Introduction: Acne is one of the most prevalent skin conditions, representing a constant challenge to dermatologists, especially in severe cases as nodulocystic acne, which can be resistant to medicament based treatment. Traditional therapy includes topical and oral drugs that are not always effective and often lead to bacterial resistance and side effects. The use of lasers in the treatment of inflammatory acne has increased lately due to the ease, clinical efficacy, and minimal side effects of this type of therapy. Objective: To evaluate the effects of fractional laser in patients with nodulocystic acne resistant to treatment with isotretinoin. Methods: Application of laser therapy sessions with Nd:YAP in 9 patients. Assessment of the degree of patient satisfaction and comparison of photographs taken before and after treatment by dermatologists not linked to the study. Results: Average reduction of 65% in inflammatory lesions, satisfaction of all patients who underwent treatment, and approval in the assessment carried out by dermatologists. Conclusions: The fractional Nd:YAP laser was proven effective in the treatment of inflammatory acne and may represent a new therapeutic option for this pathology, especially for patients who do not respond to conventional treatment.

Keywords: ACNE VULGARIS; LASERS; LASER THERAPY.

Lipoid proteinosis is a rare, recessive autosomal multisystem genodermatosis characterized by progressive deposition and accumulation of an amorphous hyaline material in the skin and mucous membranes. The present study reports a 25-year follow-up of a patient with the disease and the combination of medical and surgical treatments used-such as protection against sun rays, oral vitamin E, 0.01% retinoic acid, 20% azelaic acid, excision of verrucous lesions, manual dermabrasion with sandpaper, and chemical peels with Jessner's solution and 35% trichloroacetic acid.

Keywords: LIPOID PROTEINOSIS OF URBACH AND WIETHE; AMBULATORY SURGICAL PROCEDURES; SURGICAL PROCEDURES, MINOR; CLINICAL EVOLUTION.

Introduction: Pincer nails are characterized by an over-curvature of the nail in the transverse axis, causing the pinching of the nail bed at its distal portion. It most commonly affects the toes, occurring rarely in the fingers. Objective: To demonstrate the Fanti's technique for the treatment of pincer nails. Methods: Eleven patients from the Hair and Nails Ambulatory, bearing pincer nails, underwent surgery for the correction of the condition with the Fanti's technique. Results: All patients had complete clinical improvement during the 14-month follow-up period. Conclusions: The present study demonstrates the Fanti's surgical technique for the correction of pincer nails, where anatomical and functional improvement of the operated nails could be observed.

Keywords: NAIL DISEASES; NAILS; NAIL BITING.

The Highly Active Antiretroviral Therapy promoted a better quality of life for seropositive patients. However, metabolic changes in patients, such as HIV lipodystrophy syndrome, may occur with antiretroviral therapy. Thus, it is necessary to adopt strategies to prevent and treat lipodystrophy and other possible side effects of. We report the case of a female patient with prior antiretroviral therapy and decreased thickness of the lower limbs bilaterally, especially in knees and distal third of the legs. The sites with evidence of lipoatrophy were filled with polymethylmethacrylate, with satisfactory results and adherence by the patient.

Keywords: HIV-ASSOCIATED LIPODYSTROPHY SYNDROME; POLYMETHYL METHACRYLATE; ACQUIRED IMMUNODEFICIENCY SYNDROME.

Introduction: Hidradenitis is a chronic inflammatory disease that has a negative impact on the patient's quality of life but which has few effective therapeutic options. Currently, the use of laser technology has been standing out as a treatment. Objective: To evaluate the use of 1,340nm ND:YAP laser (Neodimiun:Ytrium Aluminum Perovskite) to treat hidradenitis. Methods: Performing 4 1,340nm ND:YAP laser sessions in 3 patients bearing hidradenitis. Results: All patients had a clinically and histologically evidenced reduction of inflammatory lesions. Conclusions: In the present study, the 1,340nm ND:YAP laser was effective in the treatment of hidradenitis, and can potentially become a new therapeutic option.

Keywords: HIDRADENITIS; LASERS; LASER THERAPY

Introdução: A non-invasive alternative for the treatment of localized fat is cryolipolysis that, by freezing adipocytes, reduces fat volume in the region where the procedure was performed. Objective: To statistically describe the experience of a referral center for this procedure. Methods: A cross-sectional study with 251 patients undergoing cryolipolysis was carried out with the epidemiological analysis of patient data. Results: Thirty-eight males and 213 females underwent the procedure, with a total number of 740 treated areas. The anterior abdomen (lower third) was the most popular region, with 45.30% of cases. Eighty-eight percent were satisfied or very satisfied with the result. Nearly all cases required 2 or more sessions to achieve this degree of satisfaction. Conclusions: Cryolipolysis is a noninvasive method for the selective reduction of fat that has shown efficacy in reducing the subcutaneous tissue, with minimal and reversible side effects in this study.

Keywords: LASERS; ABDOMINAL FAT; LIPOLYSIS

Introduction: The use of botulinum toxin in the periorbital muscles is aimed at reducing expression lines in that site, correcting the eyebrows' height and treating blepharospasm. However, the application of botulinum toxin in this area can lead to undesirable side effects, such as ptosis, edema in the lower eyelids, artificial appearance of the demarcation area between the orbicularis muscle's treated area and the malar region, ectropion and hematomas.
Objective: To treat the dynamic wrinkles in the lower portion of the orbicularis oculi muscle through injections of microdoses of botulinum toxin.
Methods: A prospective monocentric study with the analytical longitudinal observation of 300 patients undergoing treatment with botulinum toxin microdoses in the lower eyelids' rhytids was carried out. Sociodemographic data, patient satisfaction, dose quantification and complications were analyzed.
Results: Sixty-six percent of the patients showed a total improvement of the wrinkles after the first session. The other required an additional session. Eighty-six percent preferred the treatment with this therapeutic modality.
Conclusions: Despite the great benefit offered by the classic injection points for the treatment of periorbital rhytids types I to III, the authors observed the need to treat rhytids type B (presence of wrinkles on the lower eyelid). Due to the high rate of complications in this region, microdoses of botulinum toxin were proven to be effective and safe.

