Some cosmetics manufacturers have sought to employ ecologically correct manufacturing processes and use ingredients sourced from biodiversity. The present paper introduces a scientific review for professionals who prescribe such products. The bibliographic survey was performed using databases and keyword searches. Cosmetic products can be conventional, natural or organic. Those classified as natural contain ingredients of natural origin, while a great part of the raw materials used in organic ones must be certified as organic. Labels indicate the type of ingredients used in natural and organic formulations, however there is no standardization, meaning that prescribers should have sound conceptual knowledge on the subject.

Keywords: Control and sanitary supervision of cosmetics; Cosmetics; Cosmetic industry; Cosmetic labeling

Lesions located in fingers and toes, including the involvement of the nail apparatus, are not rare in dermatological practice. Many of them can be treated by dermatologist physicians qualified in dermatological and ungual surgeries, who rely on their knowledge of the origin and types, pathophysiology, and available therapeutic options for these lesions. The present study is aimed at presenting a bibliographical review on the various lesions that can affect this topography.

Keywords: Dermatologic surgical procedures; Fingers; Nail diseases

INTRODUCTION: Identification of the underlying causes of idiopathic cutaneous hyperchromia at the orbital region (ICHOR) is crucial in selecting the best therapeutic management.
OBJECTIVE: This study aims to evaluate the histopathological changes of different types of ICHOR.
METHODS: Forty-nine healthy volunteers were classified into (i) hyperpigmented (ii) hypervascularised or (iii) tear trough groups. Melanin deposit, hemosiderin deposit, blood vessels dilatation, perifollicular inflammation, structures of epidermis ridges were assessed histologically. Its association with the type of ICHOR was analysed using Pearson's chi-squared test.
RESULTS: A total of 53.1% ICHOR subjects was diagnosed as hyperpigmented, 16.3% as hypervascularised and 30.6% as tear trough and. Pearson's chi-squared test showed that hyperpigmented group associated with high level of melanin deposit (p<0.05), and invagination of melanin pigments into the dermal layer (p<0.05). Hypervascularity was associated with dilated blood vessel (p<0.05). Interestingly, tear trough was associated with dilated blood vessels (p<0.05) and perifollicular inflammation (p<0.05).
CONCLUSION: Each type of ICHOR showed distinct histopathological changes, selection of precise targeted therapy is important in treating ICHOR effectively.

Keywords: Hyperpigmentation; Histology; Melanosis

INTRODUCTION: Vitiligo is a hypopigmented disorder characterized by irregular loss of of the skin pigmentation. Current therapeutic modalities focus on increasing melanin production and modulating immune system responses. The use of some combined topical agents, in appropriate concentrations, is a possibility for the treatment of such hypopigmentation disorders.
OBJECTIVE: To follow-up patients who used a combination of creams in the experimental times of 6 and 14 months and to determine the effectiveness of the formulation.
METHODS: Forty-one patients with generalized stable vitiligo participated in the study. Patients applied a cream containing acetyl hexapeptide-1, mometazone furoate and dihydroxyacetone. The sites of the lesions included eyelids, forehead, face, neck, fingertips, hands, feet and legs. The variations in the treated patches were evaluated by dermatologists at each experimental visit. The percentage of repigmentation was evaluated after 6 months.
RESULTS: After 6 months of treatment, 8 patients (19.51%) had an excellent response to treatment, while a good response was observed in 19 patients (46.34%), moderate response in 10 (24.39%), and unsatisfactory in 4 (9.75%). Eyelids, face and forehead presented the best rate of repigmentation, while fingertips response was generally unsatisfactory.
CONCLUSIONS: The data support the efficacy of the new cream evaluated by the present study.

Keywords: Skin Pigmentation; Skin Cream; Vitiligo

INTRODUCTION: Interpolation flaps are well-established techniques for nasal reconstruction after the removal of skin cancers. Ideally, they should be performed after complete analysis of the surgical margins using Mohs micrographic surgery.
OBJECTIVE: To compare the paramedian forehead flap with the nasolabial interpolation flap for nasal reconstruction after Mohs surgery.
METHODS: Retrospective descriptive study of a consecutive sample of patients submitted to interpolation flaps for nasal reconstruction after Mohs surgery.
RESULTS: Twenty patients were included in the study, with 10 individuals undergoing each flap modality. Eighteen (90%) patients had defects involving multiple nasal anatomic subunits. The nasal tip (n = 10) and dorsum (n = 7) were the most affected areas in patients who underwent paramedian forehead flap, while the nasal ala (n = 10) and sidewall (n = 7) were the most affected in patients who underwent nasolabial interpolation flap. The removal of an additional portion of a subunit was performed in 15 (75%) patients. Complications were minimal and uncommon.
CONCLUSIONS: The paramedian forehead flap is more indicated for defects affecting the nasal tip and dorsum, while the nasolabial interpolation flap is more suitable for the restoration of the nasal ala. The subunit principle allowed incision lines to be camouflaged.

