INTRODUCTION: Axillary bromhidrosis is a disease of significant psychosocial impact characterized by bad odor in the armpits. The cause of bromhidrosis is multifactorial, and studies indicate that it is related to the bacterial transformation of substances secreted by the apocrine glands. Some cases of bromhidrosis are difficult to control by clinical therapies, and surgical therapies are well indicated. Surgical treatments for the disease aim to remove the axillary sweat glands and range from more aggressive to minimally invasive procedures. This review aims to list and compare all surgical alternatives described in the medical literature.

Keywords: Surgical Procedures, Operative; Sweat Glands; Hyperhidrosis; Apocrine Glands

Microinfusion of drugs into the skin (MMP^®) is a technique described by Arbache in 2013. It uses a tattoo machine to infuse drugs to treat skin diseases. This study aims to review the literature and list the indications already published on this technique, the medications used in the procedure, and this technique’s safety profile. Despite being widespread among dermatologists, microinfusion of drugs into the skin (MMP^®) requires careful analysis, as many indications lack scientific literature. Even though it is a promising technique, it needs further studies to consolidate its indications and assess its safety profile.

Keywords: Infusions, Intralesional; Research and New Techniques; Tattooing

INTRODUCTION: Liposuction is one of the most performed cosmetic surgeries in the world. Its mortality varies from 2,6 (6) to 19 (7) deaths/100 thousand. Data were obtained through questionnaires from medical societies (4-10) and retrospective data from forensic medicine institutes. However, both methods present flaws: the first due to professional bias and information duplicity, and the second due to the lack of data on the cause of death.
OBJECTIVES: To identify the number and causes of liposuction deaths through documentary records of news published in the press and study of death certificates.
METHODS: This is a documentary, descriptive-quantitative study. Knowing the deceased patients’ names and the cities where the death occurred, we obtained death certificates from the civil registry offices.
RESULTS: We surveyed 102 deaths and 86 death certificates. Pulmonary thromboembolism was the most cited cause of death in 17.44%, 45% on the same day of surgery. 53.6% of surgeries were performed in hospitals, and 61.76% of them, alone. Most physicians responsible for the surgeries were plastic surgeons (74%). Still, none were registered as a specialist in Dermatology at the Federal Medical Council. In 12.98% cases, doctors who participated in the surgery filled out the death certificate.
LIMITATIONS: The ethical impossibility of accessing medical records and the inadequate filling of death certificates.
CONCLUSION: The compulsory notification must be established by law to create a databa

Keywords: Liposuction; dead.

INTRODUCTION: Facial erythema is a frequent and often distressing complaint in patients with rosacea. Botulinum toxin has been proposed as a treatment of facial erythema with relatively good results.
OBJECTIVE: This study aims to assess botulinum toxin’s safety and efficacy in a split-face trial in two different administration modalities: intradermal injections on one side of the face and facial electroporation on the other side.
MATERIALS AND METHODS: The trial enrolled 20 subjects aged between 25 and 75 years with erythematotelangiectatic rosacea. Subjects received five units of Botulinum toxin through intradermal injections on the right side of the face. The same amount was introduced through electroporation technique on the left side. We conducted the evaluation using a standardized erythema grading system (System Vectra) and digital photographs at baseline, 2, 6, and 12 weeks.
RESULTS: The effectiveness in reducing the erythema of botulinum toxin with both the injection and electroporation was evident from the second week and persisted until week 12. Both techniques were effective.
CONCLUSIONS: Intradermal injection of botulinum toxin and electroporation seems both effective and safe for treating erythema related to rosacea. The mechanism of action is still controversial.

Keywords: Erythema; Mesotherapy; Botulinum Toxins, Type A

INTRODUCTION: Mohs micrographic surgery (MMS) can achieve high cure rates in skin cancer treatment and remove as little healthy tissue as possible.
OBJECTIVE: This study aims to characterize patients undergoing Mohs micrographic surgery and to assess predictive factors for a higher number of surgical phases.
METHODS: Observational, cross-sectional, retrospective, and descriptive study conducted in a reference service for micrographic surgery from 2013 to 2019. The medical records of 230 patients (256 lesions) were reviewed.
RESULTS: Injuries with recurrence had significantly more stages than injuries without recurrence (1.69 stages versus 1.31 stages). Tumors greater than 2 cm had a greater number of phases than those smaller than 1 cm and between 1.1 and 2.2 cm (2.0 versus 1.08 and 1.22, respectively). When comparing the locations of the lesions with the number of phases, there was no significant difference. There was a considerable difference regarding the preoperative histological subtypes: aggressive basal cell carcinomas (BCC) required a higher number of phases than non-aggressive BCCs.
CONCLUSIONS: Our study demonstrates, corroborating data from the literature, that the risk factors described are directly related to a greater number of stages of Mohs micrographic surgery.

