Hair transplantation is one of the therapeutic options for the treatment of cicatricial alopecia; however, the adherence between the scalp and the periosteum hinders its execution and compromises the final result. The use of adipose tissue grafting, as fat fragments harvested from the infra-gluteal crease, at least 30 days before the transplantation to optimize the results, is proposed.

This is case report of lichen planus pigmentosus associated with classical lichen planus treated with intense pulsed light. Intense pulsed light technology has been used successfully for removal of various benign pigmented skin lesions and, in this rare case, it has proved its effectiveness.

Keywords: LICHEN PLANUS, PHYSICOCHEMICAL TREATMENT, PHYSICAL-CHEMICAL TREATMENT, HYPERPIGMENTATION

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

Keloids are dermal fibroproliferative benign disorders that develop at the site of cutaneous injury, due to an imbalance of the mechanisms that control tissular repair and regeneration. The pathogenesis is not well understood, however it is postulated that an imbalance between anabolic and catabolic factors occurs in the healing process, resulting in overproduction of collagen. There are several treatment modalities, nevertheless recurrence rates are high. The objective of the present paper is to describe five cases of keloid in the ear lobe that showed a good response to a combination therapy: excisional surgery, corticosteroid injection, and pressure device.

Keywords: KELOID; AMBULATORY SURGICAL PROCEDURES; ADRENAL CORTEX HORMONES; PRESSURE

Introduction: Introduction: Not focused ultrasound is a noninvasive alternative to improve body contour.
Methods: It's reported five cases treated with eight weekly sessions of not focused ultrasound on the abdomen.
Results: The treatment did not affect the routine of patients; it was comfortable and safe for most. There was a reduction in the thickness of the fat layer evaluated by ultrasound and in the circumferential measures in all patients, with clinical improvement evidenced in the photographic documentation especially in patients with lesser thickness of subcutaneous.
Conclusion: The device was safe, and was shown clear reduction in abdominal subcutaneous tissue.

Keywords: ADIPOSE TISSUE; ULTRASONIC THERAPY; ULTRASONOGRAPHY; ABDOMINAL SUBCUTANEOUS FAT

INTRODUCTION: Liposuction is one of the most performed cosmetic surgeries in the world. Its mortality varies from 2,6 (6) to 19 (7) deaths/100 thousand. Data were obtained through questionnaires from medical societies (4-10) and retrospective data from forensic medicine institutes. However, both methods present flaws: the first due to professional bias and information duplicity, and the second due to the lack of data on the cause of death.
OBJECTIVES: To identify the number and causes of liposuction deaths through documentary records of news published in the press and study of death certificates.
METHODS: This is a documentary, descriptive-quantitative study. Knowing the deceased patients’ names and the cities where the death occurred, we obtained death certificates from the civil registry offices.
RESULTS: We surveyed 102 deaths and 86 death certificates. Pulmonary thromboembolism was the most cited cause of death in 17.44%, 45% on the same day of surgery. 53.6% of surgeries were performed in hospitals, and 61.76% of them, alone. Most physicians responsible for the surgeries were plastic surgeons (74%). Still, none were registered as a specialist in Dermatology at the Federal Medical Council. In 12.98% cases, doctors who participated in the surgery filled out the death certificate.
LIMITATIONS: The ethical impossibility of accessing medical records and the inadequate filling of death certificates.
CONCLUSION: The compulsory notification must be established by law to create a databa

Keywords: Liposuction; dead.

Reconstruction of the scalp after suspected skin lesions excision is a challenge. Tamir et al. described the three-point-advancement (Mercedes flap) to close circular wounds. These tissue advancements create triangles in the edges, which must be removed. However, extensive lesions do not allow the three points to join, preventing central closure. Valesky et al. described the central closure using total skin grafts made from the triangles. The literature lacks these case reports, making it difficult to incorporate them into surgical practice. We applied this modified technique to five patients with good aesthetic and functional results.

Keywords: Scalp; Surgical flaps; Plastic surgery procedures; Skin transplantation; Skin neoplasms

Schwannomas are benign nerve sheath tumors derived from Schwann cells. The sites most often involved are the head and neck (25-48%), with only 1% occurring in the oral cavity. Most schwannomas occur in adult individuals between the third and fifth decades of life. Lip involvement is extremely rare during childhood and adolescence, with few reports in the literature. The prognosis is favorable and surgical excision is the treatment of choice. We report an interesting case of upper lip schwannoma in an adolescent with successful surgical treatment and no evidence of recurrence after 4 years.

Keywords: Neurilemmoma; Lip; Neoplasms; Schwann Cells.

BACKGROUND: Keloids are abnormal proliferations of scar tissue that do not regress spontaneously. Studies on the quality of life in patients with auricular keloids are rare. This condition is a frequent complaint, occurring in a highly visible area.
OBJECTIVE: To assess the impact of auricular keloids on the quality of life of affected individuals, demonstrating that psychological and physical symptoms are common and significantly affect patients.
METHODS: This is a cross-sectional, observational analytical study conducted in São Paulo. Patients with auricular keloids completed the QualiFibro questionnaire, a validated tool specific for assessing quality of life in individuals with auricular keloids.
RESULTS: Seventeen patients with auricular keloids were analyzed. The questionnaire revealed that most participants experienced some degree of physical impairment (76% reported itching, and 58% reported pain in their keloids). All participants showed psychological distress to varying degrees.
DISCUSSION: Patients often associate their keloids with feelings of shame and low self-esteem. We believe that raising awareness of the negative psychological impact of this condition can help dermatologists better understand these patients’ concerns and provide empathetic support, aiming to make them feel more comfortable in their own skin.

Keywords: Keloid; Quality of Life; Ear Auricle.

INTRODUCTION: HIV-associated facial lipoatrophy can impair social relationships, treatment adherence, and mental health, frequently leading to depression. Correction of facial lipoatrophy is associated with significant improvement in quality of life.
OBJECTIVES: To evaluate the efficacy of poly-L-lactic acid (PLLA) in correcting HIV-related facial lipoatrophy.
METHODS: Sixty-one patients with HIV-associated facial lipoatrophy received PLLA injections once a month until clinical improvement. The primary endpoint was the need for retreatment. Two independent dermatologists and the researcher classified lipoatrophy according to photographs. Malar skinfold thickness was measured with an adipometer.
RESULTS: All patients showed improvement in facial lipoatrophy after receiving a mean of 7.9 vials of PLLA. Skinfold thickness improved by 105%. Maximum follow-up was 58 months, and the mean duration of the effect was 33.4 months. Patients who discontinued HAART or had higher CD4+ cell counts at baseline presented better responses. Lower responses were observed in patients with very severe lipoatrophy and thinner skin.
CONCLUSION: PLLA treatment is an effective and durable alternative for patients with moderate HIV-associated facial lipoatrophy, but of limited effectiveness for patients with thin skin and very severe lipoatrophy.

Keywords: HIV-Associated Lipodystrophy Syndrome; Polylactic Acid-Polyglycolic Acid Copolymer; Antiretroviral Therapy, Highly Active; Skinfold Thickness