Posterior corneal morphological changes in primary congenital glaucoma

Purpose: To compare posterior corneal morphology between older treated and younger untreated children with primary congenital glaucoma (PCG) using anterior segment optical coherence tomography (ASOCT) and intraoperative OCT (iOCT), respectively. Methods: In this comparative study, ASOCT of older PCG children were compared with iOCT of younger untreated PCG patients. Differences between the two groups with respect to posterior corneal morphology were studied. Results: Observed morphological patterns within posterior cornea in older treated (age: 72–300 months) children (87 eyes) included Descemet’s membrane (DM) excrescences (70%), thickened DM (35%), intracameral twin protuberances (92%), and DM detachment (26%). Changes within pre?Descemet’s layer (PDL) (28%) included thickening, breaks, and detachments. Extent of Haab’s striae was associated with thickness of DM/PDL complex (P = 0.008) when analyzed in the treated group. In contrast, in the untreated group (n = 53 eyes, age 1–63 months), posterior corneal changes were limited to diffuse hyper?reflectivity of the DM/PDL complex, with absence of DM tears. Conclusion: Posterior cornea thickens and Haab’s striae become more circumscribed in eyes of older treated children compared to untreated PCG eyes, probably reflecting a healing response of posterior cornea over time.

Axenfeld-Rieger Syndrome: Case Report

Aims:To describe a Axenfeld-Rieger Syndrome.Presentation of Case: MCL, 7 years old, female, brown, was taken to the ophthalmology outpatient clinic of the Hospital Universit醨io Ant鬾io Pedro, Brazil by her parents, complaining of low visual acuity and malformation of the pupil perceived since birth.Discussion: Axenfeld-Rieger Syndrome is a rare and hereditary disease. Clinically, Axenfeld's anomaly is characterized by the presence of posterior embryotoxon, and there may be adherence of iridian tissue in its periphery. In addition to Rieger's anomaly, posterior embryotoxon is added to iris hypoplasia and iris thickness defects, uveal ectropion and pupillary alterations, such as corectopia. Rieger's syndrome is associated with extraocular changes, of which hypodontia, myicrodontia, maxillary hypoplasia, telecanthus, hypertelorism and hypospadias stand out.Conclusions: Therefore, the importance of early diagnosis, follow-up and adequate treatment becomes evident in order to preserve the visual function of patients and thus avoid an unfavorable evolution.

Efficacy of 2 940 nm Er∶YAG laser combined with electronic injection of collagen in treatment of striae gravidarum / 中华医学美学美容杂志

Objective:To assess the efficacy and security of 2 940 nm Er∶YAG laser combined with electronic injection of collagen in treatment of striae gravidarum.Methods:The symmetrical spots on both sides of abdomen of 21 subjects with striae gravidarum were divided into treatment and control groups by simple randomization method in the Department of Burn and Plastic Surgery, 903 Hospital from November 2017 to May 2019. The treatment group were treated with 2 940 nm Er∶YAG laser combined with electronic injection of collagen every 2 months for 3 sessions, and control group were received 2 940 nm Er∶YAG laser combined with electronic injection of physiological saline. The total effective rate, satisfaction, striae width, histopathology, and the adverse reaction were evaluated at 6 months after treatment.Results:A total of 19 subjects completed the whole trail. The clinical effective rate of the treatment group was 89.47% and the control group was 68.42%. In the treatment group, 11 cases were satisfied with and 6 cases were very satisfied with treatment outcome. In the treatment group, 8 cases were satisfied with and 3 cases were very satisfied with treatment outcome. The difference of total effective rate and satisfaction was statistically significant ( χ2 was 3.91 and 5.54, P was 0.045 and 0.019). The maximum width decreased by (1.53±0.97) mm on treatment side, and (1.37±1.01) mm on control side. The difference of striae width was statistically significant. No adverse effect was observed on both sides. Conclusions:The combination of the 2 940 nm Er∶YAG laser with electronic injection of collagen for treatment of striae gravidarum is a safe and effective approach for improving of striae gravidarum.

