Giant congenial melanocytic nevi are uncommon lesions that have a higher risk of developing into cutaneous melanomas. When located on the face, they can cause neurological problems, including leptomeningeal melanocytosis and epilepsy. They can also be unattractive. A case of a 17-year-old female patient with congenial melanocytic nevus affect- ing one-third of the right side of her face is reported. The patient underwent the lesion’s resection and reconstruction with a partial skin graft in a single surgery. The objective of this study was to demonstrate a therapeutic proposal for congenial melanocytic nevi located in the periorbicular region.

Keywords: NEVUS, PIGMENTED, NEVI AND MELANOMAS, SKIN, TRANSPLANTATION, AUTOLOGOUS

Talon noir was first described in 1961 by Peachey as atraumatic petechial eruption characteristic of basketball players' heels, and were originally called calcaneal petechiae. It is a dermatosis linked to trauma, with asymptomatic lesions, marked by the presence of blood within the stratum corneum. It presents varied clinical manifestations, with the location depending on the involved provocative fac-tor. The present study describes a case of talon noir in a patient with psoriasis vulgaris and demonstrates the importance of the correlation of clinical, dermoscopic, and histopathological characteristics.

Keywords: BLOOD STAINS, NEVI AND MELANOMAS, FOOT

Introduction The pigment mainly responsible for the color of the skin, melanin is directly influenced by exposure to sunlight. Objective: The present study assessed the effects of solar radiation on the levels of melanin in areas exposed and not exposed to the sun, taking into consideration the seasonality of exposure. Methods: Melanin levels were evaluated on the forehead, sacral region, and forearm, in the post-summer and post-winter periods, using spectrophotometry. Results: The levels of melanin after winter were lower than those after summer in the forehead (168.1 vs. 177.0), sacral region (132.0 vs. 140.4), and forearm (218.7 vs. 260. 4), with a statistically significant reduction only in the forearm (p<0.0001).Additionally, erythema was significantly less intense in the forearm and forehead (p<0.0001 and p=0.002) after winter than after summer. Conclusion: The significant reduction of melanin levels in the forearm after winter reinforces the influence of seasonality on skin pigmentation changes to body areas exposed to the sun without protection.The small variation in the levels of melanin found in the unexposed area (sacrum) confirms that the effect of exposure to the sun on the levels of melanin is predominantly local. Increased production of melanin is directly related to local exposure to UV rays.

Keywords: MELANINS; ERYTHEMA;SOLAR RADIATION; PIGMENTATION.

Introduction: Childhood is considered a critical period for photoprotection, since approximately 80% of the exposure to the sun occurs during this phase of life. Objectives: To evaluate the characteristics of the knowledge and sun protection habits of children and their caregivers. Methods: A cross sectional study was conducted with questionnaires from October 2011 to July 2012. Results: 177 children (mean age = 7.66 years); 64.9% of children assessed exposure to the sun as dangerous, 88.7% knew what sunscreen is, and 94.3% considered its use important; however, 66.6% believed it was necessary only in summer. Regarding photoprotection habits, 37.3% reported exposure to the sun between 10a.m. and 4p.m. Among caregivers, 81.3% reported an absence of daily application of sunscreen on their children, and 33.9% reported that their children had already had some type of sunburn. Conclusions: Strong dissociation between knowledge and practice regarding exposure to the sun was observed in the present study. The discrepancy between knowledge and habits that was observed in the two groups can be explained by the quality of information on exposure to the sun. The present study’s data point to the need for a wider dissemination of adequate knowledge, both by the media and by physicians, to nurture healthy practices regarding exposure to the sun.

Keywords: SOLAR ACTIVITY; SUN PROTECTION FACTOR; SUNSCREENING AGENTS; CHILD RESTRAINT SYSTEMS; CAREGIRVES

Introdução: Hyperpigmentation is a common dermatological condition, usually associated with exposure to the sun and relative difficulty of treatment. Pycnogenol^® is an extract obtained from the French pine tree Pinus pinaster, with known antioxidant and anti-inflammatory activity, having been proven to inhibit melanin synthesis in previous studies. Objective: To evaluate the whitening activity of Pycnogenol^® in an ex vivo experimental model after exposure to ultraviolet A and B, infrared-A radiations and visible light. Method: Human skin fragments obtained from elective plastic surgery were treated with Pycnogenol ^® and then irradiated with ultraviolet A and B, and infrared-A radiations, and visible light, having been sent for histological evaluation of melanin pigmentation by the Fontana-Masson staining technique. Results: The histological evaluation demonstrated an increase in melanin deposition in all irradiated groups. However, fragments pre-incubated with Pycnogenol^® showed a reduction in the deposition of this pigment after irradiation. Conclusions: This study demonstrates the reduced melanin deposition in skin culture treated with Pycnogenol^® after irradiation with ultraviolet A and B, and infrared-A radiations, and visible light, concluding that this substance may have lightening properties.

