Fundaments: chemical peelings represent damage to the skin or an accelerated form of exfoliation induced by caustic agents, having several indications; they are classified as superficial, medium-depth, and deep. The number of publications on the subject is elevated, but critical analysis are necessary to achieve objective conclusions.
Objectives: verifying the efficacy and safety of chemical peelings through a systematic review of the literature.
Methods: from January 5 to February 15, 2009, searches in three data bases were performed: Cochrane Library, MEDLINE (1966 – 2009), and LILACS. Criteria for study selection were established, with emphasis on methodological quality. The best comparative or controlled studies were described individually. The remaining review articles and descriptive and experimental studies were analyzed together.
Results: we found 414 publications and reviewed 165; 129, or 78%, corresponded to descriptive (82), review (37), or experimental (10) studies. The remaining 36 (22%) represented controlled or comparative studies, of which 19 (53%) were randomized and only four had the ideal delineation, i.e., placebo-controlled, randomized, and blind. Agents mentioned more often included: glycolic acid, salicylic acid, trichloroacetic acid (TCA), and phenol. Few studies evaluated the histologic effects and/or used quantitative parameters to determine their efficacy and safety.
Limitations: the heterogeneity of the studies; few studies with good methodological quality.
Conclusions: there are no doubts related to the the benefits of chemical peelings, which are demonstrated more by the clinical experience than by well-conducted and reproducible studies that are fundamental for the elaboration of new conduct guidelines.

Introduction: The botulinum toxin is a valuable option for the treatment of dynamic facial wrinkles. The Lanzhou botulinum toxin type A (LBTX-A) was introduced in China in the early 90’s and approved in Brazil in 2003. Objective: Evaluate the efficacy and tolerability of LBTX-A for the cosmetic treatment of dynamic wrinkles of the upper face. Material and Methods: In a prospective, open-label, multicenter study, 110 subjects of both sexes (aged from 25 to 65 years) were treated with a total of 53 U of LBTX-A each, distributed in fi fteen sites in the frontal, corrugator, procerus, orbicular ocular lateral muscles. The patients were reviewed 7 times within 180 days. Efficacy was assessed by electromyography, photographic analysis and the investigator’s and patient’s opinions. Tolerability was assessed by the incidence of adverse events.Results: Two weeks post-injection, 94% of the treated patients considered the result as good or excellent. Results lasted 90 days in most cases. After injection, most patients reported mild or no pain, and minimal and reversible side effects as facial edema (6 patients), stuffiness feeling (3 patients) and eyelid ptosis (2 patients). Conclusions: We conclude that LBTX-A is effi cient and well tolerated for the treatment of dynamic facial lines.

Keywords: BOTULINUM TOXIN TYPE A, INJECTABLES, WRINKLES, FACIAL DYNAMIC LINES

The aim of this report is to highlight and warn cosmetic dermatologists about the need of a complete and careful examination of any patient that looks for our evaluation, even when they ask only for cosmetic treatments and/or procedures. This is nowadays a very important concern as people and some physicians are involved in an exaggerated search for eternal beauty. This represents a very profitable practice for dermatologists and plastic surgeons. But we should never forget that a dermatologic consultation can be an opportunity to discover an unnoticed dermatosis or signs related to systemic diseases.

Keywords: ANEURYSM, CAROTID ARTERY, EXTERNAL, ESTHETICS

Background: It has been proposed that thermal water can be used as an anti-inflammatory and mild hydrating agent in the preparation of skincare formulations. However, due to the complex process and strict quality control associated with its extraction from the ground, an oligoelements complex that mimics the effects of thermal water on skin is being used instead. Objective:To evaluate the stability and effects of thermal water and its oligoelements in the formulation of cosmeceuticals, as well as their immediate effects on the skin. Methods: An aqueous gel, a gel cream and an emulsion were prepared with and without the addition of oligoelements and submitted to physical stability analysis.The more stable preparations were tested on study subjects’ forearms. The objective evaluation of the effects on the skin’s texture and hydration was conducted according to biophysical and image analysis techniques before, immediately after and 2 hours after application. Questionnaires assessed participants’ subjective perceptions of the various formulations.The possible anti-inflammatory effects were not evaluated. Results: The effects of the more stable gel formulations were assessed on 15 study subjects.The gels increased the content of the aqueous corneum stratum, while the waters only produced an improvement of the skin’s texture. Conclusion: The results obtained from the subjective and objective analyses coincided and suggested the usefulness of the oligoelements complex in cosmeceutical products for moisturizing the skin.