Keywords: Mohs surgery; Nose neoplasms; Surgical flaps

INTRODUCTION: Skin cancer is the most frequent tumor in transplanted patients. Evaluating how transplanted young adults behave regarding the exposure to the sun is an important step in introducing prevention programs in this population.
OBJECTIVE: To evaluate the photoprotection habits of transplanted young patients and to determine whether the guidance on the use of sunscreen increases the use of photoprotection measures.
METHODS: Cross-sectional study. A questionnaire was applied at the post-transplant post-adolescents clinic.
RESULTS: Forty-nine patients were interviewed (mean age = 22.9 years, SD = 4.6 years). The rate of use of sunscreen was 40% among those who had not been instructed and 93.2% among those who had been instructed. There was a statistically significant association between having been instructed on the use of and using sunscreen (p = 0.01). Most patients reported having used sunscreen. Limitations of the study: the interviewees’ level of schooling was not evaluated.
CONCLUSIONS: Young transplanted patients who are instructed during the consultations to use sunscreen adhered more to the application of sunscreen than patients who had not been instructed. It is of utmost importance to educate transplanted young adults about skin cancer prevention whenever possible, preferably at each visit.

Keywords: Kidney transplantation; Organ transplantation; Skin neoplasms; Skin care; Sunscreening agents; Young adult

INTRODUCTION: Cutaneous flaps can be complicated by both ischemia and estrogen deficiency. In this manner, it is desirable to improve the healing process with the use of medicinal plants, such as Aloe vera.
OBJECTIVE: To evaluate the effect of Aloe vera’s glycolic extract on skin flaps performed on oophorectomized rats.
METHODS: Cutaneous flap was performed in 20 animals, distributed in four groups, submitted to differentiated procedures, with microscopic (21st day) and macroscopic analysis (seventh and 14th day).
RESULTS: Microscopic variables were not significant. Two groups showed improvement in the general condition of the wound, and only one presented significant closure of the wound.
CONCLUSIONS: The Aloe vera extract yielded promising parameters regarding the macroscopic aspects; however further studies are necessary for a better evaluation.

Keywords: Aloe; Wound healing; Estrogens

INTRODUCTION: Photoaging results from the action of external agents, the main being ultraviolet radiation. It is clinically characterized by yellowish skin with irregular pigmentation, presence of wrinkles, atrophy, telangiectasias, decreased elasticity, and premalignant and malignant lesions. It corresponds to one of the most common dermatological complaints, requiring that dermatologist physicians keep up-to-date regarding treatments.
OBJECTIVE: To evaluate the effect of imiquimod in the treatment of photoaging.
METHODS: A prospective intervention study was carried out involving 12 female patients. The response was clinically assessed by the patient and examiner physician, and in light of histological parameters.
RESULTS: Six of the 12 patients, experienced side effects – three of which dropped out of the study. Of the 9 patients who completed the treatment, 8 perceived an overall improvement in the appearance of the skin. The examiner physician could observe improvement in 8 patients – slight in 6, and significant in 2 of them. Regarding histological aspects, there were decreases in solar elastosis (4 patients), melanin amount (5 patients) and fibrosis (4 patients).
CONCLUSIONS: Imiquimod can be an option for the treatment of photoaging, and should be evaluated in subsequent, controlled studies with larger samples.

Keywords: Skin; Skin aging; Administration, Topical

INTRODUCTION: Acne scars treatment is challenging since, in the most of the cases, there are different types of scars in the same patient.
OBJECTIVE: Associate three distinct acne scar treatment techniques in the same session in order to optimize results.
METHODS: Retrospective observational study evaluating 25 patients with acne scars treated with the following sequence of associated techniques: high frequency electrosurgery, CO₂ laser and Nd:YAP laser.
RESULTS: High patient satisfaction index and evident improvement in photographs in most of cases.
CONCLUSIONS: The combination of techniques in one session was safe and effective in the treatment of acne scars, a condition of great psychological impact to affected individuals.