Avaliação da eficácia da carboxiterapia na melhora da sensibilidade tátil, da satisfação corporal e do aspecto de estrias albas na região glútea em mulheres: um ensaio clínico randomizado / Evaluation of the effectiveness of carboxitherapy in improving tactile sensitivity, body satisfaction and appearance of stretch marks in the gluteus region in women: a randomized clinical trial

Introdução: Estrias são lesões dérmicas lineares que acometem ambos os sexos, sendo duas vezes mais comuns em mulheres. Objetivos: Investigar se a carboxiterapia é eficaz para melhorar a sensibilidade tátil, a satisfação corporal e o aspecto de estrias albas localizadas na região glútea de mulheres. Métodos: 38 mulheres hígidas com estrias albas bilateralmente na região glútea participaram do estudo. A aplicação da carboxiterapia foi realizada em um glúteo e porção superior da coxa através da introdução da agulha hipodérmica paralelamente as estrias. Foram realizadas doze sessões com duração média de 20 minutos cada, com intervalo de sete dias. A eficácia da intervenção foi avaliada através de registros fotográficos, avaliação da dor, avaliação da sensibilidade tátil, e autoavaliação de satisfação pós-tratamento. Resultados: Não houve diferença estatisticamente significativa entre o grupo experimental e o grupo controle no que diz respeito à avaliação dos registros fotográficos. Houve redução significativa entre a dor e melhora da sensibilidade nas voluntárias. Também houve diferença significativa da satisfação com a aparência do próprio glúteo antes e após o tratamento. Conclusão: A carboxiterapia foi eficaz em melhorar a sensibilidade tátil e a satisfação com o corpo de mulheres hígidas com estrias albas na região glútea. (AU)

Introduction: Stretch marks are linear lesions that affect both sexes, being twice as common in women. Objectives: To investigate whether carboxytherapy is effective in improving tactile sensitivity, body satisfaction and the appearance of stretch marks located in the gluteal region of women. Methods: Thirty-eight healthy women with bilateral stretch marks in the gluteal region participated in the study. Carboxitherapy was applied to a gluteus and upper thigh by introducing the hypodermic needle in parallel as stretch marks. Twelve sessions were held with an average duration of 20 minutes each, with an interval of seven days. The assessment of the intervention was assessed through photographic records, pain assessment, assessment of tactile sensitivity and automatic assessment of satisfaction after treatment. Results: There was no statistically significant difference between the experimental group and the control group regarding the evaluation of photographic records. We observed a significant reduction between pain and improved sensitivity in the volunteers, and a significant difference in satisfaction with his appearance before and after treatment. Conclusion: Carboxytherapy was effective in improving tactile sensitivity and body satisfaction in healthy women with stretch marks in the gluteal region. (AU)

Topical corticosteroid induced ulcerated striae

Abstract We report four cases of ulcerated striae following misuse of fixed dose combinations creams containing clobetasol propionate with antifungal and antibacterial agents.

Microagulhamento: uma revisão / Microneedling: a review

Introdução: O microagulhamento também denominado como terapia de indução percutânea de colágeno (TIPC), consiste numa técnica aplicada através de um equipamento chamado roller. A técnica é indicada para rejuvenescimento, alopecia, todos os tipos de cicatrizes, acne, foto rejuvenescimento, estrias, flacidez de pele, melasma, rugas de expressão e melhora do aspecto geral da pele. Objetivo: Realizar revisão da literatura para identificar as principais aplicabilidades clinicas no uso do microagulhamento. Métodos: A pesquisa foi realizada no período de 2009 a 2018, em bases de dados eletrônicas PubMed e Scielo. Os estudos assim recuperados foram descritos e analisados. Resultados: Foram selecionados 12 artigos e 2 livros por apresentar conteúdo relevante. Conclusão: O microagulhamento é uma técnica simples, tratamento inovador e vem sendo utilizado para diferentes patologias dermatológicas. A técnica age pela estimulação natural de colágeno através da resposta ao processo inflamatório e outra facilitando o sistema de acesso transdermal de ingredientes (SATI), conhecido como Drug Delivery.

Introduction: Microneedling, also called percutaneous collagen induction therapy (PCIT), is a technique applied with an equipment called roller. It is suitable for rejuvenation, alopecia, all types of scars, acne, photo rejuvenation, stretch marks, skin flaccidity, melasma, expression wrinkles, and improvement of the general aspect of the skin. Objective: Perform a literature review to identify the major clinical applications of microneedling. Methods: The research was done from 2009 to 2018, in electronic databases PubMed and Scielo. The studies recovered were described and analyzed. Results: We selected 12 articles and two books for their relevant content. Conclusion: Microneedling is a simple technique, an innovative treatment that has been used for different dermatological pathologies. This method acts by naturally stimulating collagen by responding to the inflammatory process and also by activating the transdermal ingredient access system (TIAS), known as Drug Delivery.