Keywords: Mohs Surgery; Skin Neoplasms; Carcinoma, Basal Cell; Carcinoma, Squamous Cell Surg Cosmet

INTRODUCTION AND OBJECTIVE: The Campanha Nacional de Prevenção ao Câncer de Pele (National Skin Cancer Prevention Campaign), promoted by SBD, is an annual event to inform about the early diagnosis and prevention of skin cancer. Considering the participants’ profile, composed mostly of older adults, and the campaign educational goals, it's opportune to identify the proportion of people with cognitive impairment to improve communication.
METHODS: We perform a cognitive screening of 2018 Campaign participants using a "10-point cognitive screener" score. The participants included were ≥ 60 years. We excluded those who were unable to communicate or denied consenting.
RESULTS: The study interviewed 66 participants. The median age was 68 years (p25-p75:63-73), and 42 (64%) were women. Twenty-four participants (36%) had some elementary school, and 13 (20%) had a neurological or psychiatric disease. The crude and adjusted by schooling 10-CS scores had a median of 8 (6-9). Twenty-five of the interviewed patients (38%) had adjusted score below eight, indicating cognitive impairment, and six (9%) had a probable impairment. The cognitive deficit was associated with a history of neurological disease and low schooling.
CONCLUSIONS: Despite covering all ages, the campaign prioritizes the risk population, including older adults. Therefore, campaign volunteers should adapt the communication to participants’ profile.

Keywords: Dermatology; Skin Neoplasms; Disease Prevention; Mild Cognitive Impairment; Epidemiology; Early Detection of Cancer

INTRODUCTION: The venous lake is a venous ectasia that usually occurs on the lips and oral mucosa of the elderly. Although sclerotherapy is one of the most suitable treatments for this condition, dermatologists don't use this technique very often. Also, the concentration of the sclerosing agent, dose, and method of application are not standardized.
OBJECTIVES: This study aims to report the use of ethanolamine oleate 5% (EO5%) as a sclerosing agent to treat the oral venous lake and suggest a sclerotherapy protocol.
METHODS: We used a standardized protocol to treat an oral venous lake in ten consecutive patients, based on the experience of a University Dermatology Clinic, specialized in Stomatology. EO5% was applied in deep and central intralesional injections, with a predetermined volume proportional to the lesion’s dimensions. Results: Six patients had total lesion regression with one session. Another three patients achieved satisfactory regression with two monthly sessions, and one patient required three monthly sessions. All participants reported edema or burning for one to three days.
CONCLUSION: The oral venous lake treatment with EO5% is a safe and effective technique that can be used in the dermatologist's clinical practice.

Keywords: y, Venous Lake, Ethanolamine Oleate.

INTRODUCTION: Burn is a tissue injury and affects social functioning and relationships. Complications of burns lead to disruption of social relationships and, consequently, social dysfunction.
OBJECTIVE: This study aims to determine the effect of multimedia training on burned patients’ social functioning in Shahid Motahhari hospital in Tehran.
METHODS: This clinical trial study assessed 100 burned patients. The intervention group received multimedia self-care discharge training on a CD in addition to the standard education. The social function of the quality of life was examined in both groups before the intervention, 3 months and 6 months after the intervention.
CONCLUSIONS: Results showed that before the intervention, the mean score of social function of quality of life in intervention and control group was 1/55± 0/46, 1/92± 0/6, respectively, which was statistically significant (p <0.001). Mean and standard deviation of social function of quality of life in the intervention and control groups three and six months after intervention were2/47± 0/56, 4/05± 0/77, 2/15±0/39, 3/29 ± 0/95, also statistically significant (p<0.001).

Keywords: Self care; Multimedia; Patient discharge; Social adjustment; Burns

INTRODUCTION: Obesity is a disease that affects public health worldwide due to its comorbidities and premature death risk. Therefore, extracorporeal shock wave therapy (ESWT) technology can help treat and prevent its comorbidities.
OBJECTIVE: This study aims to assess whether ESWT can stimulate lipolysis and/or apoptosis of the fat cells of obese individuals.
METHODS: This is a comparative interventional study based on immunohistochemical analyzes of a set of subcutaneous tissue samples from women with obesity submitted to ESWT treatment. The biological material was collected at the time of bariatric surgery.
RESULTS: The survey included 14 obese women. Positivity was shown in the expression of Casp3 (p<0.0001), cCasp3 (p<0.0024), CD68+ macrophages (p<0.0001), HSL (p<0.0001), and adipophilin (p<0.0013) in the intervention sample compared to the control.
CONCLUSIONS: We conclude that ESWT stimulates apoptosis with consequent autophagic lipolysis in the adipose tissue of obese women. Thus, ESWT can be considered useful, safe, and promising adjuvant therapy for reducing adipose tissue and, consequently, for preventing and/or treating obesity.

