Post-inflammatory hyperchromia is an important sequel of inflammatory dermatoses. In addition to depigmenting topical treatments, chemical peels can be effective in treating it. The present report describes a case of post-inflammatory hyperchromia after treatment of Lichen Planus handled with thioglycolic acid peels. Thirty percent thioglycolic acid applied in the form of a peel is described as a therapeutic option with discrete results and can be considered an ally in managing this dermatologic condition.

Keywords: CHEMEXFOLIATION; HYPERPIGMENTATION; THIOGLYCOLATES

Introduction: Laser toning technique is performed with the Q-switched Nd:YAG laser 1064 nm, aiming at stimulating neocollagenesis. The technique can also be associated with the application of suitable medicines for drug delivery, increasing its potential for skin permeation.
Objective: To evaluate the results of laser toning Q-switched Nd:YAG laser 1064 nm associated with drug delivery through a pilot study.
Methods: Four patients underwent four laser sessions with application of a formula for drug delivery or placebo, fortnightly.
Results: According to the photographic assessment, laser toning promoted improvement of acne, pores, wrinkles and sensitivity. When associated with the drug delivery, there was superiority in results. In clinical evaluation differences were observed only in the pores analysis (+11%). 75% of patients had acneiform eruption.
Conclusion: Results of this pilot study show that laser toning can be enhanced when combined with drug delivery.

Keywords: LASERS; ADMINISTRATION, CUTANEOUS; COLLAGEN; HYDROXYPROLINE; HYALURONIC ACID; ASCORBIC ACID

The topical route for the delivery of drugs is essential in dermatology: it optimizes the penetration of medicaments, and when performed with the assistance of lasers, it takes place in a uniform and controlled manner. The degree of evidence of drug delivery is being investigated for many drugs. Moreover, the technique combines outstandingly with lasers for rejuvenation and treatment of skin diseases. It is therefore possible to conclude that the use of lasers for drug delivery is promising. While there are clinical studies on some substances that allow their indication and use, others require further controlled analyses, with longer follow-up periods, aimed at allowing thorough evaluations.

Keywords: LASERS; ADMINISTRATION, CUTANEOUS; SKIN ABSORPTION; DRUG DELIVERY SYSTEMS; DRUG ADMINISTRATION ROUTES

Intense pulsed light is a device that emits high intensity, polychromatic, non-coherent and not collimated light. IPL versatility allows combining parameters to treat a variety of skin vascular and melanocytic lesions, epilation and non ablative photorejuvenation. This article describes classic and innovative indications for intense pulsed light use based on medical literature.

Keywords: INTENSE PULSED LIGHT THERAPY; SKIN DISEASES; COSMETIC TECHNIQUES

Six patients underwent two sessions of microneedling associated to drug delivery on the face, hands or stretch marks, at three-week interval between sessions. Patients were evaluated using clinical analysis and objective measures. Compared to baseline, objective face analysis showed decrease in acne lesions and improvement in the skin texture. The evaluation of stretch marks showed great improvement, and face and hands presented excellent results compared to baseline. The association of microneedling to drug delivery for rejuvenation of the face and hands, and for the treatment of stretch marks presented promising results in our study.

Keywords: ADMINISTRATION, CUTANEOUS; HYALURONIC ACID; REJUVENATION; STRIAE DISTENSAE; TRANEXAMIC ACID; HYDROXYPROLINE

Both microneedling and ablative fractional laser can be used for the treatment of scars. The present article reports the case of a female patient who had the first half of a perioral scar treated with ablative fractional CO2 laser, and the second half treated with microneedling, using a 2mm roller. Outcomes were superior in the half treated with laser.

Keywords: Cicatrix; Collagen; Lasers

INTRODUCTION: The treatment of unsightly hypertrophic scars secondary to surgeries in the thoracic region area challenging, particularly if associated to striae distensae. Surely, more than one therapy should be used, which will demand a long treatment time.
OBJECTIVES: To evaluate the effect of the association of fractional ablative and non-ablative lasers, microneedling and drug delivery in the management of hypertrophic scarring and striae distensae.
METHODS: Patient showing hypertrophic scars and striae on the anterior thoracic region was submitted to four monthly sessions of fractional ablative and non-ablative lasers, associated to microneedling and drug delivery.
RESULTS: At the end of the treatment protocol, the patient had improved mobility of the treated areas, quality of the skin and striae distensae in the treated region.
CONCLUSIONS: The associated treatment showed good results in the concurrent management of atrophic and hypertrophic scars.