Keywords: HYPERPIGMENTATION; SKIN LIGHTENING PREPARATIONS; SOLAR RADIATION

Introduction: Infrared radiation (IR-A) causes structural changes in the skin, similar to those caused by prolonged exposure to ultraviolet radiation. Evaluation of efficacy and safety of cosmetic products concentrates in in vitro tests and clinical trials. A promising alternative is the use of fragments of human skin from elective cosmetic surgery, to evaluate the actual clinical benefits of a product applied topically.
Objective: The objective of this study was to correlate IR-A radiation effects in biopsies and in ex vivo skin fragments and in human fibroblasts culture by quantifying MMP-1, TIMP-1 and GADD45a mediators.
Methods: Collection of biopsies from 15 volunteers after IR-A applications for 5 consecutive days. Exposure to IR-A radiation of human skin fragments from elective cosmetic surgery, and human fibroblasts culture. Measurement of MMP-1, TIMP-1 and GADD45a mediators for further comparison of results.
Results: In the three models used, the IR-A radiation induced an increase in MMP-1, inhibited the synthesis of GADD45a, and did not changed TIMP-1 values.
Conclusion: Due to the positive correlation of the models studied, it may be suggested the use of ex vivo skin as plausible and sustainable tool to overcome differences between knowledge generated from in vitro and clinical experiments.

Keywords: SKIN AGING; MATRIX METALLOPROTEINASE 1; SOLAR RADIATION; IN VITRO TECHNIQUES

Introduction: The number of cases of cutaneous carcinoma has been steadily increasing, which calls for the necessity of improving cost effective health strategies aimed at preventing that disease and related complications.
Objective: To perform a cross-sectional study with data collected directly from the participants, through the application of a questionnaire.
Methods: Once the data was collected, the bivariate logistic regression was used to calculate the odds ratio (OR) and the 95% confidence interval (CI) between the independent variables and the risk behavior, which corresponded to the non-daily use of sunscreen and/or other photoprotection method. The sample consisted of 200 students – of which 50% studied mathematical sciences and 50% studied biological sciences.
Results: There was no significant difference between the students' behavior according to the different science field they were studying. Women presented lower risk behavior as compared to men (OR = 0.07; CI 95% = 0.01 - 0.56).
Conclusions: Most university students do not protect themselves adequately when exposed to the sun, with this risk behavior being lower in women. Actions aimed at photo-educating students are important.

Keywords: Disease prevention; Skin; Solar radiation; Students

INTRODUCTION: The chest is a photoexposed area that shows effects of photodamage. Microneedling is a safe option for the rejuvenation of this area, also leading to improvement in dyschromias.
OBJECTIVE: To evaluate histologic cutaneous response after three monthly sessions of microneedling for the treatment of dyschromias on the chest.
METHODS: Three monthly sessions of microneedling, with 1.5mm length needles were performed, as well as skin biopsies before and 90 days after commencement of the study. Histologic samples were evaluated with H&E and Fontana-Masson stains. Melanin content was measured based on dermal clusters.
RESULTS: Six patients between 38 and 67 years of age, phototypes II-III, Glogau scale II-IV were included. A positive correlation was observed between the time and dermal content of melanin (p=0.029): three sessions of microneedling reduced this content on D90 compared to the beginning (6.4 ± 1.7 MC on D0 versus 3.1 ± 0.4 on D90, p = 0.05). Three patients reported global skin improvement on D90.
CONCLUSIONS: The proposed mechanism of microneedling to promote lightening includes fibroblast proliferation and neocollagenesis in the upper dermis. This is the first study to evaluate the histology of the findings associated to lightening of the chest due to microneedling.