Liquen plano, variante pápulo-escamosa o clásica: afectación vulvar y extragenital / A lichen planus subtype papulo-squamous or classic: Vulvar and extragenital presence

Resumen: ANTECEDENTES: El liquen plano de vulva se manifiesta como una lesión erosiva, papuloeritematosa o hipertrófica aislada o con afectación extragenital concomitante. CASO CLÍNICO: Paciente de 41 años, sin antecedentes médicos de interés, que acudió a consulta por la aparición de lesiones cutáneas pruriginosas de dos meses de evolución. A la exploración se objetivaron múltiples pápulas eritematoescamosas, violáceas, hiperqueratósicas, concomitantes con fenómeno de Koebner y tendencia a la agrupación, ubicadas en la cara anterior de los antebrazos y las muñecas, el dorso del pie y el tronco; en los pliegues inguinales, región vulvar y perianal, y de forma asintomática en el surco interlabial izquierdo, una pápula no pruriginosa de 3 mm, de tonalidad violácea con reticulado blanquecino en la superficie (estrías de Wickham), y otras dos pápulas de 11 y 3 mm. Se estableció el diagnóstico de liquen plano pápulo-escamoso vulvar, variante hipertrófica cutánea. Puesto que la enfermedad aparece de forma espontánea, se decidió el tratamiento expectante y para el prurito se indicaron antihistamínicos por vía oral. Seis semanas después desaparecieron las lesiones cutáneas (sin cambios cicatriciales). CONCLUSIONES: En pacientes con procesos dermatológicos complejos se requiere la correcta anamnesis y exploración ginecológica, sobre todo cuando hay afectación de las mucosas, para evitar el infradiagnóstico. La biopsia de las lesiones es útil en caso de duda, sobre todo en las lesiones vulvares aisladas de tipo hipertrófico.

Abstract: BACKGROUND: Vulvar lichen planus is a subtype of dermatological pathology that is presented as erosive, papulo-erythematous, or hypertrophic lesions on the vulva. This lesion could appear in isolation or with concomitant extragenital involvement. CASE REPORT: A 41-year-old patient with no previous history of interest, who attended due to the onset of itchy skin lesions of two months of evolution. At medical examination, multiple erythematous squamous, violaceous, hyperkeratotic papules were observed, with Koebner phenomenon and a tendency to cluster at the forearms and wrists, dorsum of the feet and trunk. The same lesions were seen in inguinal folds, vulvar and perianal region. We also notice an asymptomatic non-itchy 3 mm papule with violet edge in left labia majora (it had a whitish reticulate on the surface called Wickham's striae) and other erosive papules 11 mm and 3 mm respectively, with violet edge. No vaginal or other mucosal lesions were seen. Diagnosis of vulvar papule-squamous lichen planus was established which coexists with a cutaneous hypertrophic form. Given the self-limited nature of this pathology, a wait-and-see approach and symptomatic treatment of pruritus with oral antihistamines was adopted. Six weeks later, disappearance of the cutaneous lesion without cicatricial areas was observed. CONCLUSIONS: It is essential to carry out an anamnesis and gynecological examination in dermatological preocedures, especially when mucosas are involvement to avoid under-diagnosis. The biopsy of the lesions will be useful when there are doubts in the diagnosis, and it is essential in isolated hypertrophic vulvar lesions.

Comparação do uso do laser de baixa potência (660 NM E 830 NM) em estrias atróficas de mulheres jovens / Comparing low power laser use (660 NM AND 830 NM) in atrophic striae in young females

O laser de baixa potência é um recurso utilizado em lesões de pele, contudo ainda pouco explorado no tratamento de estrias alba. Objetivo: comparar dois comprimentos de laser de baixa potência (660 nm e 830 nm) sobre estrias albas. Um grupo de 24 mulheres foi dividido em três: G1 ­ 660 nm; G2 ­ 830 nm; G3 ­ placebo. Realizaram-se 12 aplicações de laser, durante quatro semanas. Foram avaliadas fotos das estrias no antes, depois e após duas semanas das aplicações do laser para mensurar a área ocupada pelas estrias por meio de planimetria digitalizada, bem como seus aspectos. Pela planimetria observou-se redução estatisticamente significativa na área ocupada em G1. Na análise qualitativa, o grupo tratado com laser de 660 nm apresentou melhora no aspecto das estrias. A aplicação utilizando o laser de baixa potência com comprimento de onda de 660 nm demonstrou efeitos positivos na área analisada, bem como no aspecto das estrias.

Although low-power laser is employed in skin lesions, it is only scantily used in the treatment of white striae. Comparison of two low-power laser lengths (660 nm and 830 nm) on white striae. A group of 24 females was subdivided into three groups: G1 ­ 660 nm; G2 ­ 830 nm; G3 ­ placebo. Twelve laser applications were undertaken during four weeks. Photographs of striae before, after and after two weeks of laser application were performed to measure area with striae by digital planimetry and their aspects. Planimetry revealed statistically significant decrease in area occupied in G1. Group treated with 660 nm laser qualitatively improved striae aspect. Application with lower-power laser at 660 nm had a positive effect on the area analyzed and in the aspects of the striae.

