Introduction: Acne scars are common, and their treatment is challenging. Several techniques have been used to remove, reposition, and flatten acne scars to improve the appearance of the skin’s surface. More recently, fractional CO₂ laser has been used to correct such scars due its good results and shorter recovery time.
Objective: To evaluate and compare fractional CO₂ laser vs. dermabrasion-based treatment of acne scars.
Methods: Nine patients were assessed – six received fractional CO₂ laser and three were treated with dermabrasion. Subjective and objective parameters were evaluated for both treatment modalities.
Results: Both patient groups showed objective and subjective improvement.
Conclusions: This study has demonstrated that fractional CO₂ laser and dermabrasion-based treatments have similar efficacy in moderate to severe acne scars.

Keywords: CICATRIX; ACNE VULGARIS; LASER THERAPY.

Fractional photothermolysis was developed as an alternative to ablative lasers (which are effective but pose a high risk of complications) and non-ablative lasers (which have limited effectiveness). Fractional photothermolysis has been successfully used in diverse dermatological conditions. This study describes the case of an Asian male patient with atrophic scarring secondary to trauma in the left paranasal region, who underwent treatment with 1,550 nm non-ablative fractional Erbium Glass laser, which led to a significant improvement in the lesion. This case corroborates the use of less-invasive procedures in difficult-to-treat dermatoses and in treating Asian skin types safely and effectively.

Keywords: LASERS; THERAPEUTICS; CICATRIX; ATROPHY.

Introduction: Scars caused by burns have the potential to cause clinical, social, and functional disruptions. Dermatologists should be able to intervene in this process by combining technological advances with traditional techniques. Objective: To evaluate the effect of Intense Pulsed Light applications on scars after burns, based on clinical parameters described in the international Vancouver Scar Scale. Methods: A prospective study was carried out with six patients who underwent five monthly Intense Pulsed Light sessions over the entire area of a wound. The analysis of the results was conducted by three evaluation groups: 3 physician researchers, the patients included in the study, and 3 physician observers. The evaluation was implemented using the Vancouver Scale, a questionnaire based on this scale, and additionally a general rating used by all evaluators based on a numerical scale. The data obtained by examining the differences before and after the treatment, was analyzed through the Wilcoxon signed-rank test. Results: A statistically significant decrease was observed in the analyses of all clinical parameters of the scars, when evaluated before and after the completion of the treatment. Conclusions: The present pilot study demonstrates the advantages of Intense Pulsed Light as an approach to this specific type of scar, with an aim of stimulating further studies in order to improve this low-cost technology, as compared to lasers.

Keywords: LASERS; INTENSE PULSED LIGHT THERAPY; CICATRIX; BURNS.

Introduction: With several treatment options available - including laser - atrophic acne scars are nonetheless difficult to treat. The use of fractional technology results in dermal-epidermal ablation columns, interspersed with intact skin islands, allowing selective thermal damage, effective treatment and faster recovery. The objective of the present study is to demonstrate the efficacy and safety of fractional laser use in the treatment of atrophic acne scars among the Brazilian population. Methods: An open, prospective, interventional study was carried out with patients with acne scars, without restriction regarding the gender and skin phototype. Exclusion criteria were: pregnancy, breast-feeding, presence of infections or blood dyscrasias and the use of anticoagulants. The evaluation was performed by comparing texture, appearance, and relief as observed in digital photographs. Results: Of the 30 selected patients, 24 were included in the study. An improvement was noted in the parameters evaluated in the cases that underwent fractional laser (CO2, Erbium-Glass or both). Individuals who underwent multiple treatments showed better results. All those treated with 4 sessions had improvements greater than 50%. Post-inflammatory hyperpigmentation was detected in 7 of the 24 treated patients. Conclusion: The present study showed that, when using appropriate parameters and adequate care, fractional laser-assisted resurfacing is an effective and safe method for treating atrophic acne scars in the Brazilian population.

Keywords: ACNE VULGARIS; CICATRIX; LASERS; CHEMEXFOLIATION

Both microneedling and ablative fractional laser can be used for the treatment of scars. The present article reports the case of a female patient who had the first half of a perioral scar treated with ablative fractional CO2 laser, and the second half treated with microneedling, using a 2mm roller. Outcomes were superior in the half treated with laser.

