Introduction: Melasma is an acquired and progressive hyperpigmentation of photoexposed areas. For being a recurrent and refractory dermatosis, its treatment continues to be a challenge.Objective: To evaluate the efficacy and security of the Skin Whitening Complex in the treatment of the facial melasma,and to compare it to the hydroquinone. Materials and methods: Double-blind Comparative study of 13 women bearers of melasma. All received two different formulations, labelled as “right side of the face" and left "side of the face". The formulations were applied twice a day for 90 consecutive days. Only the pharmacist responsible for the formulations had knowledge of their content. The tests of Wilcoxon and 2 of McNemar-Bowker were employed in the statistical analysis. Results: Ten of the 13 patients presented the global clinical improvement of the melasma. Four patients presented total improvement and six (p = 0004) presented partial improvement in the hemiface treated with hydroquinone 4%. In the hemiface treated with Skin Whitening Complex 5%, the improvement was total in two patients, and partial in six (p = 0007).There were no statistically significant differences between the two treatments (p = 0223). Conclusions: Although the treatment with hydroquinone 4% presents better clinical results, there were no statistically significant differences between the two treatments. Skin Whitening Complex 5% has shown efficient and safe in the treatment of the melasma.

Keywords: MELANOSIS/THERAPY, HYPERPIGMENTATION, HYDROQUINONES

Introduction: Nevus of Ota is a dermal melanocytic nevus located in the skin area that is innervated by the second and third branches of the facial nerve. It occurs mainly in patients of Asian ethnic background. The present study was aimed at evaluating the therapeutic response in the Western population, where higher skin types and characteristics diverse from those that have already been studied are common. Methods: A retrospective study based on the analysis of medical records, an active search of patients and the application of a questionnaire. All study patients were treated with 1,064 nm Q-Switched Nd:YAG laser, with or without a 532 nm tip, with 1 to 4-month intervals between sessions, 10ns pulse duration, 3mm spot size, 1 to 3 Hz frequencies and 2 to 12 J/cm2fluences. Results: According to the research physicians' evaluation, from the seven assessed patients, three had excellent improvement (greater than 75%), two had good response (51-75%) and one had moderate response (25-50%). The analysis of the degree of patient satisfaction showed that four patients reported being very satisfied and three, satisfied. The best results were observed in patients with phototypes up to grade IV and after having undergone seven sessions. Conclusions: QS lasers have proven a useful tool for treating patients with Nevus of Ota and high skin phototypes.

Keywords: NEVUS OF OTA, TREATMENT OUTCOME, LASERS

Introduction: Gynoid lipodystrophy may affect up to 95% of post-pubertal women. Treatments are aimed at improving the skin's appearance. Invasive procedures have long recovery times and may cause complications. Non-invasive methods, such as radiofrequency, are increasingly becoming popular. Objective: To evaluate unipolar radiofrequency's safety and efficacy in the treatment of gynoid lipodystrophy. Methods: Eight women with gynoid lipodystrophy grades II and III, in the gluteus region and thighs, underwent treatment with four sessions of unipolar radiofrequency at fortnightly intervals. Clinical-photographic, laboratory, and ultrasound evaluations of the patients were performed before, during, and 30 days after the end of the last session. Results: Improvement in the sagging of the skin was clinically observed in all treated patients. Four patients also had improvement in morphology. The ultrasound evaluation showed a statistically significant increase (p <0. 05%) in dermal thickness after the treatment in seven of eight patients. There were no laboratory abnormalities. Conclusions: Unipolar radiofrequency is an effective and safe method in the treatment of gynoid lipodystrophy in the gluteus region and thighs.

