Introduction: Calcium hydroxyapatite is a radiopaque material that was traditionally used to provide radiologic contrast. It has recently been approved for use in cutaneous filling.
Objectives: To define the radiologic characteristics of Calcium hydroxyapatite and its potential to compromise radiologic evaluations.
Methods: Twelve patients received Calcium hydroxyapatite filler in the malar eminence and had radiography of the face (frontal, lateral, mentum-nasal-plaque (Waters), and Hirtz axial incidence technique) 1-8 weeks after the procedure. The X-rays were examined by two radiologists – one of whom was unaware of the filling procedure.
Results: The Hirtz axial incidence technique demonstrated amorphous radiopaque images in the suprazygomatic soft tissues in all cases, in both evaluations. Radiesse® was not detected using the other techniques, and did not illustrate the filler''''''''s position and symmetry. The evaluation of subjacent osseous structures was not compromised by the material''''''''s presence.
Discussion: Calcium hydroxyapatite can be identified in facial radiography when evaluat- ed using a method that avoids overlapping with adjacent osseous structures. Although it does not impair the osseous evaluation, it is recommended that the radiologist or dentist is noti- fied of the material''''''''s presence.
Conclusion: Cutaneous fillings containing Calcium hydroxyapatite can be identified, although not precisely located, using conventional X-ray.

Keywords: FACE, DURAPATITE, X-RAYS

Introduction: Patients (n = 56) received incobotulinumtoxinA for the treatment of dynamic facial wrinkles.
Objective: To test the efficacy of incobotulinumtoxinA in correcting facial wrinkles.
Methods: The toxin was applied in in the usual doses and regions.
Results: Only 38 patients returned for evaluation after treatment. Of those, 19 complained about the low efficacy, short duration or absence of effects of the toxin. The total dose applied in patients who expressed satisfaction with the outcome (19 patients) was 872 units, while in the dissatisfied group (19 patients) it was 748 units – which was later increased by an additional 30.62% (229 units) of the initial dose.
Conclusion: Although some clinical studies demonstrate that this botulinum toxin has an efficacy similar to others available, this study has not succeeded in reproducing that fact.

Keywords: BOTULINUM TOXINS, FACE, THERAPEUTICS

This article describes the case of a female hepatitis C patient who presented with a foreign body granuloma in the nasolabial folds and glabella five years after receiving an application of permanent dermal filler. The patient used interferon and ribavirin for treating hepatitis C for six months, and the granulomas appeared 30 days after the end of the treatment. Treatment with oral steroids was carried out, with a gradual improvement in the appearance of the skin.

Keywords: GRANULOMA, POLYMETHYL METHACRYLATE, FACE

Photography is an essential tool in the dermatologist's daily practice and can be used in various ways. From simple records of lesions verified in dermatological examinations to illustrations of a treatment's result, photographs document more clearly and concisely what is seen due to the utterly descriptive nature of this medium. Nevertheless, it is important to note that the present article refers specifically to what is known as Medical Photography, a type of photography that reproduces subject matter with maximum detail and relevant information. To achieve this, it is necessary to master the basics of photographic technique, including knowledge of available equipment and the fundamentals of digital technology, and also to establish a photographic routine that includes the standardization of the images.

Keywords: PHOTOGRAPHY, DERMATOLOGY, FACE, SURGICAL PROCEDURES

Introduction: Filling techniques are an important procedure in modern therapeutic approaches to rejuvenation, and are currently in wide use. Objective: To assist the practice of dermal filling procedures and reduce associated risks. Method: Division of the face into 22 regions in which filling procedures are indicated, providing detailed description of the nervous and vascular structures of each. Results: This didactic, practical, and detailed new division of the regions of the face highlights the possible risks related to anatomical features, thereby facilitating implementation, and reducing the risks and complications of filling techniques, such as the widely-feared amaurosis and tissue necrosis. Conclusion: Only a thorough knowledge of facial anatomy enables the safe realization of dermal filling procedures.

Keywords: ANATOMY, RISK ZONE, FACE.

Dermoscopy of lentigo maligna on the face has reliable and well-tested parameters for its diagnosis. However, some benign lesions such as pigmented actinic keratoses have dermoscopic aspects that are common in malignant lentigo, making the correct diagnosis difficult. This fact often leads to unnecessary excisions of benign lesions. The present article discusses these morphological parameters in light of the dermoscopic analysis of the commonalities between lentigo maligna and pigmented actinic keratosis, also touching upon the aspects already described for the diagnosis of pigmented actinic keratoses.

Keywords: DERMOSCOPY; HUTCHINSON'S MELANOTIC FRECKLE; KERATOSIS, ACTINIC; FACE.

