Background: It has been proposed that thermal water can be used as an anti-inflammatory and mild hydrating agent in the preparation of skincare formulations. However, due to the complex process and strict quality control associated with its extraction from the ground, an oligoelements complex that mimics the effects of thermal water on skin is being used instead. Objective:To evaluate the stability and effects of thermal water and its oligoelements in the formulation of cosmeceuticals, as well as their immediate effects on the skin. Methods: An aqueous gel, a gel cream and an emulsion were prepared with and without the addition of oligoelements and submitted to physical stability analysis.The more stable preparations were tested on study subjects’ forearms. The objective evaluation of the effects on the skin’s texture and hydration was conducted according to biophysical and image analysis techniques before, immediately after and 2 hours after application. Questionnaires assessed participants’ subjective perceptions of the various formulations.The possible anti-inflammatory effects were not evaluated. Results: The effects of the more stable gel formulations were assessed on 15 study subjects.The gels increased the content of the aqueous corneum stratum, while the waters only produced an improvement of the skin’s texture. Conclusion: The results obtained from the subjective and objective analyses coincided and suggested the usefulness of the oligoelements complex in cosmeceutical products for moisturizing the skin.

Keywords: TRACE ELEMENTS, COSMETICS, WETTING AGENTS

Introduction: Since patients with vitiligo are believed to be more susceptible to developing malignant neoplasias due to the lack of melanin in the affected skin, the use of sunscreens is critically important.
Objective: To evaluate the pattern of sunscreen usage in vitiligo patients.
Methods: A transverse study of vitiligo patients was conducted from August 2009 to April 2010. The following variables were studied using a questionnaire and physical examination: demographic data (gender, age, education level, and phototype); clinical characteristics of the condition (age at diagnosis, affected areas of the body, and clinical type); sunscreen use (frequency, protection factor, and duration of use); and habits of sun exposure.
Results: Of the 121 study subjects, 43 used sunscreen – mainly with sun protection factor 30 – on a daily basis.The variables associated with daily use were female gender (p = 0.001, OR = 4.76, 95% CI = 1.80-12.59) and recommendation by a dermatologist in the first medical visit (p = 0.047, OR=2.28, 95% CI = 1.01-5.28).
Conclusion: A pattern of sunscreen usage was determined for patients with vitiligo. In addition, it was verified that a dermatologist''''''''s recommendation to wear sunscreen had a statistically significant impact (p = 0.047, OR=2.28, 95% CI = 1.01-5.28).
Keywords: vitiligo; evaluation; sunscreening agents.

Keywords: VITILIGO, EVALUATION, SUNSCREENING AGENTS

This paper describes a lip filling technique that administers hyaluronic acid using microcannulas. This technique considerably reduces the number of punctures compared to the conventional method, which uses needles. In addition, the microcannula’s blunt tip reduces the risks of intravascular injection of the substance and of disrupting key structures such as vessels and nerves. The results obtained by the authors confirm the less frequent occurrence of adverse effects and a high degree of physician and patient satisfaction.

Keywords: HIALURONIC ACID, LIP, REJUVENATION

Introduction: In order to protect against visible light, pigmented sunscreens have been developed by combining organic non-particulate sunscreens and opaque pigments. No reliable method has yet been proposed to measure the protection offered by these pigments.
Objective: To evaluate the effectiveness of white and colored sunscreens in the protection against visible light. Methods: Twenty sunscreens marketed in Brazil were evaluated (13 colored and 7 white). Colorimetric measurements were used to classify the brightness and translucency of the roducts, which were applied to polymethylmethacrylate sheets. Spectrophotometric measurements were taken to evaluate the product''''''''s absorbance within the visible light spectrum between 400 and 450 nm, using the Absorptive Efficacy in the visible light range as a parameter.
Results: Colored products presented a higher Evis than white products. Statistical analysis demonstrated that there is strong correlation between absorptive effectiveness and the product''''''''s brightness and translucency. No correlation was verified between absorptive effectiveness and the products'''''''' sun protection factor.
Conclusions: Absorptive efficacy in the visible light range was a useful parameter in the assessment of sunscreens'''''''' effectiveness in protecting against visible light. Pigmented products provide more effective photoprotection within that band.