Keywords: Acne vulgaris; Cicatrix; Laser therapy

INTRODUCTION: Hair transplantations promote the redistribution of hair strands on the scalp, aiming at covering the bald area. Hair transplantation using the FUE technique (Follicular Unit Extraction) usually occurs after the harvesting of the grafts. However, the earlier the grafts are implanted, the better the integration with the receiving area.
OBJECTIVE: Increase transplanted hair strands integration in the receiving area by leaving the grafts outside the body for the shortest time possible, during the implementation of hair transplantation using the FUE technique.
METHODS: An electronic chair and a litter (also electronic) were designed aiming at allowing that the harvesting and implantation of hair follicles be performed concomitantly.
RESULTS: The devices allowed modifying the surgical field, resulting in the possibility of concomitant harvesting and implantation.
CONCLUSIONS: Termed FAST FUE, this methodology provides allows simultaneous harvesting and implantation, reducing surgery time and leaving the grafts for a shorter time outside of the body.

Keywords: Alopecia; Hair; Hair/transplantation

Systemic sclerosis (SE) is an autoimmune disease of the connective tissue. Of unknown etiology, it is characterized by sclerosis (fibrosis), which affects the skin, blood vessels and internal organs. The diagnosis is confirmed by a compatible clinical picture, autoantibody research and capillaroscopy of the nail bed. The present report highlights the importance of the dermatologist physician in the diagnosis of systemic diseases. Based on the observation of the skin – which is visible and palpable in all of its dimensions – and in the interpretation of all its signs, it is possible to conclude that it can reveal early internal disorders that could develop unnoticeably.

Keywords: Scleroderma, systemic; Fibrosis; Autoantibodies

Skin cancers in the head and neck region account for 70-75% of malignant cutaneous tumors, of which 80% are basal cell carcinomas. Between 3-6% of malignant cutaneous tumors occur in the auricular pavilion. The authors of the present paper report an alternative technique for reconstructing the ear helix after excision of tumors, without the use of the classic compensation triangle. This method allows that the scar be located in the helical sulcus, resulting in a better aesthetic result, without unaesthetic retractions or scars located transversely to the helix.

Keywords: Dermatologic surgical procedures; Ear, External; Ear neoplasms

Onychocryptosis is a common condition in adolescents and young adults. Many conservative and clinical treatments have already been described. The authors of the present paper describe the standardization of the onychocryptosis surgical technique using 88% phenol, which is performed at a university hospital’s dermatology outpatient clinic since 2009.

Keywords: Dermatologic surgical procedures; Dermatology; Phenol; Nails, Ingrown; Research and new techniques; Technical aspects

Lower lip squamous cell carcinomas (SCC) correspond to 20-30% of all oral cavity cancers. It mainly affects men over 50 years of age who have previous history of smoking, alcoholism and exposure to the sunlight. The diagnosis is clinical, confirmed by histological analysis. The present paper describes a case of a patient with a SCC affecting more than 1/3 of the lower lip, who underwent resection of the primary lesion and a conservative reconstruction of the lesion’s region, due to the great local mobility, aimed at preserving the functionality without compromising the aesthetic outcome.

Keywords: Carcinoma, squamous cell; Mouth neoplasms; Reconstruction

Alopecia areata is a chronic condition of hair follicles and nails with unknown etiology, which causes hair loss. It emerges in several clinical types, with the diffuse form, where there is acute and diffuse hair loss, being atypical. It is generally accepted that there is a T-cell mediated, organ-specific autoimmune base in alopecia areata and studies indicate that the autoantigen is associated with melanocytes. The authors of the present paper report the case of a patient who had the diffuse form of alopecia areata, with preservation of the gray hair strands

Keywords: Alopecia Areata; Alopecia; Autoantigens; Hair

Cutaneous squamous cell carcinoma (SCC) results from malignant proliferation of keratinocytes. It usually arises from the development of precursor lesions, however it may grow spontaneously on normal or chronically inflamed skin. Invasive SCC is the second most common type of non-melanoma skin cancer and accounts for 20% of all cutaneous neoplasms. The present paper reports a clinical case of cutaneous SCC, rapidly progressive and with regional metastases, which, even after complete resection of the tumor and regional lymph nodes, showed little therapeutic response and evolved to death.

Keywords: Carcinoma, Squamous cell; Neoplasm metastasis; Pathology; Skin neoplasms