Surgical repair of large defects in nasal ala is often needed. There are several reconstruction techniques, which in general are complex, require greater technical knowledge, and not always reach the desired esthetic result. The authors discuss the indications and practicality, in addition to good cosmetic results of healing by secondary intention of large defects in nasal ala.

Keywords: WOUND HEALING, NOSE, CARCINOMA, BASAL CELL

Introduction: Surgery combined with post-operative intralesional corticosteroid injections is considered a good treatment for keloids that occur in the ears, yet the recurrence rate for this procedure is not yet well established. There is no consensus about the minimum number of corticosteroid infiltrations needed to decrease the number of recurrences.
Objective: To correlate the rate of recurrence among patients who had surgery and postoperative intralesional corticosteroid injections to treat keloids in the ear lobe with the number of injections.
Methods: Retrospective study of 41 patients who underwent surgical excision of ear keloids combined with up to two (Group A) or 3 or more (Group B) triamcinolone ace- tonide intralesional injections sessions.
Results: The total recurrence rate was 37% (13% in patients from Group A and 24% in patients from Group B). Results were not more effective when the number of injections was equal to or higher than 3 (p = 0.74).
Conclusions: There was no statistical significance in the number of post-operative corticosteroid intralesional injections in the treatment of ear keloids. Further studies are necessary to corroborate these results.

Keywords: KELOID, ADRENAL CORTEX HORMONES, AMBULATORY SURGICAL PROCEDURES

Squamous cell carcinomas located on the lower lip represent 20-30% of all oral cancers, and present good prognosis when diagnosed early. Cervical lymph node metastases occur in 5-20% of cases. The case of a female patient with a nodular-ulcerated infiltrating lesion affecting one-third of the lower lip is described. The examination of lymph nodes yielded normal results. The excision of the lesion was carried out and the labial reconstruction performed using a Karapandzic flap on the right side and a Gilles flap on the left, with a commissuroplasty carried out in a second operation. The procedure produced a cosmetically acceptable result, with good recovery in speech and swallowing. No recurrences or metastases were observed within tho years of follow-up.

Keywords: CARCINOMA, SQUAMOUS CELL, LIP, SURGICAL FLAPS

Androgenetic alopecia is a condition with an important psychological impact. Clinical treatments present variable responses and require care for long periods, a factor that decreases the chances of adhesion. Microneedling with or without minoxidil injection is a new treatment modality. This study reports cases of two male patients, aged 30 and 44 years, with satisfactory partial response to four sessions of microneedling with minoxidil and three sessions of microneedling alone, using a tattoo machine and microinfusion of drugs into the skin technique.

Keywords: ALOPECIA; MINOXIDIL; NEEDLES

Introduction: Microneedling has been performed in several areas of Dermatology, including the treatment of androgenetic alopecia. However, one of its major limitations is pain, which occurs both with the use of rollers with multiple fine needles and with motorized devices equipped with microneedles.
Objective: To describe a new technique aimed at minimizing pain during the microneedling in the scalp.
Methods: An observational, prospective and comparative study of the microneedling effects was performed with a motorized device, with and without folding the skin by using the thumb and index finger of the surgeon’s non-dominant hand. This procedure was termed “pinch technique” by the authors. The pain was assessed by the patient based on a visual analogue scale, and the data analyzed with the Student’s t-test, in order to verify the existence of statistical difference between the data sets.
Results: Fourteen patients bearers of androgenetic alopecia (13 men and 1 woman) were treated. The analysis of the data on the pain reported by the patients suggested that the arithmetic mean of the data obtained from the areas where the technique was not applied was greater than that obtained in areas where the technique was employed.
Conclusions: The described technique was proven effective in reducing pain during the microneedling procedure. That outcome resulted from the alteration of the perception of pain due to the tactile stimulus and the increase in the distance of the needles regarding the galea, which is richly innervated.

Keywords: AMBULATORY SURGICAL PROCEDURES; ALOPECIA; NEEDLES

INTRODUCTION: Idiopathic guttate hypomelanosis (IGH) is a common photoaging manifestation, with no standard treatment and presenting mixed results to interventions. In Brazil, the use of micro-needling associated with 5-fluorouracil (5-FU) has been proposed to treat IGH.
OBJECTIVE: To compare the use of MMP^® (micro-infusion of drugs on the skin) with 5-FU, with MMP^® only as micro-needling (with no drugs), and intralesional 5-FU injected with an insulin syringe in the treatment of IGH.
METHODS: In a single blind randomized clinical trial, we compared the three treatments: MMP^® versus MMP with 5-FU and intralesional 5-FU injection for 180 IGH lesions in the forearm of nine patients.
RESULTS: After two treatment sessions, 5-FU alone was the most effective treatment, with statistical significance, compared with micro-needling alone. MMP+5-FU efficacy was lower than intralesional 5-FU injection and higher than micro-needling alone, although without statistical significance.
CONCLUSIONS: The intralesional application of 5-FU was more effective in the treatment of solar leukoderma. The use of a smaller quantity of medication is the great advantage of the MMP + 5-FU technique. Further studies are needed to standardize these techniques.

Keywords: Drug delivery systems; Fluorouracil; Hypopigmentation; Skin aging

Strips hairstyle technique with elastic hair bands is a way of managing hair to help on scalp procedures and to facilitate dermatologists' practice.

Keywords: Hair; Laser therapy; Laser therapy, low-level; Needles