Introduction: Standard dilution of botulinum toxin is performed with 0.9% saline solution. Some studies show that when diluted in lidocaine and epinephrine, the toxin preserves its function without compromising effectiveness or safety.
Objective: To establish whether the paralyzing effect of ona-toxin type A reconstituted in anesthetic (2% lidocaine) and vasoconstrictor agent (1: 50,000 epinephrine) is as effective as that of the same toxin reconstituted in saline solution, at 48 hours, 1 week, 2, 4, 12 and 24 weeks, for the treatment of periocular lines. To compare the tolerance to pain between the two reconstitution alternatives.
Methods: Fifteen patients with periocular wrinkles were randomized to receive onabotulinum toxin diluted in lidocaine with epinephrine or in saline. Re-evaluations were carried out in 48 hours, 1 week, 2, 4, 12 and 24 weeks.
Results: The data indicate that there was no difference in the symmetry and durability of the botulinum toxin, nor in the pain during the application.
Conclusions: There was no statistically significant difference in the frequency of lateral periocular muscle paralysis and symmetry resulting from the applications of onabotulinum toxin reconstituted in lidocaine with epinephrine or in saline solution. This outcome is consistent with those of previous studies.

Keywords: BOTULINUM TOXINS, TYPE A; DILUTION; LIDOCAINE

INTRODUCTION: Skin cancer is the most frequent tumor in transplanted patients. Evaluating how transplanted young adults behave regarding the exposure to the sun is an important step in introducing prevention programs in this population.
OBJECTIVE: To evaluate the photoprotection habits of transplanted young patients and to determine whether the guidance on the use of sunscreen increases the use of photoprotection measures.
METHODS: Cross-sectional study. A questionnaire was applied at the post-transplant post-adolescents clinic.
RESULTS: Forty-nine patients were interviewed (mean age = 22.9 years, SD = 4.6 years). The rate of use of sunscreen was 40% among those who had not been instructed and 93.2% among those who had been instructed. There was a statistically significant association between having been instructed on the use of and using sunscreen (p = 0.01). Most patients reported having used sunscreen. Limitations of the study: the interviewees’ level of schooling was not evaluated.
CONCLUSIONS: Young transplanted patients who are instructed during the consultations to use sunscreen adhered more to the application of sunscreen than patients who had not been instructed. It is of utmost importance to educate transplanted young adults about skin cancer prevention whenever possible, preferably at each visit.

Keywords: Kidney transplantation; Organ transplantation; Skin neoplasms; Skin care; Sunscreening agents; Young adult

INTRODUCTION: The standard application of botulinum toxin for frontal wrinkles is at the intramuscular level. Some authors have suggested that the combination with intradermal application can bring about a more natural result, avoiding the paralyzing effect of the intramuscular application only. Objective: Establish if the paralyzing effect of type A onabotulinum toxin in the forehead, applied intradermally, is as effective as of the same toxin applied intramuscularly after: 48 hours, one, two, four, eight and 12 weeks for the treatment of frontal wrinkles.
MATERIAL AND METHODS: Sixteen patients with frontal wrinkles were randomized to receive intramuscular or intradermal onabotulinum toxin and were reevaluated after 48 hours, one and two weeks, one, two and three months.
RESULTS: Data were collected from 16 patients. Mean age was 33 years (standard deviation 5.96). Paralysis occurred in 93.3% in the intramuscular side and in 53.5% in the intradermal side in two weeks (p= 0.07). Median pain grade was 2.69 in the intramuscular side and 4 in the intradermal side (p=0.072).
CONCLUSIONS: Despite the highest frequency of the presence of paralysis in the intramuscular side in all evaluations, there was no statistically significant difference between the sides.

Keywords: Botulinum toxins type A; Injections, intradermal; Injections, intramuscular