Can perineal tear be predicted by severity of striae gravidarum score?

Background: The objective of this study was to wether perineal tear predicted by scoring of severity of striae gravidarum. The objective of this study was to predict perineal tear by simple non-invasive method and help to prevent maternal morbidity.Methods: Three hundred ninety four patients delivered normally were included in this study. Striae gravidarum score was assessed using the Atwal numerical scoring system. The association was examined between striae and perineal tear as the outcome measure, defined by tears or laceration, and the total striae scores (TSS) was obtained.Results: In present study population mean age was 25.16 years ranging from 16-40 , mean gravidity was 2.16 ranging from 1 -8 ,average baby birth weight was 2.713 kg ranging from  1.62-4.58 The only predictors of perineal tears that were found to be statistically significant in our study were severity of striae gravidarum and episiotomy given or not. In patients with moderate to severe striae there was tear in 90 patients as compared to 29 patients with no or mild striae. 224 patients belonging to no or mild striae group delivered without any perineal tear whereas 51 patients in moderate to severe striae group delivered without tear. Out of these 51 patients 5 were given episiotomy. 2 patients who were given episiotomy had perineal tear as compared to 117 patients who were not given episiotomy. This shows that patients who had an episiotomy were less likely to have perineal tear in most cases.Conclusions: This study demonstrates a significant relation between severity of striae gravidarum and perineal tear. The findings suggest that striae gravidarum assessment may be used in the clinical setting even by paramedical staff as a simple and noninvasive tool to better define women at risk for perineal tear.

Uso da micropigmentação como método de camuflagem para cicatriz de estrias / Use of micropigmentation as a camouflage method for stretch mark scarring

As estrias são atrofias cutâneas lineares derivadas de um processo cicatricial. Elas se formam quando a tensão do tecido provoca uma lesão do conectivo dérmico, ocasionando uma dilaceração das malhas, gerando a perda da elasticidade e da compactação. A micropigmentação, também conhecida como dermopigmentação, dermografia, dermatografia ou tatuagem é uma técnica que consiste em um procedimento minimamente invasivo, utilizado para implantar pigmento na camada subepidérmica, para corrigir pequenas anormalidades ou para fins estéticos. O objetivo deste trabalho foi verificar a eficácia da camuflagem de cicatrizes de estrias por meio da micropigmentação. Após aplicação da sessão de micropigmentação foi verificado melhora da aparência das estrias na voluntária que seguiu corretamente as orientações. (AU)

Striae are linear cutaneous atrophies derived from a cicatricial process, they are formed when the tissue tension causes a lesion of the dermal connective, causing a tear of the meshes, generating the loss of elasticity and compression causing an injury. Micropigmentation, or also known as dermopigmentation, dermography, dermatography, or tattooing is a technique that consists of a minimally invasive procedure, used to implant pigment in the subepidermal layer, to correct small abnormalities or for aesthetic purposes. The objective of this case study was to verify the efficacy of the camouflage of scars by micropigmentation. After application of the micropigmentation session, it was verified an improvement in the appearance of the striae in the volunteer who followed the guidelines correctly. (AU)

Clinical significance and treatment of striae gravidarum during pregnancy: a review article

Abdominal stretch marks found during pregnancy may be indicative of poor skin elasticity. One who does not have stretch marks may have better skin elasticity and may be less likely to tear perineal and vaginal tissue during vaginal delivery. Striae gravidarum (SG) is a common phenomenon of stretch marks observed during pregnancy that may be an indicator of poor skin elasticity. The type and amount of collagen in connective tissue are considered to determine the individual’s elastic index. The skin surface is made up of a complex network of crossing thin lines. The two-dimensional relationship between primary and secondary lines determines the skin texture and its grade of irregularity. SG is caused by changes in the structural connective tissue due to a hormonal elect on the alignment and reduced elastin and fibrillin in the dermis. Severity scoring of SG was observed using the numerical scoring system of Atwal. This score provides a rank based on observation of four areas in which SG is most commonly observed (abdomen, hips, buttocks, and breast).

