Introduction: Skin photoaging can be treated with ablative therapies that cause immunological changes to the skin. Objectives: To evaluate the results of chemabrasion in the treatment of perioral wrinkles and the change in number of Langerhans cells. Material and Methods: Application of 35% trichloroacetic acid followed by manual dermabrasion using waterproof sandpaper, in 12 female patients with perioral wrinkles and results were then examined 30 days and 1 year later. Immunohistochemistry was used to measure Langerhans’ cells which were counted before treatment and 1 month post-treatment. Results: Improved perioral photoaging and reduced number of Langerhans’ cells (p = 0.002) were seen in all patients. Conclusions: Chemabrasion provides effective results in the treatment of perioral wrinkles but Langerhans cells remain low for 30 days after therapy.

Keywords: SKIN AGING, CHEMABRASION, METHODS, DERMABRASION, TRICHLOROACETIC ACID, THERAPEUTIC USE, IMMUNOHISTOCHEMISTRY, LANGERHANS CELLS

Introdução:There is no standardized approach to immediate post-procedure care for epidermal ablation; the conscientious choice of products can provide greater comfort to the patient, reduced risks and complications, and shorter recovery times. Objective: To analyze the safety and effectiveness of silicone spray in tissular restoration after two epidermal ablation procedures – fractional ablative 2,790 nm YSGG laser and dermabrasion. Methods: Patients with photoaging or acne scars (n = 20) applied silicone spray on one side of the face and liquid Vaseline (control) on the other side of the face after the procedures.Transepidermal loss of water was measured in all patients. Results: Erythema and burning sensation were the most common findings, and were significantly more frequent in the areas where Vaseline was applied. Conclusions: Silicone spray is safe and effective for use after epidermal ablative procedures, and is significantly superior to Vaseline in controlling burning sensations and erythema

Keywords: SILICONES, WOUND HEALING, DERMABRASION, LASER THERAPY

The aging process causes significant changes to the face. There is an increasing demand for aesthetic facial procedures such as blepharoplasty, rhytidectomy, and the use of filling substances and botulinum toxin, among others. The subnasal region receives comparatively less attention. This report aims to demonstrate the use of upper lip lifting combined with dermabrasion as an option to obtain greater facial harmony. In addition, it emphasizes the possibility of its use in association with other surgical procedures.

Keywords: LIP, RHYTIDOPLASTY, SKIN AGING, DERMABRASION

Flaps are widely used in the surgical reconstruction of the nasal region. During the post-operative period, an unattractive depressed scar in relation to the nearby skin can be observed. Even after abrasion – which the literature recommends 30-60 days after the procedure – this complaint often persists. This study proposes tangential excisions with a razor blade (shaving) of the flap''''''''s entire area until it is level with the surrounding region, followed by dermabrasion to refine any remaining irregularities. The results are deemed excellent since the scars become less noticeable – a very satisfactory outcome due to the aesthetic and social importance of the treated area.

Keywords: SURGICAL FLAPS, NEOPLASMS, DERMABRASION

Lichen planus pigmentosus is a rare variant of lichen planus and represents a therapeutic challenge. Dermabrasion was performed with a good clinical response in the treatment of this condition, on the face of a female patient who also bears frontal fibrosing alopecia.

Keywords: DERMABRASION; LICHENOID ERUPTIONS; ALOPECIA.

Eccrine spiradenoma is a rare benign adnexal epithelial neoplasm characterized by a bluish-pink, slow-growing solitary nodule, coursing with paroxysmal pain, mainly in young adults. It is most commonly located in the trunk and extremities. Bleeding and/or ulceration are common in the giant vascular variant, which is characterized by a size greater than 2 cm in diameter and a high degree of vascularization seen on histology. Its clinical characteristics are unspecific and require biopsy with histological analysis for diagnosis. Its histology presents one or more basophilic intradermal lobules enveloped in a fibrous capsule without connection to the epidermis. It presents two types of cells: small cells with dark nuclei in the periphery and large cells with light nuclei in the center. An accurate diagnosis is important due to the fact that it can develop into a potentially fatal malignancy - which is a rare phenomenon and occurs most often in the multiple variant. A rare case of eccrine spiradenoma in the abdomen with bleeding associated is described in the present paper, as well as a discussion on possible treatments.

Keywords: ECCRINE SPIROADENOMA, BENIGN EPITHELIAL NEOPLASIA, SEBACEOUS GLANDS

Patients with scars often seek dermatologists for improving the symptoms (pruritus, pain), aesthetics and functionality (for example, to improve the range of motion in the joints). After anamnesis and description of the scar, the patient should be informed about the best repair techniques, based on scientific evidence and the physician's personal experience. The authors describe the main surgical techniques to treat scars, such as Z-plasty, W-plasty, dermabrasion, among others

Keywords: CICATRIX; SURGERY; DERMABRASION

Introduction: Rhinophyma is the final stage of rosacea. It leads to the stigmatization of the patient.
Objective: To establish the safety and efficacy of dermachemabrasion in the treatment of rhinophyma.
Methods: The method, which consists of tangential excision and dermabrasion with sandpaper followed by 30% trichloroacetic acid on the previously sanded area, was prospectively applied in 7 patients. The excised material was histologically studied aiming at detecting hidden neoplasias. Safety and efficacy were evaluated clinically and through standardized photographic records.
Results: The patients' ages ranged from 57 to 68 years (6 men, 1 woman). The complete reepithelialization occurred within 7 to 14 days. The 7 patients progressed without infection, with satisfactory reepithelialization and results from the aesthetic point of view, with absence of dyschromias or scarring. The histological analysis revealed the presence of a hidden neoplasia (superficial basal cell carcinoma) in one case.
Conclusion: Dermachemabrasion is a low cost, simple to execute and effective treatment that leads to excellent cosmetic results in addition to having the advantage of the possibility of histological analysis, which is extremely important, since there are reports of hidden malignancy in rhinophyma.

