Conventional ablative lasers remove the epidermis and part of the dermis completely, and achieve excellent results in the treatment of photoaging. Non-ablative lasers have become more popular, since they inflict less thermal damage on the dermis and do not remove the epidermis, thus reducing the recovery time and the risk of side effects. Fractioning has recently been introduced in non-ablative lasers, with the goal of developing a system with the efficiency of the ablative and the safety of the non-ablative lasers. Fractional ablative lasers form total dermal-epidermic ablation columns, whereas fractional non-ablative lasers generate microscopic zones of dermal-epidermic thermal lesions, yet they preserve the stratum corneum.

Keywords: LASERS, CARBON DIOXIDE, POSTOPERATIVE COMPLICATIONS, REJUVENATION, PHOTOAGING

Fordyce granules are referred to as benign ectopic sebaceous glands characterized by multiple yellow papules, occurring mainly in the lower lip. It is mainly observed in adult men. The present study describes two cases of patients with Fordyce granules who were treated using a CO2 laser and obtained good cosmetic results.

Keywords: MOUTH MUCOSA, LASER THERAPY, CARBON DIOXIDE

Tattooing has existed in humankind's culture since the onset of civilization. Tattoo removal attempts are also very ancient. The following current methods are reported for the removal of tattoos: dermabrasion, surgical excision, and laser procedures. The most commonly used lasers for tattoo removal are: QS-Nd:YAG (1,064 and 532nm), QS-Ruby (694nm) and QS-Alexandrite (755nm). The present review is aimed at studying the action mechanism of lasers for tattoo removal and the correct indication for each type of pigment, in addition to describing complications and the best manner of preventing them.

Keywords: LASERS; LASER THERAPY; TATTOOING.

Introduction: Several therapeutic modalities, such as surgeries, cutaneous filling, and ablative techniques are used for perioral rejuvenation. Objective: The present study was aimed at evaluating the efficacy and side effects of an ablative method, using fractional carbon dioxide (CO₂) laser in the treatment of perioral wrinkles. Methods: A retrospective study was carried out with 20 female patients who underwent a single session of fractional CO₂ laser, with high energy and density, for the treatment of perioral wrinkles. Photographs taken before and 90-days after the procedure were evaluated by two examiners unrelated to the study, who looked at the effect of the laser on the deep static wrinkles, fine lines, skin texture, and color. The patients were also classified, pre-and post-treatment, according to the classification of Baker for perioral wrinkles. Results: Three months after the treatment, it was possible to observe clinical improvement in 100% of the patients, in all the variables evaluated. In the classification of Baker, five patients classified as Grade II, and three who classified as grade III became Grade I and Grade II, respectively. Patients initially classified as Grade I did not have alterations in their classification for presenting few superficial wrinkles. Observed side effects were: transient erythema and edema in the early post-procedure period. Conclusion: Fractional CO₂ laser has proven to be a safe and effective option for the treatment of perioral wrinkles.

Keywords: SKIN AGING; LASER THERAPY; CARBON DIOXIDE.

There are many treatments proposed for the aging skin. CO2 laser has a growing indication as such. The author reports a case involving a complication using treatment with this technology in the periorbital region.

Keywords: BLEPHAROPLASTY; LASER THERAPY; CARBON DIOXIDE; TREATMENT OUTCOME.

Over the last centuries, several surgeries for eyelid reconstruction have been developed, perhaps due to the complexity of this anatomical area. Tumors larger than two-thirds of the lower eyelid preclude their direct closure and require surgical reconstruction that preserves the anatomy of the eyelid. The purpose of the present study is to present a technique for reconstruction of the lower eyelid with jugal mucosa and Mustardé flap or advancement flap, without reconstruction of the tarsus. This technique was performed in a series of six cases, all presenting satisfactory post-operative results. These patients did not present distortion of the anatomy nor ectropion.

Keywords: CARCINOMA, BASAL CELL; CARCINOMA, SQUAMOUS CELL; MOUTH MUCOSA; EYELID NEOPLASMS; SURGICAL FLAPS.

