Introduction: Some foods can have therapeutic value in the treatment of photoaging. Objective: To clinically evaluate the efficacy of a nutritional supplement in the improvement of photoaging signs and correlate with an in vitro study. Methods: A nutritional supplement was evaluated clinically and in vitro, with a culture of fibroblasts. Patients with clinical signs of photoaging (n = 48) were studied while using a nutritional supplement, with clinical and instrumental (cutometry) evaluations at 56, 84 and 112 days. Results: There was progressive and significant improvement (p < 0.05) in the elasticity, firmness, fine lines and general appearance of the skin.The fibroblast cultures indicated a significant rate of collagen synthesis when compared to the control culture after 48 hours of incubation. Discussion: The oral use of some vitamins and natural compounds has a therapeutic effect on the signs of photoaging.This study has demonstrated that a combination of linseed oil, lycopene, carotenoids, vitamin E, zinc and selenium possibly improve the signs of aging not only through antioxidant and anti-inflammatory mechanisms, but also by increasing collagen production. Conclusions: Nutritional supplements are useful in the care of photoaged skin.

Keywords: FIBROBLASTS, SKIN AGING, ANTIOXIDANTS

Introduction: Cutaneous fillings are a common procedure in today's dermatology, with the majority being carried out with hyaluronic acid isolated or combined with other substances. Objective: To study the effects of adding hyaluronic acid and polyethylene glycol to cultures of human dermal fibroblasts. Methods: The study evaluated: cell proliferation and production of type 1 collagen (COL1A1) in the presence or absence of anti-CD44 antibodies (membrane receptor for hyaluronic acid); the synthesis of metalloproteinase-1 (mmp-1), of tissue factor inhibitor of metalloproteinase-1 (TIMP - 1) and of transforming growth factor-α (TGF-α) through the analysis of gene expression via PCR (polymerase chain reaction); cell proliferation through the detection of the incorporation of a thymidine analogue in the cellular DNA. Results: Increased proliferation of fibroblasts and collagen synthesis were observed in the cultures exposed to hyaluronic acid, partially inhibited by the presence of anti-CD44 antibodies in the cultures. The exposure of cultures to hyaluronic acid enhances the production of TIMP-1 and TGF - α, and reduces the expression of MMP-1. These effects were not noticed in the cultures exposed to polyethyene glycol. Conclusion: In an in vitro setting, the addition of hyaluronic acid to cultures of human dermal fibroblasts increases proliferation and synthesis of COL1A1, TIMP-1 and TGF-α, decreasing that of MMP-1. The addition of anti-CD44 to the cultures reduces cell proliferation and collagen synthesis, which may indicate the role of that receptor in mediating those events.

Keywords: FIBROBLASTS, HYALURONIC ACID, EXTRACELULAR MATRIX.

Introduction: The dermis is mainly composed of the extracellular matrix and fibroblasts that produce collagen types I and III, and elastic fibers. Objective: To verify through a prospective, comparative controlled clinical study whether there is an increase in the production of collagen fibers in healthy human skin after the injection of autologous fibroblasts in the dermis. Methods: Two skin fragments were collected from the right retro-auricular region of four women aged between 25 and 60 years. In one of the fragments, histology was carried out with Hematoxylin-Eosin and Picrosirius to qualify and quantify the collagen fibers (Control Group). A second fragment underwent enzymatic digestion in the laboratory aimed at extracting and culturing fibroblasts. After satisfactory growth (1 x 107 cells / ml) the cultured fibroblasts were injected in the left retro-auricular region of the patients (Study Group). Three months after biopsies were harvested from this region, they were subsequently stained with Hematoxylin-Eosin and Picrosirius for comparative study between the two groups. Results: Statistical analysis of the number of collagen fibers in the three layers of the dermis - upper, middle and deep - comparing the study and control groups, showed that the mean and median observed after the injection of the cells were greater than those observed before the injection. Conclusion: The injection of fibroblasts results in an increase in the amount of collagen fibers in all regions of the dermis, with the increase being greater in the deeper regions.

Keywords: FIBROBLASTS; CELL-AND TISSUE-BASED THERAPY; COLLAGEN

Introduction: Tuberous sclerosis is a dominant autosomal genodermatosis, classically characterized by facial angiofibromas, fibrotic plaques, periungual fibromas, leaf-shaped hypochromic maculae and fibrous frontal plaques.
Case report: A patient bore this disease, with Koenen tumors in all nail beds of hands and feet, which were resistant to the conventional treatment — simple excision and electrosurgery. Amputation of the nail beds was performed followed by reconstruction with full thickness skin grafts.
Conclusion: The amputation of the nail apparatus and reconstruction with full thickness skin grafts in aggressive, recurrent or high morbidity cases can be an effective therapeutic option.