Keywords: SUNSCREENING AGENTS, PHOTOBIOLOGY, SUNLIGHT

Introduction: Intense pulsed light is commonly used for hair removal. Corticosteroids of low or medium potency are generally employed for pain and inflammatory reaction relief following such procedures. Botanical compounds, such as andiroba oil emulsion, have been proven to have moisturizing and anti-inflammatory effects. Objective: To compare the effectiveness of andiroba oil emulsion to desonide as an option to topical corticosteroids. Methods: A prospective, comparative, double-blind study evaluated nine female patients who underwent air removal with intense pulsed light in the inguinal region. The patients were treated immediately after the procedure with desonide on one side and andiroba oil emulsion on the other. The patients rated the pain sensation using a visual analog pain scale, and an observer dermatologist physician evaluated the inflammatory reaction caused by the procedure, comparing the two sides blindly. Results: There were no significant differences in pain relief or inflammation between the two products. The analgesic and anti-inflammatory potential of andiroba oil emulsion practically equaled that of desonide. Conclusions: This pilot study''''''''s results indicate that andiroba oil emulsion can be a treatment option following photoepilation.

Keywords: BURNS, HAIR REMOVAL, THERAPEUTICS, GLUCOCORTICOIDS, WETTING AGENTS

Introduction: First-degree burns can cause intense pain and, in the medium- and long-term, sequelae. In a previous study, the authors found that an emulsion of andiroba oil and desonide-a low potency corticosteroid-were equivalent for relieving pain and improving erythema caused by intense pulsed light-based epilation. The andiroba oil emulsion is used for treating radiation dermatitis in patients with breast cancer,through local application, before and after radiotherapy. Objective: To confirm the previous study's results and evaluate whether a pre-procedure program of preparation and prevention provides any benefit. Methods: A prospective, comparative, double-blind study was carried out with 33 patients, who blindly used andiroba oil emulsion and a humectant in the axillae (each product was applied on one side) before the epilation procedure. Epilation was performed using intense pulsed light, with parameters according to the skin phototype of the patients. After the procedure, the andiroba oil emulsion was applied on the side that had been prepared with the emulsion itself, while the desonide was applied on the contralateral axilla. Patients assessed pain intensity according to a visual analogue scale, and a dermatologist assessed the erythema using a modified scale, at several experimental time points. Results: Pain and erythema were less intense in the side prepared with the andiroba oil emulsion. The efficacy of both treatments proved to be equivalent. Conclusions: Thee fficacy and safety of the andiroba oil-based emulsion, as well as its protective effect on the skin in the pre-treatment preparation program, were confirmed in clinical use.

Keywords: BURNS; HAIR REMOVAL; GLUCOCORTICOIDS; WETTING AGENTS.

Introduction: Melasma is a common pigmentary condition that affects exposed body areas, especially in the frontal and malar regions. Hydroquinone is an effective active principle in the treatment of hyperpigmentation, however, due to issues linked to its tolerability, many studies are being conducted aimed at developing alternative therapies with equivalent effectiveness.
Objective: To evaluate the efficacy and tolerability of a cosmeceutical formulation containing ellagic acid, hydroxyphenoxy propionic acid, yeast extract and salicylic acid in Brazilian patients with mild to moderate melasma.
Methods: Forty patients with mild to moderate melasma on the face used the cosmeceutical twice daily, combined with sunscreen for 90 days. Subjective assessments of efficacy and tolerability were carried out. Measurements of the MASI grade and the application of the MELASQoL-BP questionnaire were also performed. The evaluation of the skin's brightness and the colorimetric characteristics were obtained by colorimetry.
Results: After 90 days of treatment, a significant improvement could be observed in the clinical and colorimetric parameters evaluated, and in the quality of life questionnaire. In addition, the MASI score improved by 43%. The treatment was effective without causing adverse events.
Conclusions: The evaluated cosmeceutical formulation was proven as an effective alternative to hydroquinone for the treatment of melasma, with excellent cutaneous tolerability profile.

Keywords: HYPERPIGMENTATION; MELANOSIS; BLEACHING AGENTS

Introduction: Overexposure of the skin to the sunlight can cause photoaging and promote the emergence of malignant neoplasms. Sunscreens are used to prevent these alterations and may occasionally cause adverse reactions in children and adults.
Objective: To analyze the frequency and types of adverse reactions caused by sunscreens in adults and children.
Methods: Data analysis of in vivo, non-invasive clinical studies performed at a clinical research institute.
Results: Data from 2,263 adults and 523 children were evaluated, with 13.92% and 4.44%, respectively, presenting some type of reaction.
Conclusions: Sunscreens are effective in preventing photoaging and skin cancer. Cosmetic formulations containing sunscreens may cause adverse reactions with low prevalence.

