skin-colored or yellowish papules or nodules, mainly involving the pelvic region.The latter is observed as a solitary or sessile papule. Treatment with surgical excision is usually enough. Nevus lipomatosus cutaneous superficialis may be associated with other conditions such as multiple lipomas, as in our case.

Keywords: Nevus; Dermis;Adipocytes; Lipoma