Introduction: Isotretinoin was initially used to treat severe inflammatory acne and is now widely recognized as an effective therapy for acne vulgaris. Many factors are associated with the recurrence of this condition, which ranges from 5.6-65.4%. There is much con- troversy regarding the importance and contribution of each factor.
Objectives: To determine the recurrence rate in patients who underwent full treatment with oral isotretinoin (dose between 120 and 150 mg/kg) and risk factors.
Methods: Retrospective study of data from 276 patients treated with isotretinoin. The analysis was carried out after a minimum of 30 months after the end of the treatment. Recurrence was defined as the appearance of new active lesions that required retreatment.
Results: While the recurrence rate in patients who underwent the full dose was 25.53%, it reached 81.03% in those who received an incomplete dose. The other studied factors presented no statistical significance.
Conclusion: Oral isotretinoin therapy is effective in producing a significant and long- term reduction of acne. Nevertheless, it is important to note that recurrence can occur, especially when recommended doses are not reached.

Keywords: ACNE VULGARIS, ISOTRETINOIN, RECURRENCE

Extramammary Paget's disease is a rare cutaneous neoplasm typically occurring in the vulva of Caucasian women after menopause. Clinically, the most common symptom is pruritus, when an erythematous, desquamative and eczematous lesion can be observed. Due to the rarity and nonspecific appearance of the disease, it can be confused with other dermatological conditions, delaying diagnosis. The present case demonstrates a form of vulvar extramammary unilateral Paget's disease confirmed by anatomical pathologic and immunohistochemical study. The standard treatment used for the disease in this case was surgical and the patient underwent complete excision of the lesion, with continued monitoring every six months.

Keywords: GENITAL NEOPLASMS, FEMALE; VULGAR NEOPLASMS; VULVAR DISEASES; PAGET DISEASE, EXTRAMAMMARY.

Introduction: Progressive macular hypomelanosis is characterized by the emergence of hypopigmentation, predominantly in the trunk region of young women of mixed racial origin. Although recent studies suggest that Propionibacterium acnes may have an important role in the pathogenesis, its etiology remains unclear. Objective: To evaluate the prevalence of the condition with regards to gender, age, skin phototype, affected areas and disease onset, and the relationship with ordinary acne and oily skin in the city of Niterói, Rio de Janeiro State, in the coastal region of Southeast Brazil. Methods: Retrospective epidemiological study that uses the analysis of medical records of 103 patients with diagnosis of progressive macular hypomelanosis, from 2001 to 2012. Results: Eighty-two percent of studied patients were women and 18% men, with a predominance of phototypes III (42.7%) and IV (42.7%). The average age of onset of the disease at diagnosis was 26 years. In 46.0% of patients the disease duration ranged from 1 to 4 years. When two areas were affected (50%), the dorsum was the most frequent (79.0%), followed by the abdomen (20.0%). In 98% of cases, patients had oily skin, and 71.8% had active acne. Conclusion: Progressive macular hypomelanosis is a chronic condition that primarily affects the skin of the dorsum and abdomen of young women with skin phototypes III and IV, who are also bearers of oily skin and acne. There are still many doubts regarding the true etiology and treatment of progressive macular hypomelanosis. The high percentage of association with skin oiliness and acne vulgaris suggests that these clinical conditions are possibly related.

Keywords: HYOPIGMENTATION; EPIDEMIOLOGY; ACNE VULGARIS

Introduction: Acne scars result from inflammation of acne vulgaris and are a frequent cause of complaints in dermatology practices. Atrophic scars are the most common, and may be classified into superficial, medium, and deep. There are several treatment options for deep atrophic scars, however they have limited efficacy in general, undesirable side effects and are expensive.
Objective: To evaluate the treatment of deep atrophic scars with high frequency electrosurgery.
Methods: Ten patients with deep atrophic acne scars received 3 high frequency electrosurgery treatment sessions with intervals of 1 month. The following were used to evaluate the outcome 1 month after the last session: histological aspects of selected scars as compared to the baseline; ratings attributed to the results by the patients (worsened, unchanged or improved); and standardized photographs at baseline and 1 month after the last session performed by a physician not related to the study, who also rated the results (worsened, unchanged or improved).
Results: Histological analysis evidenced a reduction in local fibrosis. All patients noticed improvement in the lesions. The evaluator dermatologist physician verified the presence of clinical improvement in all patients.
Conclusion: High frequency electrosurgery is a straightforward, inexpensive and effective method for the treatment of atrophic deep acne scars.