The observation of mucous membranes should be part of a dermatological examination. It is known that early diagnosis is critical for the prognosis of patients with malignant melanocytic lesions. Nevertheless, integrating this step into the examination routine and performing a differential diagnosis between benign and malignant mucosal lesions with only clinical signs, are great challenges. Dermoscopy is still seldom-used for pigmented lesions of mucous membranes, however recent studies have shown its potential. In light of a case of melanoma of the lip, the authors provide tips and data from the literature that highlight the usefulness of the technique, and support the use of dermoscopic examination in the dermatologist's routine.

Keywords: DERMOSCOPY; HUTCHINSON'S MELANOTIC FRECKLE; KERATOSIS, ACTINIC; FACE.

Adverse reactions associated with drugs presenting cutaneous manifestations are among the most common, expressing itself with multiple clinical aspects and causing significant morbidity. The fixed drug eruption (FDE) is a common adverse reaction with cutaneous involvement and is associated with the use of numerous drugs. Dipyrone is a drug with analgesic and antipyretic effects prescribed widely used in Brazil, however, it is known for its potential to triggering adverse reactions, including the FDE. This report shows an EMF case related to the use of dipyrone, with unique clinical presentation and correlate the clinical, histopathological and dermatoscopic found.

Keywords: DERMOSCOPY; FACE; PATHOLOGY

Introduction: Currently there is a growing demand for non-invasive therapies aimed at treating facial aging. Non-ablative fractional lasers lead to excellent outcomes, with reduced side effects. Objective: To evaluate the facial rejuvenation achieved by 1,340nm non-ablative fractional laser using a single pass at high energy versus three passes at medium energy, through a prospective comparative study. Methods: Twenty patients with facial aging were treated with 2 or 3 laser sessions with 4-week intervals. The right hemiface was treated with three passes of 1,340nm non-ablative fractional laser at a fluence of 90 mJ, pulse duration of 5ms and 100 mtz/ cm2. The left hemiface was treated with a single pass of the same laser at a fluence of 120 mJ, pulse duration of 5ms and 100 mtz/cm2. The evaluated variables were spots, wrinkles, porphyrins and overall appearance. Results: The patients (n = 20) were evaluated during 6 to 24 months. The photographic evaluations demonstrated a significant improvement of the spots on the right hand side and wrinkles on the right and left hand sides. Eighteen of the 20 patients reported satisfaction with the treatment. Conclusion: 1,340nm non-ablative fractional laser was proven as a modern, safe and effective alternative for facial rejuvenation. For spots, the triple passes at medium energy protocol led to a superior response. However, regarding wrinkles there was no difference between the single pass at high energy and triple pass at medium energy protocols.

Keywords: LASER; REJUVENATION; FACIAL AGING; FACE

Facial hemiatrophy, or Parry-Romberg syndrome, is characterized by the progressive atrophy of the tissues of half of the face, affecting skin and subcutaneous tissue. Its clinical manifestations are very varied. Preferred therapeutic strategies for the treatment of the syndrome were not yet completely established. The authors describe a case of mild facial hemiatrophy, in which the patient underwent lipofilling (autologous fat grafting), progressing with satisfactory result. Treatment alternatives, its advantages and disadvantages are widely discussed in the study, with fat grafting emerging as an excellent therapeutic option due to its safety, low cost and replicability.

Keywords: Face; Facial hemiatrophy; Transplantation, autologous

Diagnosing basal cell carcinomas, both clinically and dermoscopically, is part of most dermatologists' daily routine. However, tumors of this lineage, when densely pigmented, can be a challenge for the physician and surgeon. Dermoscopic features typical of melanocytic lesions may be present in these carcinomas, and the similarity with melanoma results in a real dilemma. More in-depth knowledge on this topic can make a difference in the management of these cases.

Keywords: Carcinoma, Basal cell; Dermoscopia; Diagnosis; Melanoma

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

Barraquer-Simons syndrome is characterized by progressive atrophy of the subcutaneous cellular tissue limited to the upper part of the body. The condition manifests during childhood or adolescence. Usually, there is no previous family history and the etiology remains obscure. Fat grafting has been shown to be an effective, simple, safe and low-cost therapeutic approach in the treatment of this syndrome, but longer follow-up times are necessary to enable conclusions about long-term tissue preservation. Fat grafting allows wide diffusion of the method because it provides a less invasive treatment and good aesthetic results.

Keywords: Lipodystrophy, Familial Partial; Transplants; Face

O fibroxantoma atípico (FXA) é um tumor mesenquimal raro que geralmente acomete pacientes com idade avançada, do sexo masculino, em áreas fotoexpostas. É mais frequente na cabeça e pescoço, mas também pode ocorrer no tronco e nas extremidades. Atualmente, é considerado um tumor benigno de diagnóstico por exclusão, com baixa taxa de recidiva e metástase. O tratamento é realizado com excisão cirúrgica, o que permite o diagnóstico por avaliação histológica e imuno-histoquímica.

Keywords: Tórax; Oncologia Cirúrgica; Dermoscopia; Neoplasias; Imuno-Histoquímica; Sarcoma