Avaliação da eficácia e segurança do microagulhamento com 5-fluorouracil para o tratamento de estrias albas: ensaio clínico randomizado duplo-cego / Evaluation of the efficacy and safety of microneedling with 5-fluorouracil for the treatment of striae alba: double-blind, randomized clinical trial

Introdução: Estrias são um desafio cotidiano ao dermatologista. Na busca por terapias alternativas, surgem o 5-fluorouracil (5-FU) e o microagulhamento ao associarem as seguintes propriedades: inibir fibrose, estimular renovação do colágeno e induzir pigmentação da pele. Objetivo: Avaliar a eficácia e segurança do 5-FU, isolado ou associado ao microagulhamento, no tratamento das estrias albas. Métodos: Estudo duplo-cego comparativo, durante 180 dias, entre três grupos: Grupo A - microagulhamento e 5-FU; Grupo B - 5-FU intralesional; e Grupo C - microagulhamento sem medicação. Mensurou-se a melhora por meio de uma escala numérica de coloração da pele, considerando-se resultados positivos aqueles com redução da discrepância entre a cor da pele adjacente e a da estria. Avaliou-se também a satisfação do paciente e a irritação com cada técnica. Resultados: Grupo A obteve 10% de melhora clínica excelente; 10%, muito boa; e 60%, leve. No grupo B, nenhuma paciente teve melhora excelente ou muito boa. Já no grupo C, observaram-se 20% de melhora clínica muito boa e 70% de melhora leve. Conclusões: Todas as técnicas apresentaram algum grau de melhora das lesões. Assim, propõem- se novos estudos comparando-se as três técnicas, com amostra mais ampla, para avaliar se maior número de sessões resultaria em resultados mais expressivos.

Introduction: Stretch marks are an everyday challenge to the dermatologist. In the search for alternative therapies, we find 5-fluorouracil (5-FU) and microneedling for associating the following properties: inhibition of fibrosis, stimulation of collagen renovation and induction of skin pigmentation. Objective: To evaluate the efficacy and safety of 5-FU, in isolation or associated to microneedling, for the treatment of white stretch marks (striae alba). Methods: Comparative, double-blind study over 180 days, between 3 groups: Group A: microneedling and 5-FU; Group B intralesional 5-FU and Group C microneedling without medication. We measured improvement through a numerical scale of skin coloration, considering positive results those with reduction of the discrepancy between the adjacent skin and the stretch mark. We also evaluated patient satisfaction and irritation with each technique. Results: Group A achieved 10% of excellent clinical improvement, 10% very good and 60% mild. In group B, none of the patients had excellent of very good improvement. In group C, there was 20% of very good clinical improvement and 70% of mild. Conclusions: All techniques showed some degree of improvement of the lesions. Therefore, we propose new studies comparing all three techniques, with a larger sample, to evaluate if more treatments would result in better results.

Application of platelet-rich plasma in dermatology / 中华皮肤科杂志

Platelet-rich plasma (PRP) is a platelet concentrate isolated from the autologous whole blood after centrifugation,and its optimal working concentration is 4-7 times that of the blood platelet count in the whole blood.After the activation by thrombin or calcium chloride,platelets can release various growth factors,which can promote hemostasis,wound healing and angiogenesis.Considered as a kind of low-cost and safe therapy,it has been widely applied to the repair of soft tissue and hard tissue injuries.PRP has also been widely applied to dermatology,including hair loss,skin rejuvenation,scar repair and wound healing.This review summarizes the application of PRP in dermatology.

Uso do laser de baixa potência em estrias de distensão: ensaio clínico randomizado controlado / Use of low level laser therapy in striae distensae: a randomized controlled trial

OBJETIVOS: Avaliar os efeitos da laserterapia de baixa potência (660 nm) no tratamento de estrias albas. MÉTODOS: Foi realizado um ensaio clínico randomizado com 20 mulheres divididas por igual em grupo controle e grupo tratamento. Para inclusão elas deveriam possuir estrias albas em região glútea e aceitar participar do estudo. Os critérios de exclusão foram: realização de outro tratamento para estrias, estado gravídico, uso de esteroides, tabagismo, diagnóstico de câncer, áreas hemorrágicas na pele, diagnóstico de epilepsia, diagnóstico de trombose, ou qualquer alteração cognitiva. Foram realizadas 12 aplicações de laser 660 nm, durante quatro semanas. Após mais quatro semanas de seguimento, foi realizada uma reavaliação. Após cada aplicação foram feitas fotos da região para avaliação do tamanho das estrias por meio de planimetria digitalizada, que avalia a porcentagem de área ocupada pelas estrias. Para essa avaliação foram utilizadas as fotos por ocasião da primeira aplicação (AV1), da sexta (AV2), da 12ª (AV3) e da última avaliação, após quatro semanas do término do tratamento (AV4). Foram realizadas também avaliações qualitativas por tato (profundidade) e inspeção visual (tonalidade e tamanho). RESULTADOS: A análise pela planimetria demonstrou que não houve diferença entre a área ocupada pelas estrias quando se compararam as diversas avaliações do mesmo grupo, até a AV3. Porém na AV4 (quatro semanas após a última aplicação de laser) do grupo tratamento, houve diminuição estatisticamente significativa da área de estrias em relação à AV1. No grupo controle, não houve diferença entre AV4 e as outras avaliações. Na comparação entre os dois grupos, não houve diferença nas três primeiras avaliações. Porém na AV4 o grupo tratamento mostrou menor área das estrias em relação ao grupo controle. Na análise qualitativa o grupo tratado apresentou menor visibilidade e menor profundidade das estrias ao tato. CONCLUSÕES: A terapia com 12 sessões de laser de baixa potência durante quatro semanas teve efeito positivo no tratamento de estrias albas, com os resultados tornando-se evidentes somente quatro semanas após a última aplicação. O laser de 660nm mostrou-se um método não invasivo, indolor e de rápida aplicação.