Keywords: SUNSCREENING AGENTS; CONTROL AND SANITARY SUPERVISION OF COSMETICS; SUN PROTECTION FACTOR; COSMETICS

Introduction: The use of moisturizers improves the skin barrier’s function and might be useful in atopic dermatitis.
Objectives: To assess the efficacy and safety of an active moisturizer-barrier repairer based on glycerin, erythritol, Imperata cylindrica and homarine as an adjuvant treatment in atopic dermatitis.
Methods: Application of the moisturizer in children with mild to moderate atopic dermatitis for 1 month, with subjective and objective evaluations after 15 and 30 days.
Results: Data from 35 children — 20 girls (57.15%), 15 boys (42.86%) / 26 Caucasians (74.29%), 6 mulattos (17.14%), 3 dark skinned (8.57%) — aged 1 to 10 years (mean age = 5.6) were analyzed. The values of the variables sleeping disorders, dryness, desquamation, pruritus and softness of the skin had significantly decreased on the 30th day of treatment as compared to the baseline. The objective evaluation of the severity using the Scoring Atopic Dermatitis severity index revealed a decrease to 9.30 from 25.27 (p <0.0001). There was a reduction in the use of dexchlorpheniramine and hydrocortisone to 5.72% each on the 30th day, from 25.71% (p = 0.0233) and 34.29% (p = 0.0075) on the 15th day, respectively.
Conclusions: The use of the moisturizer for 30 days improved the analyzed symptoms with a significant reduction in the Scoring Atopic Dermatitis severity index with decreased need for antihistamines and topical corticosteroids. The use of a suitable moisturizer was effective and safe as an adjuvant treatment for children with atopic dermatitis.

Keywords: DERMATITIS, ATOPIC; HYGROSCOPIC AGENTS; CHILD

INTRODUCTION: Photoprotection is indicated to reduce the exposure to cutaneous actinic damage and it is important to prevent skin cancer. The face is the most irradiated area of the body and is also where skin cancers most commonly occur.
OBJECTIVE: To evaluate the amount of sunscreen applied and its facial coverage in patients previously diagnosed with skin cancer, treated at a Brazilian public institution.
METHODS: Quasi-experimental study involving 40 patients undergoing skin cancer follow-up. Participants were asked to apply sunscreen on their face, as usual, and the mass used was measured. After, participants were photographed under Wood's light to evaluate the homogeneity of the sunscreen´s coverage, and facial sunscreen coverage failure.
RESULTS: Fourteen (35%) participants applied an estimated amount lower than recommended (2mg/ cm2). The regions with smallest coverage were the ears and the "H" area of the face.
CONCLUSIONS: The insufficient or heterogeneous sunscreen application on face, neck and ears may promote a false perception of protection, leading to irresponsible exposure. As the population ages and the incidence of skin cancers increases, it is essential to stimulate photoprotection, with appropriate information, especially among high-risk individuals.

Keywords: Sunscreening Agents; Skin Neoplasms; Sunburn; Sunlight

INTRODUCTION: Seborrheic dermatitis is a chronic inflammatory disease in areas with a higher concentration of sebaceous glands and the participation of the fungi of the genus Malassezia sp.
OBJECTIVE: To assess the effectiveness of treating moderate to severe seborrheic dermatitis using two shampoo formulations in monotherapy.
METHODS: Patients with moderate to severe seborrheic dermatitis of the scalp, with or without chemically processed hair, were grouped according to the degree of affection and used one of two versions of shampoo monotherapy for four weeks. Relapse after treatment cessation was also evaluated.
RESULTS: There was a significant reduction (p <0.05) of oiliness since the first application. The other signs (erythema and peeling) showed significant improvement for both treatments. Participants also reported a considerable improvement in pruritus, erythema, and peeling. The effect on the hair strands was considered positive with both procedures. After one week of suspension, the relapse rate was considered non-significant (p <0.05).
CONCLUSIONS: Both versions of shampoos were able to promote effective control of moderate to severe seborrheic dermatitis. These formulations also demonstrated not to harm the hair strands, even when chemically processed, a fundamental fact to treatment adherence.

Keywords: Dermatitis Seborrheic; Inflammation; Keratolytic Agents; Malassezia; Sebum

INTRODUCTION: Using sunscreen is a behavior that reduces the risk of skin cancer, among other diseases. The consumer's preferences for sunscreen types can assist dermatologists in recommending the best product to their patients.
OBJECTIVE: This study aims to indicate consumption and photoprotection habits, investigating answers to sun protection problems. Methods: An exploratory cross-sectional study, conducted through a questionnaire, with data collected directly from the participants.
RESULTS: Among the 300 interviewees, 249 declared to consume sunscreens. We found that most consumers misused sunscreens, and this problem may be related to sensory perception after applying sunscreen to the skin. Also, consumers highlighted the importance of sensory perception, whether visual, tactile, or olfactory, when purchasing this type of product.
CONCLUSIONS: This research reveals that the sensory characteristics, compliance, real effectiveness under normal conditions of use, and the market demand for sunscreens are interconnected. Thus, we suggest that dermatologists balance the importance of sensory aspects, cost, and sunscreens brand when recommending them to consumers.

Keywords: Behavior; Cosmetics; Dermatology; Questionnaires; Perception; Sunscreening agents; Sensation.

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

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