Introduction: Childhood is considered a critical period for photoprotection, since approximately 80% of the exposure to the sun occurs during this phase of life. Objectives: To evaluate the characteristics of the knowledge and sun protection habits of children and their caregivers. Methods: A cross sectional study was conducted with questionnaires from October 2011 to July 2012. Results: 177 children (mean age = 7.66 years); 64.9% of children assessed exposure to the sun as dangerous, 88.7% knew what sunscreen is, and 94.3% considered its use important; however, 66.6% believed it was necessary only in summer. Regarding photoprotection habits, 37.3% reported exposure to the sun between 10a.m. and 4p.m. Among caregivers, 81.3% reported an absence of daily application of sunscreen on their children, and 33.9% reported that their children had already had some type of sunburn. Conclusions: Strong dissociation between knowledge and practice regarding exposure to the sun was observed in the present study. The discrepancy between knowledge and habits that was observed in the two groups can be explained by the quality of information on exposure to the sun. The present study’s data point to the need for a wider dissemination of adequate knowledge, both by the media and by physicians, to nurture healthy practices regarding exposure to the sun.

Keywords: SOLAR ACTIVITY; SUN PROTECTION FACTOR; SUNSCREENING AGENTS; CHILD RESTRAINT SYSTEMS; CAREGIRVES

Platelet-rich plasma has been proven to be promising in regards to its applicability in dermatology, especially in the healing of chronic ulcers and for soothing signs of aging. The autologous platelet-rich plasma is obtained through blood centrifugation, in a way that its components are separated by density gradient. The final product is a gel rich in growth factors that act in tissue repair, activating fibroblasts and inducing the extracellular matrix remodeling.

Keywords: PLATELET-DERIVED GROWTH FACTOR; PLATELET-RICH PLASMA; TRANSFORMING GROWTH FACTORS; VASCULAR ENDOTHELIAL GROWTH FACTORS; WOUND HEALING

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

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: 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: In the Brazilian public health system, the current demand for dermatological procedures is greater than the offer, resulting in a waiting list of patients bearing dermatoses to be treated surgically. Aimed at reducing that waiting list, a collective effort of surgical procedures was carried out in the tertiary public health service. The corresponding data on the patients and lesions is disclosed in the present study. Objective: To assess the profile of the patients – and respective skin lesions – who are awaiting to undergo dermatological procedures. Methods: A simple descriptive profile analysis of the patients, treated dermatoses and procedures performed was carried out. Results: Thirty-one patients (aged between 21 and 95 years, mean = 63.7 years). Seventeen (54.83%) were women and 14 (45.17%) were men. Thirty-eight lesions were treated: 21 neoplastic (carcinomas and melanomas), 8 pre-neoplastic (actinic keratoses) and 9 non-neoplastic (nevi, keloid and neurofibroma). Conclusions: The present article is relevant due to the fact it identifies cases and patients awaiting dermatological surgical procedures in the public health system. Based on it, a better planning of public health strategies in the dermatological field should be possible. Also, it highlights the importance of the dermatologist physician’s action in the public health, diagnosing and treating pre-neoplastic and neoplastic lesions.

Keywords: DERMATOLOGY; AMBULATORY HEALTH SERVICES; HEALTH CENTERS; POPULATION STUDIES IN PUBLIC HEALTH; PUBLIC HEALTH; PUBLIC HEALTH ADMINISTRATION; NEOPLASMS; MELANOMA; CARCINOMA; CARCINOMA, BASAL CELL

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

INTRODUCTION: Healing is a phenomenon that occurs after tissue injury and involves complex cellular and molecular mechanisms. Growth factors seem to be an effective and safe complement for the treatment of wounds.
OBJECTIVE: To evaluate wound healing after electrocoagulation, comparing the vehicle in isolation and its association with epidermal growth factor.
METHODS: Double-blind clinical trial in a Dermatology service between 2016 and 2018. Patients of both genders, older than 18 years of age, submitted to electrocoagulation of two lesions and subsequent application of the vehicle (cold cream) on one and epidermal growth factor in cold cream on the other were included. Evaluations after 7, 14 and 28 days, analysed erythema, edema, crusting, discharge and healing. Analyzed: edema, edema, crusting, discharge and healing. The binomial test was used for two ratios and Fisher’s exact test was used for dichotomic data.
RESULTS: Variable results were found regarding erythema, edema, crusting and discharge, sometimes favoring the vehicle, sometimes the growth factor, however with no statistical significance. Regarding healing, epithelialization was quicker with with epidermal growth factor (p<0.05).
CONCLUSIONS: This study evaluated the impact of epidermal growth factor in the healing process, and its results reinforce scarce data of the current literature and are a foundation for future studies.

Keywords: Epidermal growth factor; Evaluation; Wound healing

INTRODUCTION: Identifying the causes of periorbital hyperpigmentation is crucial in selecting the best treatment. The identification of transcriptional profiles that may be related to hyperpigmentation around the eye area could contribute to a new approach in the treatment of periorbital hyperpigmentation – the gene therapy.
OBJECTIVE: This study aims to assess the transcriptional profile of melanogenesis, and genes related to enzymatic antioxidants in skins with periorbital hyperpigmentation.
METHODS: Based on clinical evaluation, 49 healthy volunteers were classified with or without periorbital hyperpigmentation. Genetic profiles of melanogenesis-related genes: microphthalmia-associated transcription factor (MITF), pro-opiomelanocortin (POMC), melanocortin 1 receptor (MC1R), tyrosinase (TYR), tyrosinase 1-related protein (TYRP1), and intracellular antioxidants - glutathione reductase (GR), glutathione peroxidase 1 (GPx-1), glutathione s-transferase (GST-1) - were determined by the polymerase chain reaction technique in real-time.
RESULTS: MITF, TYR, and TYRP1 gene expressions were significantly higher in the periorbital hyperpigmentation group (p<0.01). GR, GPx-1, and GST-1 gene expressions were comparable between the groups with and without periorbital hyperpigmentation.
CONCLUSIONS: The results of this study suggest that MITF is the primary regulator of melanin deposition in skins with periorbital hyperpigmentation. Up-regulated MITF is closely associated with increased TYR and TYRP1.These findings are essential in proposing a new therapeutic approach in the treatment of periorbital hyperpigmentation.

Keywords: Hyperpigmentation; Melanins; Microphthalmia-associated transcription factor

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

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