Introduction: Isotretinoin was initially used to treat severe inflammatory acne and is now widely recognized as an effective therapy for acne vulgaris. Many factors are associated with the recurrence of this condition, which ranges from 5.6-65.4%. There is much con- troversy regarding the importance and contribution of each factor.
Objectives: To determine the recurrence rate in patients who underwent full treatment with oral isotretinoin (dose between 120 and 150 mg/kg) and risk factors.
Methods: Retrospective study of data from 276 patients treated with isotretinoin. The analysis was carried out after a minimum of 30 months after the end of the treatment. Recurrence was defined as the appearance of new active lesions that required retreatment.
Results: While the recurrence rate in patients who underwent the full dose was 25.53%, it reached 81.03% in those who received an incomplete dose. The other studied factors presented no statistical significance.
Conclusion: Oral isotretinoin therapy is effective in producing a significant and long- term reduction of acne. Nevertheless, it is important to note that recurrence can occur, especially when recommended doses are not reached.

Keywords: ACNE VULGARIS, ISOTRETINOIN, RECURRENCE

Introduction: Evaluating the response of various skin types to ultraviolet radiation expo- sure is very important in dermatology. The Fitzpatrick system is the most frequently used classification technique. It is straightforward and practical, assesses photodamage and skin cancer risks, and helps in defining light-based treatments. Nevertheless, there seem to be limitations to its use in non-Caucasians.
Objective: To compare the subjective phototype evaluation method to the Fitzpatrick classification in Caucasian and Asian (East and Southeast Asian, in particular) skin types.
Methods: Caucasian and Asian women (n = 42) were classified using 3 evaluation meth- ods (clinical, Fitzpatrick and Modified Fitzpatrick). The data were collected through ques- tionnaires and analyzed using non-parametric methods. A 5% significance level was adopted.
Results: There were no statistically significant differences within each group between the clinical evaluation, Fitzpatrick classification and the Modified Fitzpatrick classification (Caucasian cr2 = 0.375, p = 0.93 and Asians cr2 = 3.5, p = 0.182).
Conclusion: The three methods evaluate phototypes equally, yet studies with larger pop- ulation samples are still necessary.

Keywords: SKIN, SKIN PIGMENTATION, PHOTOBIOLOGY

Introduction:The French cosmetics industry sells spring mineral waters that are advertised as having biological benefits.
Objective: This study analyzes, in vitro and in vivo, a Brazilian mineral water''''''''s oligomin- erals composition, as well as its physical and chemical characteristics and biological effects.
Methods: Tests to evaluate physical chemical properties, cytotoxicity (viable cells) and irritability (het-cam test) were conducted. In vitro studies were performed to evaluate its capacity to induce the genic expression and immunohistochemical detection of filaggrin and aquaporin 3, nf-kb activity and fibroblast proliferation compared to Milli Q water.
Results: This water was found to be non-cytotoxic and non-irritating. In addition, it pre- sented a high content of strontium (0.61 mg/ml). The expression of filaggrin and its immunohistochemical tests were relevant. The aquaporin 3 increased 1.8 times and nf-kb decreased its activity by 47%. It was also capable of stimulating fibroblast proliferation.
Conclusion: The initial evaluation of the mineral water from Serra do Japi (SP, Brazil) indicates that it has the potential to be an adjuvant treatment in dermatology, since the results suggest it moisturizes the skin barrier, stimulates the proliferation of fibroblasts, and repairs and inhibits inflammatory reactions. Clinical studies should be done in order to reassure the in vitro results achieved on the present study.

Keywords: MINERAL WATERS, BRAZIL, COSMETICS

Introduction: Calcium hydroxyapatite is a radiopaque material that was traditionally used to provide radiologic contrast. It has recently been approved for use in cutaneous filling.
Objectives: To define the radiologic characteristics of Calcium hydroxyapatite and its potential to compromise radiologic evaluations.
Methods: Twelve patients received Calcium hydroxyapatite filler in the malar eminence and had radiography of the face (frontal, lateral, mentum-nasal-plaque (Waters), and Hirtz axial incidence technique) 1-8 weeks after the procedure. The X-rays were examined by two radiologists – one of whom was unaware of the filling procedure.
Results: The Hirtz axial incidence technique demonstrated amorphous radiopaque images in the suprazygomatic soft tissues in all cases, in both evaluations. Radiesse® was not detected using the other techniques, and did not illustrate the filler''''''''s position and symmetry. The evaluation of subjacent osseous structures was not compromised by the material''''''''s presence.
Discussion: Calcium hydroxyapatite can be identified in facial radiography when evaluat- ed using a method that avoids overlapping with adjacent osseous structures. Although it does not impair the osseous evaluation, it is recommended that the radiologist or dentist is noti- fied of the material''''''''s presence.
Conclusion: Cutaneous fillings containing Calcium hydroxyapatite can be identified, although not precisely located, using conventional X-ray.