AIMS: To analyze the effects of low-level laser therapy (660nm) in the treatment of striae alba. METHODS: A randomized clinical trial was conducted with 20 women equally divided into a control group and a treatment group. For inclusion, they should have striae alba in the gluteal region and accept to participate in the study. Exclusion criteria were other treatment for striae, pregnancy, steroid use, smoking, cancer diagnosis, hemorrhagic areas on the skin, diagnosis of epilepsy, diagnosis of thrombosis, or any cognitive impairment. Twelve applications of 660 nm laser were performed for four weeks. After another four weeks of follow-up, a reevaluation was performed. After each application, photos were taken from the region to evaluate the size of the striae by means of scanned planimetry, which calculates the percentage of area occupied by the striae. For this evaluation, the photos taken at the first application (AV1), the sixth (AV2), the 12th (AV3) and the last evaluation, after four weeks of treatment completion (AV4), were used. Qualitative evaluations were also performed by touch (depth) and visual inspection (hue and size). RESULTS: The analysis by planimetry showed that there was no difference between the area occupied by the striae when comparing the various evaluations of the same group, until the AV3. However in AV4 (four weeks after the last laser application) of the treatment group, there was a statistically significant decrease of the stria area in relation to AV1. In the control group, there was no difference between AV4 and the other evaluations. In the comparison between the two groups, there was no difference in the first three evaluations. However in AV4 the treatment group showed a smaller area of the striae in relation to the control group. In the qualitative analysis the treated group had lower visibility and less depth of the striae to the touch. CONCLUSIONS: Therapy with 12 sessions of low-level laser for four weeks had a positive effect on the treatment of striae alba, with results becoming evident only four weeks after the last application. The 660 nm laser showed to be a non-invasive, painless and fast-applied method.

Efficacy of nonablative fractional laser in the treatment of striae gravidarum: a clinical observation / 中华皮肤科杂志

Objective To assess the efficacy and safety of nonablative 1 565-nm Er:Glass fractional laser in the treatment of striae gravidarum.Methods The left and right sides of the abdomens of 30 subjects with striae gravidarum were divided into 2 groups by simple randomization:treatment group treated with nonablative 1 565-nm Er:Glass fractional laser every 4 weeks for 3 sessions,and control group receiving no treatment.These subjects were followed up at the baseline,4th,8th and 12th week.At the same time,photos were taken,the skin flexibility was evaluated,and the width of striae was measured.Four weeks after the final treatment,clinical improvement was evaluated by 2 doctors,who were blind to the therapeutic protocol,according to clinical photos and three-dimensional (3D) images,and satisfaction scores were also evaluated.Skin biopsies were taken from the left and right sides of the abdomens of 3 subjects,and subjected to histopathological examination.Four months after the final treatment,all the subjects were telephoned for evaluation of adverse reactions and recurrence.Results A total of 27 subjects completed the whole trial.Four weeks after the final treatment,25 (92.6％) of the 27 subjects were considered to achieve an improvement by doctors.However,21 (77.8％) of the 27 subjects considered themselves to achieve an improvement.After 3 sessions of treatment,the treatment group showed a significant decrease in the largest width of striae from 4.852 mm to 3.296 mm (P ＜ 0.001) and a significant increase in skin flexibility from 0.803 to 0.878 (P ＜ 0.001).Histopathologically,the control group showed obviously atrophic epidermis and decreased collagen and elastin in the dermis,while the treatment group showed thickened epidermis and dermis,extended rete ridges,and increased collagen and elastic fibers which arranged more regularly.Immediate adverse reactions during the treatment included erythema and edema,and other adverse reactions included mild crust,itching and post-inflammatory hyperpigmentation (PIH).PIH was improved at 4 months after the final treatment compared with that at 4 weeks after the final treatment.Conclusion The nonablative 1 565-nm Er:Glass fractional laser can markedly improve the width and appearance of striae gravidarum,and increase skin flexibility in the treatment region.