Keywords: DERMATOLOGY; DERMATOLOGIC SURGICAL PROCEDURES; TUBEROUS SCLEROSIS; SKIN TRANSPLANTS

Introduction: Juvenile dermatomyositis (JDM) is a systemic disease that affects children’s proximal musculature and skin. The ulcerated stage of the disease is a therapeutic challenge.
Objective: To evaluate the improvement of ulcerated stage of JDM caused by the use of cell therapy.
Methods: Co-culture of autologous fibroblasts and keratinocytes, application of these cells in ulcers in conjunction with fibrin glue, and placement of chitosan-alginate or chitosan-xanthan membrane on the lesions.
Results: Less than 12 hours after therapy, the patient reported complete cessation of pain and, within 2 days, healing tissue emerged. Some of the ulcers were almost completely healed by the end of the 1st week, and some of the calcinoses disappeared. This technique does not cure the disease, however it improves the patient’s quality of life, and it is possible to cryopreserve healthy cells to treat new lesions. Given the fact that the cells are of autologous origin, the risk of rejection is eliminated. Furthermore, this procedure does not require debridement of the lesions or hospitalization.
Conclusions: The application of autologous cultures of fibroblasts and keratinocytes in ulcers is already considered an effective treatment in patients with burns and other skin wounds, and has now also been proven effective in the treatment of wounds in JDM.

Keywords: Calcinosis; Cell-and tissue-based therapy; Dermatomyositis; Fibroblasts; Keratinocytes; Polysaccharides; Wound healing

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

A Covid-19, doença causadora de síndrome gripal e insuficiência respiratória aguda, vem demonstrando provocar danos a diversos outros órgãos e sistemas. Várias manifestações dermatológicas já foram descritas. Relatamos um quadro de alopecia areata (AA) desencadeada possivelmente pela Covid-19 em paciente que, apesar de ter seu RT-PCR para SARS-CoV-2 negativo, apresentou IgM reagente e sintomatologia clássica relacionada à doença. Acreditamos que a Covid-19 possa ter desencadeado resposta imunológica autoimune, com a consequente produção de interferons, que levou ao quadro de AA.

Keywords: Alopecia em áreas; Autoimunidade; Coronavirus

Modern hair transplant is constantly evolving. We intend to demonstrate our techniques and methodologies, and especially to describe the dynamics of the entire surgical process of the FUE (Follicular Unit Extraction), technique, from the discussion of the surgical strategy with the patient and evaluation of the donor area to extraction and implantation. The dermatologist must understand the complexity of the procedure and the need for adequate training to achieve a good surgical result.

Keywords: Alopecia; Hair; Hair follicle; Transplant donor site

Hair transplant is a common procedure worldwide, and the method of extracting follicular units is currently the most used. This technique is used not only for androgenetic alopecia but also for other areas such as eyebrows and beard. It is essential to observe the angle of the incisions and implantation of the hairs to conduct the eyebrow transplant so the result is as natural as possible. However, in addition to being rigorous with the design of the shape and position of the eyebrow, care must be taken with the preparation from the receiving site.

Keywords: Transplants; Alopecia; Hair follicle

Hair transplantation is an option for anyone with Androgenetic Alopecia, including transgender patients who want to align their appearance with their gender identity. Thus, hair transplantation can help transform appearance and boost self-esteem, especially if hair loss is a source of gender dysphoria. We report two cases of hair transplantation in transgender patients with good results, using the Follicular Unit Extraction and Follicular Unit Transplantation techniques. Due to the scarcity of specific articles about hair transplantation in this population, we report these cases for a better understanding of the specific needs of these patients.

Keywords: Hair; Transplants; Transgender People; Gender Dysphoria; Gender Identity; Feminization.

A narrative review was performed to clarify the ontogenesis of Merkel-cell carcinoma. It is hypothesized that the cells are derived from the embryonic neural crest, skin stem cells, epithelial cells, pre-/pro-B cells, dermal fibroblasts, or metastatic cells from other types of carcinomas. The influence of epigenetics was also considered. Methodologically, to prepare the summary articles were selected from the PubMed and SciELO databases and cited references. The results suggest that it is more likely that Merkel-cell carcinoma has multiple origins, possibly from poorly differentiated cells.

Keywords:

A narrative review was performed to clarify the ontogenesis of Merkel-cell carcinoma. It is hypothesized that the cells are derived from the embryonic neural crest, skin stem cells, epithelial cells, pre-/pro-B cells, dermal fibroblasts, or metastatic