Keywords: RHINOPHYMA; TREATMENT OUTCOME; DERMABRASION; TRICHLOROACETIC ACID

Vitiligo is an acquired depigmentation characterized by partial or total loss of epidermal melanocytes. Many therapeutic modalities have been proposed for its treatment. In cases of stable vitiligo surgical treatments are preferred. Grafting by epidermal scraping is a variant of micrografts by punch technique. It is a new, simple and low cost technique, with high rates of repigmentation. The objective of this report is to demonstrate the authors' experience with this technique and discuss the results in an initial series of two cases (three lesions).

Keywords: PHOTOTHERAPY; VITILIGO; PIGMENTATION DISORDERS; DERMABRASION; MELANOCYTES

A survey on the opinion of specialists regarding skin resurfacing was performed, with the objective of comparing costs and benefits between the techniques: totally ablative CO2 laser, fractional ablative lasers, fractional non-ablative lasers, ablative fractional radiofrequency, microneedling, dermabrasion, medium peels, phenol-croton oil peels. The most effective option for the treatment of static wrinkles was the phenol-croton oil peel, in first place by 71.4% of the experts, followed by totally ablative CO2 laser, by 28.6%. Regarding downtime, procedures ranked as fastest recovery were microneedling and fractional non-ablative lasers, with 42.9% each, followed by ablative fractional radiofrequency, with 14.3%. Complete recovery period for side and adverse effects was perceived as shorter with microneedling by 50% of the experts. Regarding operating costs. The less costly procedure was medium peels, according to the opinion of 71.4% of the experts. Such results point towards a better cost/benefit of procedures such as chemical peels and micro-needling, according to the opinion of 14 Brazilian specialists who answered the questionnaire.

Keywords: Chemexfoliation; Dermabrasion; Lasers; Needles; Phenol; Pulsed radiofrequency treatment

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

The reconstruction of deep surgical defects of the nasal tip and wing of the nose often presents a challenge to the surgeon. In these cases, full-thickness skin grafting is widely used, but it often results in sinking or graft depression. We present a surgical technique that is easy to perform and reproducible; nonetheless still very little diffused in Brazil: the “Drumhead” graft. This method performs the grafting of a rigid plastic suspension together with the full-thickness skin graft. Thus, this technique constitutes another tool for the dermatological surgeon to prevent irregularities of undesirable contours, graft depression, and nasal vestibule collapse.

Keywords: Nose; Nose neoplasms; Skin neoplasms; Skin transplantation

INTRODUCTION: The perioral region is commonly affected by non-melanoma skin cancer. Mohs micrographic surgery is the treatment of choice in this area because it has the highest cure rate and preserves healthy tissue. Several methods are available for restoring the perioral region, and their selection is influenced by the surgical wound characteristics and the surgeon's preference.
OBJECTIVE: Describe the authors’ experience in perioral reconstruction after Mohs micrographic surgery and analyze the repair methods most frequently performed.
METHODS: Retrospective study of consecutive cases submitted to Mohs surgery and perioral reconstruction.
RESULTS: The study included 108 cases from 103 patients. The mean number of Mohs surgery stages was 1.4, and the mean defect size was 16 mm. Primary closure was the most used technique for reconstruction, followed by flaps (mainly V-Y, single advancement, and rotation). The association of repair methods was used in 28.7% of cases, mostly combined with flaps. Four patients had complications (necrosis and graft infection, trapdoor effect, and partial wound dehiscence).
CONCLUSION: Primary closure was the most frequent repair method, followed by flaps. Knowing reconstruction strategies and possibilities of associations is essential for proper restoration of the perioral region, maintaining its functionality, sensitivity and aesthetics.

Keywords: Lip; Lip neoplasms; Mohs surgery; Skin neoplasms

We report a case of a 72-year-old man who underwent surgical excision of a keratoacanthoma centrifugum marginatum (KCM) located on the left forearm. It is an uncommon variant of keratoacanthoma, which can assume large dimensions (up to 20 cm) and does not tend to spontaneous regression. The lesion is usually single, with raised borders, and has progressive centrifugal growth associated with central healing and atrophy. Due to its rarity and lack of pathognomonic histopathological features, KCM can be a diagnostic challenge for dermatologists and pathologists.

Keywords: Keratoacanthoma; Neoplasms; Skin neoplasms

Exogenous ochronosis is a stigmatizing dermatosis characterized by asymptomatic, bluish-black, or grayish macules in photoexposed areas. Associated with the prolonged use of hydroquinone for the treatment of dyschromias, it has a broad therapeutic arsenal, but the results are unsatisfactory and/or costly. We report the case of a female patient with histologically proven exogenous ochronosis who underwent dermabrasion associated with the use of tretinoin and topical corticosteroids with surprising results after three months of follow-up to demonstrate the possibility of therapeutic success with a low-cost technique and an outpatient clinic procedure.

Keywords: Ochronosis; Therapeutics; Dermabrasion