Keywords: Cicatrix; Lasers; Needles

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

INTRODUCTION: Idiopathic guttate hypomelanosis is an acquired leukoderma, whose available therapeutic options have inconsistent results.
OBJECTIVES: To evaluate the effect of isolated or combined ablative fractionated laser to drug delivery of piperine for treatment of idiopathic guttate hypomelanosis.
MATERIALS AND METHODS: In a prospective and comparative study, seven patients with idiopathic guttate hypomelanosis in the legs were elected, andfive lesions were selected on each leg of each. Both legs of each patient were submitted to two Er:YAG 2940nm laser sessions, followed by drug delivery of piperine 20% only in the right leg. Blind evaluators conducted the assessment through photographs and comparative measurements of the lesions.
RESULTS: The lesion size ranged from 0.2cm to 1.5 cm. Both treatments significantly reduced lesion size (p< 0.00008, right leg;p< 0.002, left leg). Thegeneralized estimating equation method showed that there was no statistical difference between the groups regarding the reduction of lesion size. The evaluation achieved better scores for the right leg (laser + piperine) (p=0.126).
CONCLUSION: Although statistically significant differences were not found between the side treated with laser and drug delivery versus the side treated only with laser, we believe that the technique may represent an option in the therapeutic arsenal.

Keywords: Administration, topical; Drug administration routes; Lasers

INTRODUCTION: Topical delivery of drugs is essential in Dermatology Due to the difficulty of permeation of the stratum corneum, drug delivery techniques have been highlighted. The use of non-specific formulations for this purpose makes raises the concern of possible adverse events and the microbiological safety of these formulations.
OBJECTIVE: To assess bacterial and fungal growth in anhydrous fluid serum through simple sterility test. Materials and METHODS: The simple sterility test was performed on an anhydrous serum containing lipophilic and hydrophilic active substances. This test was performed three months after the manufacture of the product.
RESULTS: The formulation studied was approved in the simple sterility test conducted three months after the manufacture of the product, even without the use of preservatives in the formulation.
DISCUSSION: The assessed formulation was approved in the sterility test possibly due to the fact that the serum vehicle has mineral and anhydrous origin, characteristics that do not favor the proliferation of microorganisms.
CONCLUSIONS: Although only the vehicle counting specific assets has been tested, the results of this study are promising and demonstrate the need for future studies broadly encompassing this subject.

Keywords: Drug Administration Routes; Brazilian Pharmacopeia; Skin Cream

Q-switched lasers are widely used for tattoo removal. A 48-year-old-woman with a black tattoo on the left thigh was submitted to ten sessions of Q-switched Nd:YAG 1064nm laser associated with fractional CO2 laser, performed every two months. Six months after treatment end, we observed almost complete tattoo removal, besides improvement in skin texture. Q-switched lasers promote tattoo removal by a photoacoustic phenomenon. The association with fractional ablative lasers is an option for intensely pigmented tattoos or for tattoos with several colors, which are hard to remove.

Keywords: Laser Therapy; Lasers; Tattooing

INTRODUCTION: Angiokeratoma of Fordyce are benign vascular lesions that present as small, asymptomatic, purple papule on the scrotum, shaft of the penis, or labia majora. Therapeutic options comprise several methods, including lasers.
CASE REPORT: Men presented with multiple violaceous papules on the scrotum, compatible with angiokeratoma of Fordyce. The patient was treated with a single session of long pulsed Nd:YAG 1064 nm laser.
DISCUSSION: Treating angiokeratomas with lasers has the benefit of allowing vessel coagulation without bleeding.
CONCLUSION: Even though these are benign lesions, patients seek treatment because of cosmetic concerns. Dermatologists should be aware of treatment options available.

Keywords: Ambulatory Surgical Procedures; Dermatology; Nails