Introduction: Facial paralysis triggers asymmetries and other functional and aesthetic facial changes, which lead to significant physical and psychological disorders. Botulinum toxin type A is a safe, effective, and well-tolerated therapy, making it a good option for treating those conditions. Objective: To demonstrate the clinical improvement and the degree of satisfaction among patients bearing facial asymmetries and dyskinesias, who have been treated with botulinum toxin type A injections performed by dermatologists. Methods: Patients with facial asymmetries and dyskinesias were selected between January 2011 and December 2013, to receive botulinum toxin injections aimed at reducing muscle activity on the normal side of the face (in cases of facial hemiparesis) or directly into the affected muscles in cases of dyskinesias. The clinical evaluations and photographic records in static and dynamic positions were carried out on the days of the first application (D0) and fifteen days after (D15). Each patient was rescheduled for a future session within120 days. Results: There was clinical improvement with reduction of asymmetries and dyskinesias verified at the beginning of treatment following application of the toxin. A significant improvement in the patients' quality of life, with a positive impact in different areas of their personal lives, could be noticed. Conclusions: Treatment with botulinum toxin type A, performed by dermatologists with previous experience in the management of this procedure in other conditions, proved to be an important alternative in the treatment of asymmetries and facial dyskinesias.

Keywords: FACIAL ASYMMETRY; FACIAL PARALYSIS; QUALITY OF LIFE; BOTULINUM TOXINS, TYPE A.

Pachydermodactyly is a rare, benign and acquired form of digital fibromatosis characterized by the thickening of soft tissues in the lateral regions of the proximal interphalangeal joints, typically of the digiti II, III and IV of both hands. In most cases it is associated with repeated digital microtraumas. The authors of the present article report the case of a 22-year-old patient with a typical clinical presentation of the condition. The treatment with triamcinolone injections led to a partial reduction of the thickening, in addition to hypopigmentation and hyperemia, meaning it was an unfavorable option. Although rare and benign, this typical clinical condition deserves attention, and unnecessary and costly investigations, as well as inappropriate treatments should be avoided.

Keywords: HAND DERMATOSES; SOFT TISSUE NEOPLASMS; FINGERS; YOUNG ADULT; GLUCOCORTICOIDS; CUMULATIVE TRAUMA DISORDERS; FIBROMA; TREATMENT OUTCOME