Keywords: Dermatology; Obesity; High-Energy Shock Waves; Apoptosis

INTRODUCTION: Melasma is a recurrent and challenging dermatosis despite several clinical and interventional therapeutic approaches.
OBJECTIVE: This study aims to assess the safety and efficacy of using a bleaching cream in the period immediately after serial surface peels.
METHODS: Five women with melasma used a cream containing bleaches, moisturizers, and tranquilizers during the treatment period with serial surface peels. We assessed them in D0, D7, D30, D37, D60, D67, and D90 through photographs, record of the physician’s and patient’s opinion, description of adverse events, need to interrupt using the product, and the MELASQol questionnaire.
RESULTS: We observed improved hydration, skin quality, and bleaching, with little discomfort and a significant reduction in MELASQol scores, with statistical evidence.
CONCLUSIONS: The use of a topic cream with bleaching and tranquilizing properties is an effective and safe alternative to avoid interruption of melasma treatment during the period of serial surface peels.

Keywords: Chemexfoliation; Hyperpigmentation; Pigmentation disorders

Basal cell carcinoma over the tattoo region has been poorly reported in the literature, with a total of 13 cases. All cases describe the clinical aspect of the lesion and its pathogenesis but do not characterize the dermoscopy. We report two cases of basal cell carcinoma on tattoos with clinical and dermoscopy features, treated with Mohs micrographic surgery. It was challenging to establish the tumor’s clinical and dermoscopic margins due to the tattoo’s exogenous pigment.

Keywords: Carcinoma, Basal cell; Dermoscopy; Tattooing; Mohs surgery

INTRODUCTION: Vitiligo is an acquired skin dyschromia characterized by the physical and/or functional reduction of melanocytes. We present two surgical proposals for the treatment of vitiligo.
CASE REPORTS: 1) Implant of skin graft diluted in hyaluronic acid gel: We obtained the material through curettage, diluted it in hyaluronic acid gel, and applied it to receptor areas. 2) Epidermal suspension obtained through curettage and diluted in hyaluronic acid gel: After the curettage of the donor area, we treated the material with trypsin-EDTA, centrifuged it, and diluted it in hyaluronic acid gel. The receptor area received the graft.
CONCLUSION: These are safe, easy, and satisfactory surgical procedures for the presented cases.

Keywords: Vitiligo; Keratinocytes; Ambulatory surgical procedures

Persistent Intermittent Delayed Swelling (PIDS) due to hyaluronic acid implantation is an immune-mediated inflammatory reaction resulting from immunogenic phenomena to the filler itself, and its ability to retain water, thus configuring local edema. Viral or bacterial infections can trigger the condition. As with many infectious diseases, COVID-19 may have several signs and symptoms on the skin that are not yet fully understood, but many associated skin manifestations have already been described. Through this case report, we report the novelty of an ETIP-type reaction triggered by SARS-CoV-2 infection.

Keywords: Hyaluronic acid; Coronavirus; Coronavirus infections; Foreign-body reaction

Blue nail dyschromia has several differential diagnoses. Lesion growth, associated nail dystrophy, and nail extension require evaluation for surgical excision. We report the case of a 27-year-old woman presenting a bluish, semicircular stain, occupying about 50% of the lunula. The patient presented no changes in the overlying lamina, small alteration of the distal nail portion, localized onychoschizia-type layers, and no previous trauma or bleeding history. We performed partial avulsion of the plaque and shave biopsy, evidencing an intensely pigmented lesion. Histopathological examination was compatible with blue nevus. In this case, the nevus should be located in the sub-matricial position, thus not interfering with the nail plate color.

Keywords: Nevus, Blue; Nail diseases; Surgical procedures, Minor; Ambulatory surgical procedures; Nevus, pigmented; Skin neoplasms

The increase in the incidence of basal cell carcinoma (BCC) affects all age groups, including young patients under twenty years old. Because it is poorly remembered in this group of patients, late diagnosis and treatment of this neoplasia may be more common. Like other age groups, excessive exposure to ultraviolet radiation is the main associated risk factor; however, genetic factors may also be involved in non-syndromic cases. We report a case of BCC on the face of an adolescent treated with Mohs micrographic surgery.

Keywords: Adolescent; Carcinoma, Basal Cell; Epidemiology; Mohs Surgery; Solar Radiation

Correcting facial deformities is still a significant challenge for the dermatological surgeon. The therapeutic options may vary depending on the etiology, location, costs, and attending physician’s experiences of the. Although some studies have shown controversies regarding the results of using autologous fat transplantation (AFT) to treat facial depression, we report a case with good aesthetic results after two sessions of AFT in a male patient with a depressed facial fracture after head trauma.

Keywords: Transplantation; Transplantation, Autologous; Subcutaneous fat; Skull fracture, depressed