Keywords: Cicatrix; Collagen; Lasers

INTRODUCTION: Scars are very prevalent in the world’s population and can have a significant psychological impact in the patient’s life. There are already conventional clinical and surgical methods for their treatment. However, recurrence and existing side effects drive the search for new therapeutic modalities.
OBJECTIVE: To evaluate the clinical improvement of patients with hypertrophic scarring treated with fractional ablative laser associated to triamcinolone drug delivery.
MATERIAL AND METHODS: Eighteen patients with scars to be treated were selected during eight weeks, with four fortnightly sessions of fractional ablative laser associated to 20mg/ml triamcinolone drug delivery. Before and after the treatment, the group was evaluated by three examiners, through the photographic evolution , considering the parameters appearance, dyschromia and degree of hypertrophy. Results: Fifteen patients completed the study. Of these, 35.53% had no or little improvement; 37.80%, moderate to intermediate improvement; 8.89%, expressive improvement and 17.80%, improvement near resolution.
CONCLUSIONS: The proposed association is a promising therapeutic option for the treatment of hypertrophic scars because it is quick to perform and to heal, with less side effects and better tolerated by the patient when compared to the therapies used alone, besides being easily replicable in the office.

Keywords: Cicatrix, hypertrophic; Lasers; Triamcinolone acetonide

INTRODUCTION: The treatment of unsightly hypertrophic scars secondary to surgeries in the thoracic region area challenging, particularly if associated to striae distensae. Surely, more than one therapy should be used, which will demand a long treatment time.
OBJECTIVES: To evaluate the effect of the association of fractional ablative and non-ablative lasers, microneedling and drug delivery in the management of hypertrophic scarring and striae distensae.
METHODS: Patient showing hypertrophic scars and striae on the anterior thoracic region was submitted to four monthly sessions of fractional ablative and non-ablative lasers, associated to microneedling and drug delivery.
RESULTS: At the end of the treatment protocol, the patient had improved mobility of the treated areas, quality of the skin and striae distensae in the treated region.
CONCLUSIONS: The associated treatment showed good results in the concurrent management of atrophic and hypertrophic scars.

Keywords: Cicatrix; Lasers; Needles

Necrobiosis Lipoidica (NL) is a granulomatous dermatosis, mainly affecting people with diabetes due to collagen degeneration. Although there are different treatments, all have little response. Among the options, the Intense Pulsed Light (IPL) and the Laser Erbium-YAG enhance the production and remodeling of the collagen treating the atrophy, besides reducing the erythema by the coagulation of blood vessels. We report a case of a 24-year-old woman with type I Diabetes Mellitus who underwent NL treatment on her left forearm in seven sessions with the association of IPL and 2940 nm Erbium-YAG laser. We observed improvement in central atrophy and erythema.

Keywords: Necrobiosis lipoidica; Diabetes mellitus; Lasers; Laser therapy; Intense pulsed light therapy; Collagen

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

Facial surgeries are often challenging for surgeons due to their complex anatomy, aesthetic and functional importance. Interventions in the cosmetic subunit that comprises the eyebrows can be particularly difficult. This case report aims to demonstrate the use of island flap in this region. We performed the excision of melanocytic nevus, with a good outcome and absence of postoperative complications. This technique is commonly used for facial reconstruction; however, the literature describes only a few cases using this method for eyebrow reconstruction.

Keywords: Scleroderma, Systemic; Microstomia; Lasers; Laser Therapy; Intense Pulsed Light Therapy; Combined Modality Therapy

Congenital vascular lesions can be subdivided into tumors and malformations. Hemangiomas are benign vascular tumors resulting from the abnormal proliferation of endothelial cells, whereas port-wine stains are vascular malformations of a possible autosomal dominant inheritance. To date, there are no studies associating the use of intense pulsed light and CO2 laser as a therapeutic form for these pathologies. We present a series of 10 cases of vascular injuries treated with the combination of these forms of irradiation. This combined therapy can be effective in reducing the thickness of the lesions or in attenuating the color.

Keywords: Hemangioma; Lasers, gas; Laser therapy; Intense pulsed light therapy; Vascular malformations

Exogenous ochronosis is a cutaneous hyperpigmentation condition caused by the accumulation of substances derived from phenol on the skin or mucous membranes without affecting other tissues. It occurs mainly due to the use of bleaching agents, most frequently hydroquinone. The lesions are difficult to treat, being resistant to several approaches. Sometimes it’s necessary to use laser technologies or intense pulsed light to achieve some degree of improvement. The present work consists of a literature review of publications on these technologies in exogenous ochronosis from January 1990 to July 2020.

Keywords: Hyperpigmentation; Intense pulsed light therapy; Lasers; Ochronosis

Intense Pulsed Light (IPL) is an effective technology to treat vascular lesions, pigmented lesions, and photorejuvenation, among other indications. In the case of telangiectasia, its mechanism of action is based on photothermolysis of the vessels, inducing intravascular coagulation. We report three cases where IPL was used to treat telangiectasia in a surgical scar, showing good aesthetic results after three sessions.

Keywords: Cicatrix; Telangiectasis; Intense Pulsed Light Therapy; Erythema

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