Keywords: TRACE ELEMENTS, COSMETICS, WETTING AGENTS

Introduction: The use of dermal filling techniques for soft tissue augmentation has greatly increased in recent years.Hyaluronic acid is one of the most used temporary dermal fillers in the treatment of facial wrinkles, furrows, and folds due to its effectiveness and safety. Objective: To evaluate the efficacy and safety of Perfectha®, a new hyaluronic acid filler, for nasolabial folds and lip correction. Methods: Open, multicenter study comprising 87 women. Efficacy was evaluated by the Global Aesthetic Improvement Scale and the Wrinkle Severity Rating Scale. Safety was evaluated through observation and the reporting of side effects. Results: One week after the injection of the filler, improvement in nasolabial folds and lips was observed in 86% and 89% of the women,respectively. Mild or moderate transient inflammatory reaction and ecchymoses occurred in 15% and 9% of patients, respectively, mainly in nasolabial folds. Two patients presented labial herpes simplex after treatment of the lips.The good results were maintained in 76% and 57% of women for nasolabial folds and in 72% and 45% of women for lips after 3 and 6 months, respectively. Conclusion: Perfectha® was effective and safe for these indications.

Keywords: HYALURONIC ACID, SKIN, INFLAMMATION

Introduction: The interest in minimally invasive procedures for facial rejuvenation fos- tered the development of the cutaneous filling technique to treat wrinkles and folds. Hyaluronic acid is one of the most popular fillers,as it is considered the least immuno- genic and safest in its category.
Objective: To evaluate and compare the efficacy,safety and duration of effect after the application of the filler CRMDex® in nasolabial folds,in one session versus two sessions.
Methods: Open clinical trial,with the randomization of nasolabial folds and comparison between two techniques.Women,aged 30 to 60 years old (n=30),presenting with accen- tuated symmetric nasolabial folds of minor to moderate degrees were subjected to intra- dermal injections of the same volume of CRMDex®.Three independent dermatologists evaluated the effectiveness of the treatment using the Wrinkle Severity Rating Scale.
Results: There was no difference in treatment effect for one versus two sessions.Both groups achieved a reduction of at least one degree according to the severity scale,and had a similar duration of the filling effect.The more frequent local adverse events (pain,ery- thema and edema) occurred during the injection and improved spontaneously.
Conclusions: There was no improvement in therapeutic response with the injection of smaller volumes per session.It seems that higher filler volumes may increase the risk of local adverse events.

Keywords: HYALURONIC ACID, BIOLOGICAL REACTIONS, DERMIS, CICATRIX

Although the term cellulite is inadequate, since it does not refer to cellular subcutaneous tissue inflammations or infections, it is conventionally used to describe a female condition that is characterized by a wavy appearance of the skin''''''''s surface in some areas of the body. It constitutes a frequent complaint and an important concern for the majority of women and, due to its complex, multifactorial, and not completely known etiopathogenesis, there is still no effective and definitive treatment. Consequently, many therapeutic proposals, either based on poor quality publications or lacking sufficient scientific evidence, have been introduced.Topical treatments are not effective, though some can be indicated as adjuvant therapies.There is currently no technology able to correct the structural alterations of the female adipose tissue and deep dermis. That status clearly depends on the development of technolo gies based on the selective photothermolysis principle aimed at treating superficial hypodermal fat and the deep dermis.This article presents a review of the epidemiology, etiopathogeny, histology, clinical classification, and methods for the diagnosis, evaluation, and treatment of cellulite.

Keywords: CELLUTITIS, CELLULITE/HISTOPATHOLOGY, CELLULITIS/TREATMENT

Keloids are an excessive proliferation of dermal fibroblasts following a skin injury, which are difficult to treat. Isolated measures present a low rate of efficacy, while combined techniques lead to better results.A case of keloidal scar in the pubic region after a myomectomy surgical incision is described. The scar was divided into three parts, each of which was treated with intralesional injections of 5- fluorouracil, corticosteroid and 5-fluorouracil combined with corticosteroid.

Keywords: SCAR, KELOID, THERAPY

INTRODUCTION: The Brazilian scientific production in Dermatology in the international scenario was verified by scientometrics (Sociology segment on quantitative aspects of science).
OBJECTIVE: The insertion of Brazil in the international scientific production scenario can and should be conducted from a more strategic perspective, and it is necessary to observe the production of documents indexed in Scopus in the Dermatology area and related topics in a more detailed way.
METHODS: Through exploratory, inductive, quantitative, and qualitative research on the Scopus platform – a digital platform comprising more than 25 thousand scientific articles and analytical tools to extract results and trends in the field of research, it was possible to obtain quantitative data on Brazilian scientific production in General Dermatology and six prominent dermatoses.
RESULTS: It was possible to analyze and point out the most prominent dermatoses currently in the literature and the related authors, compare Brazilian data with those from other countries that stand out in the scientific literature in Dermatology, and elaborate and justify effective strategies for the international insertion of Brazilian Dermatology scientific production.

Keywords: Impact production; Dermatology; Database; Science