Keywords: Histology; Melanins; Needles; Thorax

INTRODUCTION: Identifying the causes of periorbital hyperpigmentation is crucial in selecting the best treatment. The identification of transcriptional profiles that may be related to hyperpigmentation around the eye area could contribute to a new approach in the treatment of periorbital hyperpigmentation – the gene therapy.
OBJECTIVE: This study aims to assess the transcriptional profile of melanogenesis, and genes related to enzymatic antioxidants in skins with periorbital hyperpigmentation.
METHODS: Based on clinical evaluation, 49 healthy volunteers were classified with or without periorbital hyperpigmentation. Genetic profiles of melanogenesis-related genes: microphthalmia-associated transcription factor (MITF), pro-opiomelanocortin (POMC), melanocortin 1 receptor (MC1R), tyrosinase (TYR), tyrosinase 1-related protein (TYRP1), and intracellular antioxidants - glutathione reductase (GR), glutathione peroxidase 1 (GPx-1), glutathione s-transferase (GST-1) - were determined by the polymerase chain reaction technique in real-time.
RESULTS: MITF, TYR, and TYRP1 gene expressions were significantly higher in the periorbital hyperpigmentation group (p<0.01). GR, GPx-1, and GST-1 gene expressions were comparable between the groups with and without periorbital hyperpigmentation.
CONCLUSIONS: The results of this study suggest that MITF is the primary regulator of melanin deposition in skins with periorbital hyperpigmentation. Up-regulated MITF is closely associated with increased TYR and TYRP1.These findings are essential in proposing a new therapeutic approach in the treatment of periorbital hyperpigmentation.

Keywords: Hyperpigmentation; Melanins; Microphthalmia-associated transcription factor

INTRODUCTION: Polypodium Leucatomos Extract (PLE) is a recognized topical and oral photoprotective agent that adds biological protection to physical and chemical filters.
OBJECTIVE: To evaluate the efficacy of an SPF 90 sunscreen containing physical and chemical filters, and PLE in reducing sun damage when compared to the same formulation but without the presence of PLE.
METHODS: Ten volunteers were included, each representing 4 areas (non-irradiated skin; irradiated and unprotected skin; irradiated and protected with sunscreen not containing PLE; irradiated and protected with sunscreen containing PLE) exposed to solar radiation. Colorimetric evaluations of erythema and pigmentation were performed. Samples were collected for histopathology.
RESULTS: The area treated with PLE-containing SPF 90 sunscreen, compared to the sunscreen of the same formulation but without the presence of PLE, showed lower intensity of erythema and pigmentation, lower generation of sunburn cells, p53, and MMP-1, and higher CD1-a cell positivity (lower Langerhans cell depletion).
CONCLUSIONS: The association of Polypodium Leucatomos Extract with physical and chemical filters is effective in reducing the damage caused by solar radiation. The presence of EPL in the formulation contributed to the reduction of damage when compared to the formulation without the active.

Keywords: Sunscreens; Polypodium; Solar radiation

The nevus spilus (NS), also known as speckled lentiginous nevus or nevus on nevus, is represented by a brownish macule on which small macules of darker shades appear. It is more common on the trunk and lower limbs. The general population's prevalence is 0.2% to 2.3%, and they have a benign character. The exact risk for malignant transformation is still unknown; thus, it demands a routine clinical-dermoscopic follow-up. We present a case of malignant melanoma on acquired nevus spilus, in which early an excision was performed, with no recurrence, highlighting the importance of follow-up of these patients.

Keywords: Melanoma; Nevi and melanomas; Nevus

The increase in the incidence of basal cell carcinoma (BCC) affects all age groups, including young patients under twenty years old. Because it is poorly remembered in this group of patients, late diagnosis and treatment of this neoplasia may be more common. Like other age groups, excessive exposure to ultraviolet radiation is the main associated risk factor; however, genetic factors may also be involved in non-syndromic cases. We report a case of BCC on the face of an adolescent treated with Mohs micrographic surgery.

Keywords: Adolescent; Carcinoma, Basal Cell; Epidemiology; Mohs Surgery; Solar Radiation

Patients with giant congenital melanocytic nevus are at higher risk of developing melanoma. After the first diagnosis of melanoma, there is also a higher incidence of subsequent melanomas in the same patient. However, the ideal therapy for this type of nevus is still controversial. We report the case of a patient with giant congenital nevus associated with multiple synchronous melanomas and the proposed treatment.

Keywords: Melanoma; Nevi and melanomas; Neoplasms

Polypodium leucotomos extract was first described in the literature 55 years ago, demonstrating anti-inflammatory action in dermatoses such as vitiligo and psoriasis. It is currently available as an oral and topical photoprotection agent in more than 26 countries to prevent and treat dermatoses resulting from solar radiation, such as polymorphous light eruption, melasma, actinic keratoses, skin cancer, and photoaging, among others. In Brazil, ANVISA registered the patented Polypodium leucotomos extract in 2012. After 10 years of its launch, its recommendation by Brazilian dermatologists is well established and is presented in this review paper.

Keywords: Solar radiation; Sunscreening agents; Polypodium