Neurofibromatosis type 1, also known as von Recklinghausen neurofibromatosis, is an autosomal dominant disorder that affects 1 in 3,000 newborns. Approximately 50% of neurofibromatosis type 1 patients have no family history of the disease. The tongue, the alveolar ridge of the buccal mucosa, gums, lips, palate, floor of the mouth, and pharyngomaxillary fossa can be affected by tumors associated with this condition; the tongue is the most common site. We report the case of a 29-year-old female patient with neurofibroma in the tongue, highlighting the possibility of disease manifestations in the oral cavity and differential diagnoses.

Keywords: NEUROFIBROMATOSIS 1; NEUROFIBROMA, PLEXIFORM; NEUROFIBROMA; TONGUE NEOPLASMS.

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.

Erythroplasia of Queyrat is an in situ squamous cell carcinoma of the glans penis. Due to its unusual location, surgical treatment can cause mutilation. CO₂ laser-assisted vaporization is a treatment option with excellent aesthetic and functional results, but it requires strict follow up owing to its high recurrence rates. The authors describe a case of erythroplasia of Queyrat treated with fractional CO₂ laser, with an absence of recurrence during a one-year follow up

Keywords: CARCINOMA, SQUAMOUS CELL; CARCINOMA IN SITU; FORESKIN; LASER COAGULATION; LASERS; LASERS; GAS; PENIS; PENILE NEOPLASMS

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 skin aging process includes a functional decline of the scalp’s structures, with progressive atrophy of the dermis and follicular dermal papillae, which are crucial to the nutrition and metabolism of the hair follicle. These phenomena are directly related to a poor quality of the hair shaft.
OBJECTIVE: To evaluate the influence of a combination of nutrients on the keratinogenesis in the follicular dermal papilla.
METHODS: Cell cultures of human dermal papillae were incubated with a combination of A, C, D, E and B-complex vitamins, in addition to trace elements and keratin amino acids during 72 hours, in three different concentrations. These cultures were compared to an untreated control-culture. The papilla’s fibroblasts cell proliferation rate was determined after 72 hours.
RESULTS: The diverse concentrations evaluated promoted significant increase in cell proliferation as compared to the control group, however there was no significant difference between the concentrations studied.
CONCLUSION: The studied association of nutrients was capable to significantly act on the proliferation of cells in the human hair follicle’s dermal papilla, restoring more favorable conditions for the synthesis of the hair shaft. These findings demonstrate the presence of a significant potential in the approach strategy various causes of alopecia, including alopecia related to aging (senescent).

Keywords: Alopecia; Aging; Dermis; In vitro techniques; Nutrients

Type 1 neurofibromatosis has multiple cutaneous lesions and limited treatment options. CO₂ laser is a useful tool for the removal of neurofibromas, the main source of cosmetic disfiguration for these patients. We present the treatment of neurofibromas with CO₂ laser in a patient over 4.5 years. The patient had lesions with variable diameter, diffusely distributed. After 16 sessions of CO₂ laser, we observed clinical improvement. Although it is a palliative treatment, the cosmetic improvement achieved substantiates the demanded effort and time in view of the psychological gains for the patient.

Keywords: Lasers, Gas; Laser Therapy; Neurofibromatosis 1

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 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

A woman with type I diabetes and Hashimoto’s disease presented necrobiosis lipoidica at 15 years of age. Cyclosporine 100 mg/day was prescribed; however, an abscess in the inguinal region led to treatment interruption. Then, she tried dimethyl fumarate at increasing doses up to 120 mg/day. The lack of results led to the discontinuation of the therapy. The third attempt was isotretinoin 40 mg/day for eight months, with wound healing. Recently, after a knee scar repair surgery, necrobiosis lipoidica lesions appeared at the suture site. The patient received isotretinoin 40 mg/day again, and the lesion regressed in three months.

Keywords: Necrobiosis Lipoidica; Diabetes Mellitus, Type 1; Bacterial Infections

INTRODUCTION: Actinic keratoses are premalignant lesions with a risk of transformation to invasive squamous cell carcinoma. There is no identified correlation between clinical classification and histological grade of these lesions.
OBJECTIVES: To correlate the clinical characteristics of actinic keratoses of the forearms and back of the hands with the degree of histological atypia (Keratinocyte Intraepidermal Neoplasia); to develop and validate a clinical severity scale correlated with the histological grade of actinic keratoses.
METHODS: Cross-sectional study with 162 actinic keratoses clinically evaluated for diameter, erythema, infiltration, hyperkeratosis, and exulceration and 34 lesions with different patterns were biopsied. Clinical features were correlated with the degree of histological atypia and p53 and Ki-67 expression.
RESULTS: Only the diameter of the lesions was significantly correlated with the degree of atypia (p=0.04), and only the erythema, hyperkeratosis, and the diameter linked with the immunohistochemical markings. A clinical score including diameter, hyperkeratosis, and exulceration was developed, which associated significantly with the degree of atypia (Spearman’s Rho=0.43; p=0.01).
CONCLUSIONS: A score composed of diameter, hyperkeratosis, and exulceration correlated with the histological grade of actinic keratoses of the upper limbs was developed.

Keywords: Carcinoma in situ; Carcinoma squamous cell; Keratosis actinic; Skin diseases

INTRODUCTION: Plant extracts and actives derived from plants were developed to improve and enhance the skin healing process including Triticum aestivum L. (Triticum vulgare).
PURPOSE: To evaluate the effect of whole grain extract (EGTA-PR) and aqueous extract (EATA-FI) of Triticum aestivum L., on ex vivo skin healing.
METHODS: Skin fragments obtained from elective plastic surgery were subjected to tissue damage and treated with extracts for eight days for histological evaluation of re-epithelialization and immunofluorescence for epidermal growth factor (EGF).
RESULTS: EGTA-PR and EATA-FI accelerated the re-epithelialization process in human skin culture submitted to tissue injury. Additionally, we observed increased EGF protein labeling after treatment with EGTA-PR.
CONCLUSION: EGTA-PR showed a better performance in re-epithelialization when compared to EATA-FI, as it presented a higher protein labeling for EGF in human skin culture. Likewise, the histological results showed that the dermal redensification obtained with EGTA-PR was visually superior to that observed with EATA-FI. The results obtained are promising and corroborate the several biological actions already reported in the literature for Triticum aestivum L. extract in tissue healing stages.

Keywords: Regeneration; Epidermal growth factor; Triticum; In vitro techniques; Wound healing

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