Keywords: CICATRIX; ACNE VULGARIS; ELECTROSURGERY

Microneedling or Percutaneous Collagen Induction is a minimally invasive dermatological procedure that utilizes needles to create orifices or in the skin. Its aim is to induce collagen formation, neovascularization and production of growth factors. There is increased demand because it is a relatively simple procedure, cost-effective, safe and that yields satisfactory results. It treats localized areas and studies are being done to evaluate its role in inflammation, dyspigmentation, and photodamage. The therapeutic use includes the treatment of acne scars, stretch marks, wrinkles, melasma, hyperhidrosis, alopecia. Lately, it has been used for the transepidermal distribution of active compounds and vaccines.

Keywords: Acne vulgaris; Alopecia; Collagen rejuvenation; Dermatologic surgical procedures; Percutaneous collagen induction; Treatment outcome; Wound healing

Acne is a common condition that often results in scarring. We propose a novel treatment of acne scarring using: 1- chemical reconstruction of skin scars (CROSS), mainly with carbolic acid, 2- blunt bi-level cannula subcision, and 3- microneedling. A total of 139 patients were treated from 2017- 2018, of which 89 (64%) were Fitzpatrick Skin Types IV-VI. This triple approach to treating acne scars resulted in consistent high satisfaction from patients and photographic evidence of improvement. A combination of CROSS (to stimulate neocollagenesis), subcision (to release dermal connective tissue tethering), and microneedling (to stimulate neocollagenesis) is effective for acne scar treatment.

Keywords: Acne vulgaris; Acne keloid; Cicatrix; Cosmetic techniques

INTRODUCTION: Acne vulgaris, considered a chronic inflammatory and multifactorial disease, presents several therapeutic options. The use of probiotics is a good adjunctive treatment option due to its anti-inflammatory effect.
OBJECTIVE: Based on the promising character of these studies, which derive mostly from oral probiotic therapy, we decided to investigate what results could come from the topical use of a probiotic bacterium that has undergone the tyndallization process.
METHODS: In this study, we demonstrated the topical use of Lactobacillus plantarum GMNL06, alone, for three months.
RESULTS: We obtained a therapeutic response considered good or very good in 90% of mild or moderate acne cases.
CONCLUSIONS:Vulgar acne, considered a chronic inflammatory and multifactorial disease, presents several therapeutic options. The use of probiotics has become an adjunct treatment due to its anti-inflammatory effect. In this study, we demonstrated that the use of topical probiotics, in monotherapy, for three months obtained therapeutic response considered good or very good in 90% of mild or moderate acne cases.

Keywords: Probiotics; Bacteria; Acne; Treatment

INTRODUCTION: Burn is a tissue injury and affects social functioning and relationships. Complications of burns lead to disruption of social relationships and, consequently, social dysfunction.
OBJECTIVE: This study aims to determine the effect of multimedia training on burned patients’ social functioning in Shahid Motahhari hospital in Tehran.
METHODS: This clinical trial study assessed 100 burned patients. The intervention group received multimedia self-care discharge training on a CD in addition to the standard education. The social function of the quality of life was examined in both groups before the intervention, 3 months and 6 months after the intervention.
CONCLUSIONS: Results showed that before the intervention, the mean score of social function of quality of life in intervention and control group was 1/55± 0/46, 1/92± 0/6, respectively, which was statistically significant (p <0.001). Mean and standard deviation of social function of quality of life in the intervention and control groups three and six months after intervention were2/47± 0/56, 4/05± 0/77, 2/15±0/39, 3/29 ± 0/95, also statistically significant (p<0.001).

Keywords: Self care; Multimedia; Patient discharge; Social adjustment; Burns

O queratoacantoma (QA), apesar de frequente na prática diária, é um tumor que gera questionamentos. O aspecto mais intrigante associa-se à sua posição no limite entre malignidade e benignidade. A abordagem do tumor, bem como sua classificação, é controversa. Na definição da conduta, é importante levar em conta o potencial de transformação para carcinoma espinocelular. Desse modo, a excisão cirúrgica é a terapia de escolha, sempre que possível. Algumas situações merecem atenção adicional, como a imunossupressão associada. Neste artigo, relatamos um caso de QA gigante em um paciente com síndrome da imunodeficiência adquirida tratado com cirurgia micrográfica de Mohs.

Keywords: Ceratoacantoma; Retalhos Cirúrgicos; Neoplasias Nasais; Neoplasias Cutâneas; Cirurgia de Mohs; Síndrome de Imunodeficiência Adquirida; HIV; Imunossupressão

Sarcomas são neoplasias mesenquimais malignas, raras, que acometem, principalmente, crianças e adolescentes. O rabdomiossarcoma, subtipo oriundo da musculatura esquelética, é condição incomum em adultos, acometendo sítios de localização não habitual, crescimento rápido e de difícil tratamento. Apresenta-se caso de adulto jovem com nodulação em lóbulo auricular esquerdo, cuja análise histopatológica e imuno-histoquímica confirmou tratar-se de rabdomiossarcoma alveolar, o qual foi conduzido em conjunto com a Oncologia.

