Topical photodynamic therapy (TPT) is a well-established therapeutic modality in the treatment of non-melanoma skin cancer. It is based on light-activated chemical reaction in the presence of oxygen. In recent years, this therapy has been used in cosmiatric dermatology, and studies on the mechanisms of TPT action in dermal remodeling of the photodamaged skin have been reported. This review addresses procedures with different light sources and photosensitizers, as well as clinical and collateral effects of this therapy in the treatment of photoaging.

Keywords: PHOTODYNAMIC THERAPY, PHOTOSENSITIZER, PHOTOAGING, REJUVENATION, COLLAGEN, DERMIS

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.

Herpes zoster outbreaks following minor procedures have been documented recently in literature. Since the use of botulinum toxin is nowadays spread in several medical areas for different purposes, it is crucial to study its side effects and complications. Literature review revealed 65 cases of zoster reactivation following minor procedures, and three cases related to BTA injections (two for facial lines treatment and one for chronic migraine). In our case, a 43 year old healthy woman had herpes zoster on the face and scalp after receiving BTA injections for cosmetic purpose, with complete recovery after anti-viral treatment.

Keywords: HERPES ZOSTER OPHTHALMICUS; HERPES ZOSTER; BOTULINUM TOXINS, TYPE A; DERMATOLOGIC SURGICAL PROCEDURES