Keywords: BOTULINUM TOXINS, TYPE A; ESTHETICS; DERMATOLOGY

Introduction: Hyperhidrosis is a common disease characterized by excessive sweating. Several treatment options are described as axillary liposuction and laserlipolysis.
Objective: To compare the effectiveness of two treatment methods for axillary hyperhidrosis – one exclusively surgical (liposuction) and the other employing invasive laser therapy (laserlipolysis) – using a prospective, comparative study with a one-year follow up.
Methods: Liposuction was carried out in the right axilla, while laser lipolysis was performed in the left axilla. The evaluation was conducted using the starch-iodine test, comparative histological analysis and patient self-assessment questionnaires.
Results: Twelve patients took part in the study. The starch-iodine test indicated decreased sweating in all patients within one year after the procedures, while the histological analyses showed absence or reduction of the secreting ducts and acini on both sides and in all cases. After one year of follow-up, the patient's satisfaction index measured by the questionnaires remained positive in all cases, with 75% asserting maximum satisfaction, and 25% reporting difference between the sides (better results were described in the right hand side axilla).
Conclusions: Both techniques showed similar effectiveness after one year of follow-up. Laserlipolysis had a lower frequency of postoperative complications.

Keywords: LASERS; LASER THERAPY; DERMATOLOGY; DERMATOLOGIC SURGICAL PROCEDURES

Introduction: Tuberous sclerosis is a dominant autosomal genodermatosis, classically characterized by facial angiofibromas, fibrotic plaques, periungual fibromas, leaf-shaped hypochromic maculae and fibrous frontal plaques.
Case report: A patient bore this disease, with Koenen tumors in all nail beds of hands and feet, which were resistant to the conventional treatment — simple excision and electrosurgery. Amputation of the nail beds was performed followed by reconstruction with full thickness skin grafts.
Conclusion: The amputation of the nail apparatus and reconstruction with full thickness skin grafts in aggressive, recurrent or high morbidity cases can be an effective therapeutic option.

Keywords: DERMATOLOGY; DERMATOLOGIC SURGICAL PROCEDURES; TUBEROUS SCLEROSIS; SKIN TRANSPLANTS

Introduction: Signs of aging usually arise more intensely on the face, neck, and hands, in the form of considerable loss of volume, which is a common indicator of aging.
Objective: To compare the duration, and adverse effects of two types of subcutaneous fillers in the treatment of the volumetric aging of hands.
Methods: Group A: four patients who used the same amount of the products in both hands; Group B: four patients who used greater amounts of calcium hydroxyapatite in one of the hands and Group C: four patients who used greater amounts of hyaluronic acid also in one of the hands. The patients were evaluated through changes in a validated scale for hand aging, recorded by digital photographs before and 1,3,6,9,12,15 and 18 months after the procedure.
Results: In Group A the patients had the same duration for both fillers; in Group B patients treated with hydroxyapatite calcium had longer duration; in Group C, the patients treated with hyaluronic acid presented longer duration. Adverse effects were more frequent with the use of calcium hydroxyapatite.
Conclusions: It can be concluded that the filler duration is proportional to the volume injected for both fillers, and that hyaluronic acid is safer for the treatment of this cosmetic irregularity.

Keywords: hyaluronic acid; hand dermatoses; rejuvenation

Introduction: Molluscum contagiosum is a dermatovirosis caused by a poxvirus. In the literature there are descriptions of different therapeutic approaches of this infection.
Objective: To evaluate the efficacy of imiquimod – isolated and associated with curettage – in the treatment of molluscum contagiosum.
Methods: Group A: 20 patients used 5% imiquimod cream 3 times a week for 6 weeks. Group B: 10 patients used a creamy base 3 times a week, for 6 weeks. After the initial 6 weeks, all patients underwent curettage.
Results: Group A: 31% decrease in the number of lesions in the 6th week, with a curettage effectiveness of 97.6%; Group B: 4.8% increase in the number of lesions in the 6th week, with a curettage effectiveness of 81.1%. The mean value for the pain level during curettage was 1.8 for Group A and 3.0 for Group B.
Conclusions: Due to the facts that the rate of cure of contagious molluscum lesions increased and the pain decreased when the curettage procedure was conducted after the use of the immunomodulator, it was possible to conclude that the association of 5% imiquimod cream to the curettage may be a therapeutic possibility.

Keywords: Molluscum Contagiosum; Dermatology; Dermatologic Surgical Procedures

Eccrine spiradenoma is a rare benign epithelial neoplasm derived from the ductal and secretory portions of the eccrine sweat glands. It is characterized by slow growth and may, in some cases, undergo malignant transformation. This report describes a case involving a male patient with a painful, slow-growing lesion present for 3 years. The nodular, lobulated lesion was located on the left frontal region. Due to the left. On account of location, size, and vascularization of the lesion, as well as the need to preserve the facial musculature and ensure complete tumor removal of the tumor with minimal functional damage, Mohs surgery was chosen as the treatment technique.

Keywords: Mohs surgery; Skin; Sebaceous Glands