Keywords: Rabdomiossarcoma Alveolar; Miogenina; Desmina; Excisão de Linfonodo

A Covid-19, doença causadora de síndrome gripal e insuficiência respiratória aguda, vem demonstrando provocar danos a diversos outros órgãos e sistemas. Várias manifestações dermatológicas já foram descritas. Relatamos um quadro de alopecia areata (AA) desencadeada possivelmente pela Covid-19 em paciente que, apesar de ter seu RT-PCR para SARS-CoV-2 negativo, apresentou IgM reagente e sintomatologia clássica relacionada à doença. Acreditamos que a Covid-19 possa ter desencadeado resposta imunológica autoimune, com a consequente produção de interferons, que levou ao quadro de AA.

Keywords: Alopecia em áreas; Autoimunidade; Coronavirus

Introduction: Acne Vulgaris is a skin disease that, with the advent of social media, has become more susceptible to the spread of unreliable information.
Objective: This study aims to characterize the influence of social media on the treatment choice for Acne Vulgaris without medical advice, identify complications of inadequate treatments, and highlight the most influential social media for this purpose and the life quality of these patients.
Methods: It is a descriptive cross-sectional study with a quantitative approach whose sample consisted of 306 social media users over 18 years of age. After signing the Informed Consent ("Termo de Consentimento Livre e Esclarecido - TCLE)" the data was collected through a self-administered form along with the questionnaire "Dermatology Life Quality Index - DLQI-BRA" via "Google forms" over 30 days. The data was then tabulated online and analyzed according to descriptive statistics.
Results: The results showed a great impact, especially from "Instagram", in the dissemination of content on the subject and highlighted the role of the dermatologist on social networks as the source of information chosen by the public.
Conclusions: The public was strict about the quality of the information, but there is still a need for greater insertion of trained professionals and information based on scientific evidence on social media.

Keywords: Acne vulgaris; Online social networking; Self medication; Quality of life; Dermatology

BACKGROUND: The COVID-19 pandemic has expanded the use of social interaction technologies, connecting individuals virtually. This change has brought a new trend of dissatisfaction with appearance induced by social media, motivating the excessive search for aesthetic procedures.
OBJECTIVE: To assess the impact generated by the use of apps during the pandemic on the self-image of respondents by biological sex, age, and family income.
METHODS: We conducted a cross-sectional study with 350 participants, aged 18 years or older, residing in the state of São Paulo - Brazil, through online dissemination of an electronic form. The data obtained were tabulated and analyzed by chi-square and Cochran tests, crossing the variables income, age, and biological sex.
RESULTS: Of the total, 69.71% claim changes in the way they see themselves physically during the pandemic; 58.3% report that apps influence their self-image, as 70.6% of the answers are women between 18- 29 years old; 73.9% of women of all ages and incomes recognized the importance of skin for self-image, with this finding being discrepant among the age groups of men.
CONCLUSIONS: The use of apps during the pandemic impacted the self-image of the participants leading them to have a greater interest in obtaining future treatments and aesthetic procedures.

Keywords: Dermatology; Self-image; COVID-19; Social isolation

Atrophic acne scars result from an abnormal wound-healing response that can be treated with microneedling (MN). Insulin may play a role in wound healing. The effectiveness and safety of combining MN with topical insulin as an alternative therapy for atrophic acne scar revision have not yet been widely reported. We report the case of a 33-year-old woman with an atrophic acne scar on the middle third of her face. The patient was treated with MN and topical insulin for four sessions at two-week intervals. MN plus insulin can be considered an alternative for acne scar revision.

Keywords: Acne Vulgar; Insulina; Cicatriz; Hiperpigmentação

BACKGROUND: TikTok is a short-video platform popular among the young, the age group most affected by acne. Health-related content is often produced by creators without academic backgrounds in health care, raising concerns about information quality and reliability.
OBJECTIVE: To evaluate the educational quality, reliability, and evidence-based accuracy of TikTok videos on acne treatment in Brazilian Portuguese.
METHODS: The top 30 videos for “tratamento da acne” (acne treatment) were selected using a new TikTok account. Educational quality was assessed using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V), accuracy using the 2024 American Academy of Dermatology (AAD) Guidelines of Care for the Management of Acne Vulgaris, and reliability using the Journal of the American Medical Association (JAMA) Benchmark Criteria.
RESULTS: Only 10% of videos recommended treatments consistent with AAD guidelines. No non-medical creator provided correct recommendations, and only 33% of physician-created videos were correct. PEMAT-A/V scores were high, indicating well edited and understandable content, whereas JAMA scores were uniformly low, reflecting poor reliability..
CONCLUSIONS:Caution is warranted when using TikTok as a source of information on acne treatment in Brazilian Portuguese, as most videos analyzed were incorrect or imprecise.

Keywords: Acne Vulgaris; Cross-sectional studies; Social Media; Health Communication