Vitamin C, or L-ascorbic acid, is the most abundant antioxidant in human skin and its topical replacement has proven relevant, since this reservoir is consumed by external aggression, and it is used in the prevention and treatment of skin aging. This review was based on bibliographic research in the PubMed and LILACS databases and two consensus meetings between the authors to analyze the evidence for its topical use. The highest level of evidence of skin activity has been found in the pure and stabilized form of ascorbic acid. Derivatives, carriers, and nanoformulas are being developed, however further clinical and comparative studies are needed.

Keywords: Ascorbic Acid; Antioxidants; Skin Aging; Hyperpigmentation; Cosmeceuticals.

Techniques for removing adipose tissue are always of great interest, and among many described, the applications of sodium deoxycholate (DS) or deoxycholic acid, known as intralipotherapy, have stood out in recent years, following approval by the FDA for the treatment. of submental fat, due to the ease of application and short downtime. The objective of this study was to elucidate, through the available literature, the most frequently asked questions in this regard, and demonstrate that it is an effective and safe alternative for the treatment of localized fat.

Keywords: Atrophy; Adipose Tissue; Fat Body.

INTRODUCTION: The demand for laser procedures in dermatology is increasing, and topical anesthetics are widely used to reduce pain, enhance patient comfort, and improve treatment outcomes. Despite their frequent use, the evaluation of pain perception during diode laser hair removal using topical anesthetics has not been extensively studied.
OBJECTIVE: This study aimed to compare the analgesic effects of a commercial 4% lidocaine formulation (Dermomax ®, Aché Pharmaceutical Company, São Paulo, Brazil) with a compounded formulation containing 23% lidocaine and 7% tetracaine (Artpharma Pharmaceutical Company, São Paulo, Brazil) during LightSheer® diode laser hair removal procedures.
METHODS: A total of 74 women aged between 14 and 65 years underwent a total of 256 laser hair removal procedures. Sixty minutes before the procedure, the two anesthetic formulations were applied: the commercial 4% lidocaine on one half of the treatment area, and the compounded 23% lidocaine with 7% tetracaine on the other half. The treated areas included axillae, face, legs, and groin. The side of the body on which each formulation was applied, as well as the side to be treated first with the laser, were randomly assigned in a double-blind manner. Pain intensity was assessed using a Visual Analog Scale (VAS). Data were analyzed by comparing VAS scores across the different treatment areas.
RESULTS: Statistically significant differences in pain perception were found in all evaluated regions. The compounded formulation resulted in lower pain scores compared to the commercial formulation. No adverse effects were reported.
CONCLUSIONS: The compounded anesthetic formulation containing 23% lidocaine and 7% tetracaine was more effective in providing analgesia than the commercial 4% lidocaine product (Dermomax^®) for diode laser hair removal.

Keywords: Pain; Anesthetics; Laser Therapy.

Merkel cell carcinoma is a rare and aggressive cutaneous neuroendocrine cancer that occurs on sun-damaged skin in older White patients. It typically manifests as a solitary plaque or nodule in the head and neck region. We report an unusual presentation of Merkel cell carcinoma in a black patient who simultaneously developed two primary tumors located in the trunk region.

Keywords: Carcinoma, Merkel Cell; Immunohistochemistry; Neuroendocrine Tumors; Upper Extremity.

The appearance of the upper third of the face is a key indicator of aging and plays a significant role in communication by conveying non-verbal information. Different surgical techniques have been described for the rejuvenation of this region, with transfollicular subcutaneous forehead and brow lift enabling excellent results by lowering the hairline, reducing forehead height, softening forehead and glabellar rhytids, raising the eyebrows, and improving pseudodermatochalasis. This technique offers the advantages of reduced risk of nerve injury and excellent scalp scar camouflage.

Keywords: Dermatologic Surgical Procedures; Rejuvenation; Rhytidoplasty; Skin Aging; Surgery, Plastic.