Microagulhamento associado a fatores de crescimento e vitamina C no tratamento de estrias, fibro edema gelóide e flacidez tissular na região glútea / Microneedling associated to growth factors and ascorbic acid in the treatment of cellulite, striae distensae and skin laxity in the gluteal region

O microagulhamento é usado no tratamento de diversas afecções estéticas promovendo estímulo de colágeno. O objetivo deste trabalho foi averiguar a eficácia da associação do microagulhamento a fatores de crescimento e a vitamina C em diferentes afecções estéticas na região glútea. Foram realizadas 4 sessões de microagulhamento com intervalo de 21 dias entre as sessões. Percebeu-se significativa melhora na flacidez tissular, no fibro edema gelóide (FEG) e nas estrias e o microagulhamento mostrou-se uma técnica segura e eficaz para tratementos dessas disfunções estéticas. (AU)

The microneedling is used in the treatment of several aesthetic affections promoting collagen stimulation. The objective of this study was to verify the efficacy of the association of microneedling, growth factors and ascorbic acid in aesthetic affections in the gluteal region. Four sessions of microneedling were performed with a 21-day interval between the sessions, in which a significant improvement on skin laxity, cellulite and striae distensae was observed in the result and proved that the microneedling is to be a safe and effective technique for treating these aesthetic dysfunctions. (AU)

Microagulhamento: série de casos associados drug delivery / Microneedling: a case series associated with drug delivery

A associação do microagulhamento com o drug delivery tem-se mostrado benéfica pois potencializa os resultados de ambas as técnicas. Seis pacientes foram submetidas a duas sessões dessa associação de técnicas no tratamento da face, mãos e estrias, com intervalo de 20 dias. As avaliações foram realizadas por fotografias comparativas padronizadas. Os resultados revelaram redução da acne e melhora das manchas e textura da pele na face, melhora das manchas e textura da pele das mãos, e redução das dimensões e visibilidade das estrias. O presente estudo apresentou resultados promissores associando microagulhamento e drug delivery para tratamentos dermatológicos em face, mãos e estrias.

Six patients underwent two sessions of microneedling associated to drug delivery on the face, hands or stretch marks, at three-week interval between sessions. Patients were evaluated using clinical analysis and objective measures. Compared to baseline, objective face analysis showed decrease in acne lesions and improvement in the skin texture. The evaluation of stretch marks showed great improvement, and face and hands presented excellent results compared to baseline. The association of microneedling to drug delivery for rejuvenation of the face and hands, and for the treatment of stretch marks presented promising results in our study.

A Survey of the Awareness, Prevalence, and Characteristics of Striae Gravidarum in Dermatologic Outpatients of a University Hospital / 대한피부과학회지

BACKGROUND: Striae gravidarum (SG) is a common skin change that occurs in pregnancy. Various risk factors associated with SG have been reported, but the results are controversial. OBJECTIVE: This study aimed to determine the incidence, clinically associated factors, and awareness of SG in postpartum women at the dermatology clinic of a university hospital. METHODS: A questionnaire-based survey was conducted on women with fertility histories who had visited the dermatologic clinic of our hospital from October 2015 to December 2016. The survey items included the time of SG appearance, maternal age, and factors related to the development of SG (e.g., maternal weight gain, fetal weight and sex, and family history). We also investigated the awareness of SG development and treatment, and excluded subjects with various diseases that could affect SG. RESULTS: The subjects were 38 primiparas and 62 multiparas, and SG was observed in 91 subjects (91%). In 55.9% of the primiparous women, the SG became evident in the second trimester, although 63.1% of the multiparous women experienced the development of SG in the third trimester. There was a statistically significant difference in the time of SG appearance between primiparas and multiparas. In addition, fetal weight, maternal weight gain, and family history of SG were statistically associated with the occurrence of SG. However, fetal sex was not related to SG. The pregnant women considered the weight gain during pregnancy to be the most common cause of SG, while family history, fetal overweight, and the use of cream for skin regeneration were thought to be other causes of SG. 53.8% of the subjects with SG experienced various treatment methods, which did not show any significant difference in terms of effectiveness when compared with non-treated subjects. CONCLUSION: In our study, maternal weight gain, family history, and fetal weight were statistically significantly associated with the development of SG. We believe that this study may be useful to enhance our understanding of the awareness, prevalence, and related factors of SG in dermatologic outpatients at a university hospital. Multi-center studies with large numbers of patients are warranted to further investigate the clinical features of SG.