Keywords: CELLULITIS, ULTRASONOGRAPHY,TREATMENT OUTCOME

Introduction: Injectable hyaluronic acid is regarded as the gold standard treatment in the aesthetic correction of wrinkles, loss of contour, and restoration of facial volume. However, it is expected that consequentially adverse - sometimes severe - reactions will arise concomitant with the growth in use of hyaluronic acid-based cutaneous fillers. Objective: To evaluate the application of hyaluronidase in the treatment of adverse effects of injectable hyaluronic acid, as well as possible reactions to the intradermal injection of that enzyme. Methods: A retrospective study was carried out with 50 patients who underwent the application of hyaluronidase aimed at correcting complications or unaesthetic effects following hyaluronic acid-based filling procedures in the face. Results: Twenty-three patients had some type of adverse effect (restricted to the injection site) ranging from erythema, burning sensations, and mild edema, during or after the application, with spontaneous improvement. There were no cases of moderate to severe edema. Most patients reported regression of excess hyaluronic acid a few hours after the injection. Conclusions: Hyaluronidase is an extremely effective tool both in acute adverse events and in the reversal of unsatisfactory results, and in the dilution of biofilm. All those who use hyaluronic acid when treating their patients should have technical mastery of hyaluronidase application.

Keywords: HYALURONIC ACID; ENZYMES; ACCIDENTS.

The width of the lower third of the face is mainly determined by the size and shape of the jawbone, the thickness of the masseter muscle and the volume of adjacent subcutaneous tissue. The ideal, culturally recognized pattern for a male face corresponds to a wider lower third and a mandibular angle tending to 90º, while a female face should have a more oval appearance or the shape of a heart, and the middle third wider than the lower third. In order to achieve these aesthetically ideal proportions, botulinum toxin type A (BoNTA) has been successfully applied in the masseter muscle, which is one of the determinates of the lower face's width. Te present article reviews the current literature on the use of botulinum toxin for this purpose, offering the experience of the authors in this practice, aiming at achieving a more harmonious facial contour.

Keywords: BOTULINUM TOXINS, TYPE A; MASSETER MUSCLE; HYPERTROPHY

Adverse reactions associated with drugs presenting cutaneous manifestations are among the most common, expressing itself with multiple clinical aspects and causing significant morbidity. The fixed drug eruption (FDE) is a common adverse reaction with cutaneous involvement and is associated with the use of numerous drugs. Dipyrone is a drug with analgesic and antipyretic effects prescribed widely used in Brazil, however, it is known for its potential to triggering adverse reactions, including the FDE. This report shows an EMF case related to the use of dipyrone, with unique clinical presentation and correlate the clinical, histopathological and dermatoscopic found.

Keywords: DERMOSCOPY; FACE; PATHOLOGY

Injectable fillers have long been used for cosmetic purposes and in HIV induced lipodystrophy patients. A foreign body granuloma may be a side effect of the application of absorbable products/temporary and most often the nonabsorbable/permanent fillers. It is not possible to predict the formation of these granulomas, and it may occur regardless of the application technique. In this article we describe the surgical treatment of a patient with multiple granulomas caused by intradermal injection of PMMA in the face, with poor response to conservative treatments, and severe psychosocial impairment due to this unsightly and disfiguring complication.

Keywords: POLYMETHYL METHACRYLATE; GRANULOMA; AMBULATORY SURGICAL PROCEDURES

BACKGROUND: The SARS-CoV-2 infection has spread worldwide rapidly since its identification at the end of 2019. Globally, until April 2021, there have been more than 150 million confirmed cases of Covid-19, including over 3 million deaths. Therefore, a race was promptly started to produce an effective vaccine against the new virus. Botulinum toxin injection remains the leading non-surgical cosmetic procedure worldwide, with a high rate of efficacy and patient satisfaction.
AIMS: This study aims to analyze the association between the SARS-CoV-2 vaccine and the immediate botulinum toxin response.
MATERIALS AND METHODS: This was an observational, retrospective, and multicenter study. Data were collected between April and June 2021, and a medical record review of 71 patients from 27 to 76 years old treated with botulinum toxin injection.
RESULTS AND CONCLUSION: There were no meaningful changes in the immediate outcome of patients vaccinated for Covid-19 and botulinum toxin. However, it is vital to underline that follow-up and further studies are needed to define whether the Covid-19 vaccine can alter the duration of effect and efficiency of the botulinum toxin.

Keywords: Covid-19; Botulinum toxins type A; Vaccination