Introduction: Port wine stains (PWS) are vascular malformations present at birth, and, depending on their location, they can cause emotional changes in the patient. Studies on the treatment of PWS with intense pulsed light (IPL) and other types of lasers presented different responses. Objectives: The objective of this study was to review the literature on the treatment options of PWS with light sources, demonstrating the success of IPL associated with Nd:YAG laser. Method: A 14 years old female patient with PWS in the supralabial region was treated with the association of 1064- nm Nd:YAG laser and 560-nm IPL. She underwent eight treatment sessions with a mean interval of 30 days between each session. The study was conducted at the Célia Kalil Dermatology Clinic. Result: The port wine stains disappeared completely with a very low incidence of adverse events. Conclusion: The association of 560-nm IPL and 1064-nm Nd:YAG laser seemed an adequate treatment alternative for PWS.

Keywords: PORT WINE STAINS, LASERS, IPL, TREATMENT

Introduction: Photodamaged skin of the anterior thorax region is characterized by flacidity, wrinkles, hyperpigmentation, erythema, telangiectasia, and atrophy. Microneedling has been used for the transdermal drug delivery of active agents to the skin through microchannels. Objective: To clinically evaluate the rejuvenation of the skin of the anterior thorax region resulting from the use of microneedling associated with drug delivery. Methods: Double-blind randomized, placebo-controlled study conducted with 22 women who underwent three microneedling sessions followed by the topical application of a test product containing hyaluronic acid and other active principles or placebo. The evaluation was performed through photographic comparison carried out by a dermatologist oblivious to the study and the application of self-assessment questionnaires to patients. Results: Clinical evaluation showed improvement in the overall skin rejuvenation of the anterior thorax region in 100% of the patients. The statistical analysis showed a 28% improvement (p <0.05) with use of the test product as compared to the placebo. The responses to the questionnaires demonstrated an improvement of 30% in the patients treated with microneedling and the test product. Conclusions: The microneedling technique associated with the transdermal administration of drugs used for rejuvenation provides improved overall appearance of the skin of the anterior thorax region, with a high degree of tolerability and satisfaction.

Keywords: REJUVENATION; COLLAGEN; ADMINISTRATION; CUTANEOUS

Introduction: The dorsum of the hands is a visible part of the body and needs special attention regarding rejuvenation treatments. The combination of different techniques in this area is important to increase the effectiveness of the treatments.
Objective: This study was aimed to evaluate the clinical efficacy of a fractional non-ablative laser (1,340nm Nd:YAP) combined with intense pulsed light (IPL) for rejuvenating the hands.
Methods: A prospective comparative study evaluated 11 patients complaining of aging on hands, for 90 days. Two sessions were carried out with a two-week interval using IPL and 1,340nm Nd:YAP laser. The left hand was treated with 1,340nm Nd:YAP laser associated with IPL and the right hand with isolated IPL. The improvement was rated using scores from 1 to 4, evaluating the parameters: wrinkles, pigmentation, brightness, keratosis and overall rejuvenation observing the elasticity and filling of visible structures such as bones, tendons and vessels.
Results: By analyzing the frequencies of the categories of the variables, it was possible to observe that there was a higher frequency of improvement in the left hand. For the comparative analysis of the studied variables, the mean value of each variable computed for each hand, evidenciated that the variable overall rejuvenation and the left hand showed more marked improvements for the studied characteristics. Ten among 11 patients had a higher satisfaction degree with the combined treatment, with absence of significant adverse effects.
Conclusion: The association of 1,340nm laser to the IPL was shown to be safe and more effective than isolated intense pulsed light in the rejuvenation of the hands.

Keywords: LASERS; REJUVENATION; HAND

Keloids have functional, aesthetic and psychological impacts that can influence the patients' quality of life. Moreover, given the high rate of recurrence – particularly in large lesions located in the anterior thoracic region – they are more difficult to treat. This paper reports a successful treatment for keloids in this area using a new technique that combines intense pulsed light, botulinum toxin type A and the conventional treatment with injection of corticosteroids.

Keywords: KELOID; INTENSE PULSED LIGHT THERAPY; BOTULINUM TOXINS, TYPE A; ADRENAL CORTEX HORMONE

INTRODUCTION: The chest is a photoexposed area that shows effects of photodamage. Microneedling is a safe option for the rejuvenation of this area, also leading to improvement in dyschromias.
OBJECTIVE: To evaluate histologic cutaneous response after three monthly sessions of microneedling for the treatment of dyschromias on the chest.
METHODS: Three monthly sessions of microneedling, with 1.5mm length needles were performed, as well as skin biopsies before and 90 days after commencement of the study. Histologic samples were evaluated with H&E and Fontana-Masson stains. Melanin content was measured based on dermal clusters.
RESULTS: Six patients between 38 and 67 years of age, phototypes II-III, Glogau scale II-IV were included. A positive correlation was observed between the time and dermal content of melanin (p=0.029): three sessions of microneedling reduced this content on D90 compared to the beginning (6.4 ± 1.7 MC on D0 versus 3.1 ± 0.4 on D90, p = 0.05). Three patients reported global skin improvement on D90.
CONCLUSIONS: The proposed mechanism of microneedling to promote lightening includes fibroblast proliferation and neocollagenesis in the upper dermis. This is the first study to evaluate the histology of the findings associated to lightening of the chest due to microneedling.

Keywords: Histology; Melanins; Needles; Thorax