Radiofrequência pulsada com multiagulhas (RFPM®) no tratamento de estrias atróficas / Pulsed Radiofrequency with Multineedles (RFPM®) in the treatment of atrophic stretch marks

Introdução: As estrias atróficas representam alterações cutâneas caracterizadas pela perda de colágeno e elastina na derme, assemelhando-se a cicatrizes. Lasers fracionados, microagulhamento e peelings químicos têm apresentado bons resultados em alguns casos, mas não há um tratamento ideal. Objetivo: Avaliar a eficácia da radiofrequência pulsada com multiagulhas (RFPM®) em estrias tardias atróficas. Métodos: Estudo retrospectivo da segurança e efetividade da técnica mediante avaliação dos resultados por aplicação de questionário de satisfação aos pacientes e julgamento dos resultados clínicos por dermatologistas independentes. Resultados: Foram avaliados oito pacientes com idade entre 22 e 38 anos, submetidos à técnica, 100% dos quais relataram satisfação com os resultados, enquanto na avaliação comparativa das fotografias por dois dermatologistas independentes o índice de melhora foi de: 50% em dois pacientes e 75% em seis pacientes. A hiperpigmentação pós-inflamatória foi observada de dez a 20 dias após o tratamento em seis pacientes, tendo sido revertida após tratamento clínico. Conclusão: Esse novo procedimento se apresenta como alternativa ao tratamento de estrias atróficas.

Introduction: Atrophic stretch marks constitute skin disorders characterized by the loss of collagen and elastin in the dermis, and resemble scars. Fractional lasers, microneedling and chemical peels have led to good outcomes in some cases, however there is no ideal treatment. Objective: The objective of the present retrospective clinical study was to evaluate the effectiveness of Pulsed Radiofrequency with Multineedles (RFPM®) in late atrophic stretch marks. Methods: A retrospective study of the safety and effectiveness of the technique was carried out by evaluating outcomes with the application of a patient satisfaction questionnaire and the assessment of clinical results by independent dermatologist physicians. Results: A total of 8 patients (aged between 22 and 38 years) who underwent the technique were evaluated, of whom 100% reported satisfaction with the outcomes. Additionally, in the comparative evaluation of photographs carried out by two independent dermatologist physicians, the improvement rate was 50% in 2 patients and 75% in 8 patients . Post-inflammatory hyperpigmentation was observed in 10 to 20 days after the treatment in 6 patients, having been reversed after clinical treatment. Conclusions: The new procedure is an option in the treatment of atrophic stretch marks.

Perfil epidemiologico das alterações dermatológicas no segundo trimestre gestacional / Epidemiological profile of skin changes in second trimester

A pele no período gestacional, assim como todos os sistemas do organismo, sofre inúmeras mudanças. A maioria das alterações dermatológicas nesta fase é considerada fisiológica, no entanto, podem causar intenso estresse e desconforto cosmético para as gestantes. O objetivo do trabalho foi conhecer o perfil epidemiológico das alterações fisiológicas de pele em pacientes no segundo trimestre gestacional. Foi realizado um estudo censitário, transversal, descritivo, prospectivo e de abordagem quantitativa. Foram incluídas no trabalho todas as pacientes no segundo trimestre gestacional (n=66), atendidas pelo Sistema Único de Saúde da cidade de Criciúma, Santa Catarina, Brasil, no período compreendido entre 15 de setembro a 15 de novembro de 2012, excluindo-se as pacientes com gestação de alto risco. Os dados foram analisados no SPSS (Statistical Package for the Social Science) versão 20.0. Foi utilizado o teste qui-quadrado de associação ou independência. Como resultados, encontrou-se que a alteração dermatológica mais encontrada foi a estria (51,5%), acometendo principalmente região de abdome e mamas. 43,9% das entrevistadas revelaram queda da autoestima devido a estas modificações de pele. Alterações pigmentares foram vistas em 21,2% das pacientes. Concluímos que o aparecimento de aranhas vasculares foi mais frequente em pacientes com idade superior a 28 anos (±6,354), concluindo-se com este trabalho que a idade corresponde a um fator de risco para o desenvolvimento destas alterações.

In the gestational period, the skin, just like all the other body systems undergoes to numerous changes. Most of them are physiologic; however, they can expose these women in huge stress and aesthetic discomfort. The objective was to know the epidemiological profile of the physiological skin changes in the second trimester. It was performed a census study, transversal, descriptive, prospective and with quantitative approach. It was included in this study, pregnancy women in the second trimester enrolled in the SUS of Criciuma city, Santa Catarina, Brasil, between September 15 and November 15 of 2012, excluding high risk pregnancy. Data were analyzed in SPSS (Statistical Package for the Social Science) version 20.0. It was used chi-square test of association or independence. As results, we found that the most common dermatological change found was the striae gravidarum (51,5%), mainly affecting the region of the abdomen and breasts. 43,9% of respondents revealed decrease in self-esteem due to these skin changes. Pigmentary changes were seen in 21.2% of patients. The appearance of spider angiomas was more frequent in patients older than 28 years (± 6.354). We conclude with this work that age represents a risk factor for the appearance of spider angiomas in pregnant women.