Keywords: FACE, DURAPATITE, X-RAYS

Introduction: Vitiligo is cosmetically disfiguring and can cause significant psychological morbidity. Most therapies require protracted treatments and can lead to disappointing results. More recently, 308 nm Excimer laser has proven to be effective in treating vitiligo.
Objective: To analyze the effectiveness and patient satisfaction of 308 nm Excimer treat- ment for vitiligo patches in a variety of locations on the body.
Methods: Patients with generalized or localized vitiligo (n = 123, 321 lesions), were studied. The patients were treated at a private practice between 2007 and 2010. Two inde- pendent examiners analyzed the response to the therapy by comparing clinical and pho- tographic records before and after treatment.
Results: More than half (n = 77) of the patients presented repigmentation greater than 60%, 26 presented 40-59%, and 20% had levels less than 39%. Facial lesions responded better to treatment than those in other body parts. Elbows, hands and feet were the less sensitive areas. In general, the patients were satisfied with the treatment.
Conclusion: The use of Excimer laser for treating vitiligo was effective and safe, produc- ing satisfactory cosmetic results and improving patients'''''''' self esteem.

Keywords: VITILIGO, EXCIMER''S LASER, PHOTOTHERAPY

Introduction: Progressive macular hypomelanosis is a common skin hypopigmentation found in all ethnicities, yet it is seldom diagnosed. It affects young adults, especially women, and is often mistaken with pityriasis alba and pityriasis versicolor. It is character- ized by symmetric, well-defined, non-desquamative nummular hypopigmented macules in body areas with a greater concentration of sebaceous glands (trunk, thorax, abdomen and lumbar regions). Its etiology is poorly understood, and there is no effective treatment. A red fluorescence has recently been discovered in the lesion, suggesting the presence of porphyrin, produced by Propionibacterium acnes.
Objective: To compare the efficacy of 100 mg/day minocycline vs. placebo in the treat- ment of progressive macular hypomelanosis.
Methods: Patients over 18 (n = 20), who had suffered from the condition for more than 3 months (without treatment in the previous 3 months), who did not have an allergy to tetracycline, were randomized to receive minocycline or placebo. Wood''''''''s Lamp examina- tions and clinical evaluations (with descriptions and classifications using a color scale), and standardized picture records were conducted at baseline and 30 and 90 days after treatment.
Results: Eighteen patients completed the study. The group treated with minocycline pre- sented a statistically significant improvement (p < 0.05) compared to the control group.,br> Conclusion: 100 mg/day minocycline for 30 days was effective in treating progressive macular hypomelanosis, meaning that Propionibacterium acnes probably has a role in the condition''''''''s pathogeny.

Keywords: MINOCYCLINE, HYPOPIGMENTATION, PLACEBO EFFECT, TREATMENT

Keywords: SKIN NEOPLASMS, MOHS SURGERY, FROZEN SECTIONS

Keywords: BACTERIAL INFECTIONS, SCALP, RECONSTRUCTION

Keywords: CARCINOMA, BASAL CELL, LIP, RECONSTRUCTIVE SURGICAL PROCEDURES

Keywords: BLEOMYCIN, CICATRIX, HYPERTROPHIC, KELOID

Keywords: LIP, RHYTIDOPLASTY, SKIN AGING, DERMABRASION

Keywords: EAR, EAR DEFORMITIES, ACQUIRED, COSMETIC TECHNIQUES

Keywords: HIALURONIC ACID, LIP, REJUVENATION

Keywords: PREGNANCY, MELANOMA, DERMOSCOPY

Keywords: HYPERPIGMENTATION, EYELIDS, SKIN PIGMENTATION, PRODUCTS FOR EYES AREAS

Introduction: Melasma is a common hypermelanosis that mainly affects women and has a negative impact on the quality of life. It is a chronic and recurrent condition, and a number of treatments have already been proposed.
Objective: Assessment of quality of life for women with melasma before and after treatment with botanical extracts and hydroquinone.
Methods: A clinical, phase IV, randomized, blinded study was conducted at a clinical research institute. Women (n = 56) aged 18-60, with phototypes I-IV, were randomized into two groups (epidermal or mixed melasma). The Melasma Quality of Life Scale was used to compare the patients'''''''' quality of life before and after the use of Bellis perennis, Glycyrrhiza glabra and Phyllanthus emblica botanical extracts twice a day (Group A), or 2% hydro- quinone used at night (Group B). The Melasma Area and Severity Index was used to assess the treatments'''''''' efficacy.
Results: Appearance, frustration, embarrassment and feeling less attractive were the Melasma Quality of Life Scale variables that had the greatest negative impact on quality of life at the beginning of the study. After 60 days of treatment, there was improvement in all MELASQoL aspects, with no statistical differences between the two groups.
Conclusion: The improvement in melasma patients'''''''' self esteem provided by the use of the botanical extracts matched that of 2% hydroquinone.

Keywords: MELASMA, QUALITY OF LIFE, PHYLLANTHUS EMBLICA