Halo, cockade, eczematous, and targetoid hemosiderotic nevi are known as target nevi, classified as melanocytic nevi with special features and often mimic melanoma. This communication aims to demonstrate clinical manifestations, dermoscopic patterns, and reflectance confocal microscopy findings in 4 patients with different types of target nevi.

Keywords: Dermoscopy; Microscopy, Confocal; Melanoma; Nevus, Halo.

Eruptive vellus hair cyst is a rare condition resulting from the abnormal development of vellus hair follicles, leading to the formation of multiple follicular papules. While it can appear on the face, only five cases specifically located in the periorbital region have been described in the literature. Its treatment is challenging, particularly in the case we report here due to the peculiar location of the lesions, which increases the risk of postoperative scarring and dyschromia. We present a report that addresses the challenging diagnosis and successful treatment of a rare case of eruptive vellus hair cyst located in the periorbital region.

Keywords: Follicular Cyst; Eyelids; Surgical Procedures, Operative.

Several surgical techniques are available for the treatment of keloids on the earlobes. Depending on the size, depth, duration, and morphology of the lesion, the procedure can pose significant challenges for the dermatologic surgeon, as these factors are associated with a higher risk of recurrence and local deformities. We report two cases in which total excision with fistulectomy was performed, yielding favorable aesthetic outcomes.

Keywords: Keloid; Ear; Case Reports; Ambulatory Surgical Procedures.

Skin cancers affecting the eyelid can be a reconstructive challenge due to the complexity of the local anatomy. In addition to precise eradication of the tumor, maximal preservation of the skin is essential for both functional and cosmetic outcomes. Transposition flaps represent an excellent reconstructive option, as they require few incisions and, when well planned, do not cause ectropion, a key consideration in this topography. We describe a case series of lower eyelid reconstructions adjacent to the tarsus following Mohs micrographic surgery, using transposition flaps.

Keywords: Surgical Flaps; Mohs Surgery; Skin Neoplasms; Eyelids; Eyelid Neoplasms.

Glomus tumor is a rare, benign neoplasm typically found in areas with a high concentration of glomus bodies. It presents with a characteristic clinical triad: paroxysmal pain, cold sensitivity, and localized tenderness. We report the case of a patient with clinical suspicion of a glomus tumor, in which transillumination played a crucial role in diagnosis, surgical planning, and rapid pain relief. This case highlights the importance of maintaining a high index of clinical suspicion and the utility of transillumination for both diagnosis and therapeutic planning – particularly in settings where high-frequency ultrasound or magnetic resonance imaging is not readily available.

Keywords: Glomus Tumor; Transillumination; Nail Diseases; Surgical Procedures, Operative.

At the beginning of dermal filler use, which started with fat grafts, a variety of products were tested for this purpose, from temporary to permanent fillers. The decision to use polymethyl methacrylate (PMMA) as a permanent dermal filler should be considered with caution.

Keywords: Polymethyl Methacrylate; Plastics; Cosmetic Industry.

Fish-related injuries (ichthyism) are common among fishermen. The mandi catfish (Pimelodus maculatus) is a freshwater species that uses, as a defense mechanism, the insertion of spines equipped with venom glands, characterizing an active venomous ichthyism. In a series of 200 ichthyism cases recorded in rivers and lakes across Brazil, approximately 40% were caused by mandi catfish and other catfish species. We report the case of a patient with a "nonhealing wound" on the left leg for 5 months following local trauma. The initial diagnosis of squamous cell carcinoma was later revised to a foreign body reaction caused by the spine of the mandi catfish.

Keywords: Foreign-Body Reaction; Wounds and Injuries; Carcinoma, Squamous Cell; Fishes, Poisonous.

Scrotodynia, or genital dysesthesia, is characterized by chronic scrotal pain lasting at least 3 months, with no identifiable etiology despite thorough investigation. Although it is considered a relatively common condition, the lack of effective therapeutic options significantly impacts the quality of life of affected patients. We report a successful and sustained treatment for scrotodynia with botulinum toxin in a 69-year-old patient who had not responded to appropriately dosed oral medications for chronic pain.

Keywords: Male Urogenital Diseases; Botulinum Toxins; Pain, Intractable.