The upper lip is commonly affected by cutaneous carcinomas. The excision of the neoplasia with safe oncologic margins calls for a large incision, and sometimes flaps are necessary. In addition to its aesthetic value, a successful lip reconstruction includes the maintenance of perfect oral functionality. The authors describe a nasolabial rotation cutaneous flap associated with an advancement flap of the oral mucosa in a single surgical event, performed on a patient bearing basal cell carcinoma involving the left side portion of the upper lip.

Keywords: SURGICAL FLAPS; CARCINOMA, BASAL CELL; MOUTH MUCOSA

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

The Hailey-Hailey disease or familial benign pemphigus is a rare condition, characterized by vesicular lesions and erosions with a predilection for intertriginous areas associated with pain and burning sensation that affect the quality of life of patients. There are many topical and systemic treatments for the injuries that can temporarily promote partial or complete remission, but there is no curative treatment. Some treatment options with lasting results include dermabrasion and Erbium laser resurfacing (YAG or CO2). We report three cases of patients with recurrent lesions and limited responses to classical treatments, which showed significant clinical improvement after fractional CO₂ laser therapy.

Keywords: PEMPHIGUS, BENIGN FAMILIAL; LASER THERAPY; CARBON DIOXIDE

INTRODUCTION: The treatment of hypochromic scars is challenging, and the techniques used so far show unsatisfactory results. Bimatoprost, an analog of prostaglandin F2-alpha, has been used as a topical pigment agent, and its application as drug delivery can optimize its delivery to the dermis and potentiate pigmentation.
OBJECTIVE: To evaluate the safety and efficacy of Ablative Fractional Laser (AFL) treatment associated with bimatoprost 0.03% drug delivery in hypopigmented scars.
METHODS: The patients were submitted to the AFL, followed by the application of bimatoprost 0.03% in 4 sessions with biweekly intervals. Clinical evaluations and standardized photographs were performed. Patients’ satisfaction was assessed using a 5-question questionnaire.
RESULTS: All patients had clinical improvement in the treated areas. The degree of patient satisfaction agreed with the clinical evaluation and photographic records.
CONCLUSION: The application of AFL associated with bimatoprost 0.03% drug delivery can be a potentially effective and safe treatment for hypochromic scars.

Keywords: Lasers; Hypopigmentation; Laser Therapy

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

Case study of exceptional response to treatment of recurrent xanthelasma palpebrarum with an ablative laser. The patient underwent a single session of laser Erbium: Yttrium-aluminum-garnet (Fotona^®) 2940 nm, and we performed photographic records with Vectra^® H2 2019 before and after the procedure. Satisfactory clinical results were reported, with good pain tolerability and early recovery compared to surgical procedures and, consequently, less time away from work activities.

Keywords: Lasers; Laser therapy; Laser coagulation; Xanthelasma palpebraum

Oral mucosa melanoma (OMM) represents 0.2% to 8% of melanoma cases. It mainly affects the palate and gums of patients between 40 and 70 years old. It is initially asymptomatic, contributing to late diagnosis and poor prognosis. The treatment of choice consists of surgical resection, and adjuvant radiotherapy and chemotherapy may be used. We report a case in an 80-year-old male patient with primary gingival and hard palate melanoma who underwent tumor resection followed by palate reconstruction. We emphasize the importance of a complete physical examination and active search for lesions in the oral mucosa for early diagnosis.

Keywords: Melanoma; Mouth mucosa; Palate

Syringomas are benign adnexal neoplasms that develop from eccrine sweat ducts. They are mostly found in early adulthood, with a female gender predominance. They typically occur on the face, particularly the periorbital region, which has a high demand for cosmetic enhancement. Management of periorbital syringomas is challenging, with no consistently effective treatment available. Intradermal injection of botulinum toxin A (BTX-A) is a new treatment modality for periorbital syringoma. We present a 53-year-old female patient with periorbital syringoma who was successfully treated with intradermal BTX-A monotherapy as a painless, cost-effective treatment that produced better long-term results than carbon dioxide laser.

Keywords: Botulinum Toxins, Type A; Syringoma; Carbon Dioxide