Introduction: Complaints about wrinkles and flaccidity in the periocular region are frequent. Blepharopeeling, associated with the Baker-Gordon formula, and the application of ablative fractional CO2 lasers are considered effective options in the treatment of the periocular region. Objective: To compare the techniques, recovery process and results of blepharopeeling and fractional CO2 lasers in the periorbital region. Methods: Comparative split-face study of patients with dermatochalasis and moderate rhytids. Blepharopeeling was applied on the right side of the face, and the fractional CO2 laser was used on the left side of the face. Results were assessed through photographic analysis, measurements of the superior palpebral fold and clinical improvement. Results: Patients (n=11) demonstrated clinical and photographic improvement using both methods. The recovery time was longer for the phenol peeling. No significant differences were observed in the measurements of the superior palpebral fold. Conclusion: While both therapeutic modalities were found to be effective in the treatment of periorbital aging, blepharopeeling produced greater clinical improvement of palpebral flaccidity.

Keywords: PHENOL, LASER THERAPY, EYELIDS, SKIN AGING

Introduction: In 2006 the US Food and Drug Administration approved the use of fractional photothermolysis for the treatment of melasma. Objectives:To evaluate the treatment of melasma patients with fractional photothermolysis. Methods: Patients with a clinical diagnosis of melasma (n = 20) received three non-ablative laser sessions at 4-week intervals.The parameters used were: pulse = 15 ms, and progressively increasing energies in each session (8, 10 and 12 J). Results were evaluated using the Melasma Area and Severity Index and colorimetry analysis (with indices ITA, L, a, b) at baseline and 4 weeks after the last session. Results: Female patients (n = 18), with ages between 23 and 48 and Fitzpatrick phototypes from II to IV, completed the study. One patient did not complete both Melasma Area and Severity Index evaluations.There was a statistically significant decrease in the Severity Index (p <0.0001, CI = 95%) and an average increase in the colorimetry indices L (p = 0.0003, CI = 95%) and ITA (p = 0.0017, CI = 95%), meaning a decrease in the pigmentation. Conclusions: Fractional photothermolysis is a safe and effective option in the treatment of melasma, and should be considered an alternative to conventional methods.

Keywords: MELANOSIS, LASERS, COLORIMETRY

Introduction: Mohs micrographic surgery is a technique that offers high cure rates for non-melanoma skin cancer.
Objective: To describe the clinical and epidemiological profile of patients who underwent Mohs micrographic surgery in a reference center in dermatologic surgery.
Methods: Medical records of patients who underwent Mohs micrographic surgery in the period 2014-2015 at a dermatology reference center, in the city of Mogi das Cruzes (SP, Brazil), were analyzed.
Results: The patients' ages ranged from 38 to 87 years; of these 54% were women. The most affected topography was the nose (54% of patients). Previous history of skin cancer was positive in 62% of cases. The indication driver for micrographic surgery was the lesion's location in 67% of the patients, followed by the size (23%) and tumor recurrence (10%). The most prevalent intraoperative diagnosis was basal cell carcinoma (90%).
Conclusions: Mohs micrographic surgery is an excellent therapeutic option in cases of tumors of aggressive nature, large diameter and high-risk location. This study is in line with the current literature regarding the epidemiological data linked to the occurrence of nonmelanoma skin cancer.

Keywords: MOHS SURGERY; SKIN NEOPLASMS; DERMATOLOGIC SURGICAL PROCEDURES

Introduction: Non-melanoma skin cancer is among the most frequent neoplasms in Brazil and is deemed a public health problem. Initial diagnosis is based on clinical suspicion and includes dermoscopy. Confirmation is carried out via histological analysis. Dermoscopy also contributes to the demarcation of tumor safety margins. Objective: To analyze the accuracy of dermoscopy in the diagnosis of non-melanoma skin cancer and its effectiveness in defining the lateral margins of these tumors in excisional biopsies. Methods: Comparison of the dermoscopy-based diagnostic hypothesis with the final histological outcome and involvement of lateral margins. Results: The data relating to a total of 70 lesions suspicious of non-melanoma skin cancer arising from a group of 50 patients were evaluated from 2015 to 2017. The comparison of the diagnostic hypothesis with the final histological outcome after excisional biopsy, indicated success rates of 79.6% for suspected cases of basal cell carcinoma and 23.8% for squamous cell carcinoma. Safety margins were observed in 74% of basal cell carcinomas and in 60% of squamous cell carcinomas. Conclusions: The diagnosis of non-melanoma skin cancers depends on experienced dermatologists and pathologists, with the interaction between these professionals being crucial. Dermoscopy has contributed in a more significant way to the diagnosis of basal cell carcinoma when compared to that of squamous cell carcinoma.

Keywords: SKIN NEOPLASMS; DIAGNOSIS, DIFFERENTIAL; MARGIN

INTRODUCTION: The gold standard diagnosis of cutaneous melanoma is essentially histological. Dermoscopy adds to clinical examination improved sensitivity and specificity.
OBJECTIVE: To evaluate the histological profile of risk melanocytic lesions excised in a dermatology service.
METHODS: Case review through Excel spreadsheet and survey of dermoscopic, histological and topographic data (January 2017 to December 2018).
RESULTS: Data from 62 suspected melanoma lesions were evaluated in this period. The main histological results were: melanocytic nevi (37.1%), melanoma (19.35%), and dysplastic nevi (17.7%).
CONCLUSIONS: The positive predictive value for melanoma was 19.35%, considering the search for an early diagnosis in patients at risk.

Keywords: Neoplasms; Melanoma; Dermatology

INTRODUCTION: Basal cell carcinoma (BCC) is the most common malign neoplasm. It corresponds to 70-80% of skin tumors. The diagnosis is made based on clinical suspicion combined with dermoscopy, which also allows defining its limits.
OBJECTIVE: To assess whether clinical and dermoscopic criteria are sufficient for the diagnosis and treatment of primary and well-defined BCC.
MATERIALS AND METHODS: Review of suspected cases of well-defined primary BCC surgically approached by excisional biopsy (3 mm margin) at the Dermatology Service of the University of Mogi das Cruzes (2017 to 2019). The Chi-square test was applied to assess the significance of the margins.
RESULTS: 169 injuries were assessed, with a predominance of women in the 8th decade. The histopathological examination concluded on 141 BCCs. When evaluating the excision margins for BCC cases, there was 95% of free margins (p = 0.0004998).
DISCUSSION: There are common dermoscopic elements between BCC and other neoplasms and benign lesions, which justifies other diagnoses found. The 3 mm surgical margin was accurate for well-defined primary BCCs, speeding up healing time and reduces costs.
CONCLUSION: For clinical-dermatoscopic suspicions of well-defined BCC, an excisional biopsy was effective in the diagnosis and clinical safety margins.

Keywords: Dermatoscopy; Diagnosis; Free margins

Undifferentiated sarcomas are neoplasms of soft tissues derived from the mesoderm. We report a case of undifferentiated pleomorphic sarcoma, its dermoscopy, staging, and therapeutic approach.

Keywords: Dermoscopy; Sarcoma; Soft Tissue Neoplasms