Introdução: Skin tumors are common and may present irregular growth, requiring resections with diverse geometric shapes. Many descriptions have been reported. Objective: To describe a triangle-shaped excision technique followed by primary closure in the treatment of skin cancer. Methods: Patients (n = 11) with tumors of between 1.8 and 5.7 cm located in areas that favored the use of equilateral triangle-shaped incision and primary closure were studied. Results: All patients had their surgical closure in the shape of a “Y.”Two cases of partial dehiscence of the suture were observed in the post-operative period. Conclusions: The surgical technique of primary closure of triangular excisions of skin allows effective control of the surgical margins and leads to good cosmetic results, preserving the surrounding tissue.

Keywords: MEDICAL ONCOLOGY, AMBULATORY SURGICAL PROCEDURES, SKIN NEOPLASMS

Introduction: Melasma is an acquired hyperpigmentation that affects primarily the face and occurs more frequently in women with darker skin. There are several therapies for treating melasma, however its long-term management remains a challenge. Objectives: To evaluate fractional Erbium:YAG laser''''''''s clinical effectiveness in treating refractory melasma through the histological analysis of usual characteristics and the amount of epidermal and dermal pigment before and after treatment. Methods: Ten patients underwent three fractional Erbium:YAG laser sessions at monthly intervals. Biopsies were obtained before and after treatment. Subjective and objective clinical evaluations were carried out before, during, and after treatment. Results: No statistical improvement in Melasma Area Severity Index score was observed during the treatment. Hyperpigmentation of the basal layer and pigment deposition in the dermis was observed histologically. In seven cases, there was a reduction in the degree of hyperpigmentation in the epidermis, which was not statistically significant. Conclusions: The treatment of melasma with fractional Erbium:YAG laser was ineffective. Nonetheless, a decrease in Melasma Area Severity Index scores and in the degree of hyperpigmentation of the epidermis was detected, suggesting that fractional Erbium:YAG laser can clinically and histologically improve the degree of hyperpigmentation of the skin.

Keywords: MELANOSIS, LASERS, ERBIUM

Hyaluronic acid is the currently most used filler in dermatology due to its low risk of adverse events. The objective of this study is to report a case of granulomatous reaction after filling with two types of hyaluronic acid, in the perioral region and in the nasolabial folds. A female patient with rheumatoid arthritis treated with leflunomide presented onset of symptoms 30 months after filling. Autoimmune diseases may facilitate the occurrence of complications and should be followed carefully before filling with hyaluronic acid. As already reported with the use of interferon and omalizumab, granulomatous reaction to fillers may occur after use of leflunomide.

Keywords: HYALURONIC ACID; GRANULOMA; RHEUMATOID ARTHRITIS; FOREIGN-BODY REACTION

Sarcoidosis is a non-infectious granulomatous disease of unknown etiology in which environmental, infectious, immunological, and genetic factors appear to be correlated. Clinical manifestations can occur in any organ, however there is predominance in the lungs and in intrathoracic lymph nodes. The cutaneous involvement of the disease occurs in roughly 25% of cases, with cutaneous filling procedures figuring as a potential trigger. The authors of the present article report a case of a patient who had granulomatous lesions on the face following cutaneous filling with hyaluronic acid. In the investigation of cutaneous lesions, the patient presented diagnostic criteria for sarcoidosis, with extensive pulmonary involvement.

Keywords: sarcoidosis; granuloma; hyaluronic acid

Microneedling has traditionally been used to induce collagen formation. Scalp microneedling has been seen to stimulate the capillary cycle and anagen phase, but studies demonstrating histopathological changes after this procedure are lacking. Here we present the case of a 37-year-old woman with a 15-year history of female pattern alopecia, with diffuse hair thinning prominent in the frontoparietal region and hair miniaturization seen in dermoscopy. The patient’s condition remained stable for seven years with use of spironolactone and topical minoxidil. The patient underwent three scalp microneedling sessions at monthly intervals. Histopathological analysis was conducted before the sessions and one month after the last session. Despite slight clinical and dermoscopic improvement, the alopecia pattern remained the same, without significant changes in follicle count after the interventions. Neither inflammation nor fibrous tracts were observed after the procedure. The histopathological analysis is essential to assess the safety of scalp microneedling in the short and long term, investigate signs such as inflammation and fibrosis, and determine the effectiveness of this procedure in treating alopecia. Studies with a more significant number of cases are necessary.

Keywords: Alopecia; Pathology; Treatment outcome