Edema frontal após aplicação de minoxidil 5% e biotina em injeções intradérmicas / Frontal edema after application of 5% minoxidil and biotin in intradermal injections

A intradermoterapia, ou mesoterapia, é procedimento não cirúrgico, minimamente invasivo, que consiste em múltiplas aplicações de substâncias farmacológicas diluídas por via intradérmica ou subcutânea. Já foram relatados vários efeitos adversos posteriores a esse procedimento: alopecia, erupção liquenoide, oleoma, indução de psoríase e infecções cutâneas. A informação científica sobre o tema é escassa, e há poucos estudos com metodologia rigorosa acerca da eficácia e do mecanismo de ação da via intradérmica. Relata-se caso de edema frontal após intradermoterapia com minoxidil e biotina.

Intradermotherapy, also known as mesotherapy, is a non-surgical procedure, minimally invasive consisting of multiple applications of pharmacological substances diluted by intradermally or subcutaneously. Adversities already been reported after treatment mesoterápico as alopecia, lichenoid rash, oleoma, psoriasis induction and skin infections. There is scant scientific information on the subject, and few studies with more rigorous methodology of the efficacy and mechanism of action of intradermally. Knowing this, there was this article having a complicating account of this method in a patient of our service, and elucidate some of its benefits and other complications.

Use of dermoscopy in the diagnosis of temporal triangular alopecia

Temporal triangular alopecia, also referred as congenital triangular alopecia, is an uncommon dermatosis of unknown etiology. It is characterized by a non-scarring, circumscribed alopecia often located unilaterally in the frontotemporal region. It usually emerges at ages 2-9 years. Alopecia areata is the main differential diagnosis, especially in atypical cases. Dermoscopy is a noninvasive procedure that helps distinguish temporal triangular alopecia from aloepecia areata. Such procedure prevents invasive diagnostic methods as well as ineffective treatments.

Reconstrução do lábio inferior com técnica de Camille Bernard após excisão de carcinoma basocelular infiltrativo / Reconstruction of the lower lip with Camille Bernard's technique after excision of infiltrative basal cell carcinoma

Os tumores labiais correspondem a 15% das neoplasias de cabeça e pescoço. O retalho de Camille-Bernard é indicado para a reconstrução do lábio inferior, quando o defeito é maior do que um terço do lábio. Demonstra-se caso com resultado final satisfatório, tendo-se obtido preservação funcional, estética e sensorial, com a utilização dessa técnica para reconstrução cirúrgica do lábio inferior após excisão de tumor localmente avançado.

Lip tumors account for 15% of head and neck neoplasias. When the defect is greater than one third of the lip, the Camille Bernard's flap is suitable for the reconstruction of the lower lip. The present study describes a case with a satisfactory outcome, where functional, aesthetic, and sensory preservation of the lower lip was obtained by using this technique in its surgical reconstruction, following excision of a locally advanced tumor.

Aplicação da dermatoscopia no auxílio diagnóstico da ocronose exógena / Use of dermoscopy for diagnosis of exogenous ochronosis

A ocronose exógena consiste em hiperpigmentação crônica de áreas previamente tratadas com agentes tópicos como: a hidroquinona, a resorcina, os antimaláricos e o fenol. O diagnóstico precoce permite suspender prontamente o agente causador, uma vez que as opções terapêuticas disponíveis são escassas e com resultados insatisfatórios. Reportam-se três casos de ocronose exógena na face, diagnosticados pela dermatoscopia. O estudo dermatoscópico evidenciou estruturas amorfas de coloração cinza-enegrecido, algumas obliterando as aberturas foliculares. O exame histopatológico corroborou o diagnóstico.

Exogenous ochronosis consists of chronic hyperpigmentation of areas previously treated with topical agents such as hydroquinone, resorcinol, antimalarials and phenol. Early diagnosis allows to promptly suspend the causative agent and it is imperative since the available therapeutic options are scarce and have presented so far unsatisfactory results. Three cases of exogenous ochronosis on the face which were diagnosed with the use of dermoscopy are presented. Dermatoscopy showed blackish-gray amorphous structures, some obliterating the follicular openings. Histopathological examination confirmed the diagnosis.

Hemangiomas periorbitários: necessidade de conduta ativa - relato de dois casos / Periorbital hemangiomas: the need for active management - report of two cases

Hemangioma é o tumor mais comum da infância, frequentemente situado na cabeça e pescoço. A órbita é frequentemente acometida e indica intervenção precoce e agressiva para evitar sérias complicações visuais. Reportam-se dois casos, nos quais há impedimento da visão no primeiro e, no segundo, um hemangioma profundo acomete áreas adjacentes, confirmado por exame radiológico. Demonstra-se sucesso terapêutico após corticoterapia sistêmica agressiva, evitando sequelas visuais permanentes, além do resultado estético satisfatório. O tratamento de escolha é o corticosteroide oral, devendo ser conduta individualizada e com bom seguimento clínico dos possíveis efeitos adversos.

Hemangioma is the most common tumor of childhood and is commonly located on the head or neck. The orbit is often affected and early and aggressive intervention is required to prevent serious visual complications. This paper reports on two cases. In the first case, the patient's vision was impaired, while in the second case a deep hemangioma affecting adjacent areas was confirmed radiologically. Treatment with aggressive systemic corticotherapy was successful, thus avoiding permanent damage to the patients' vision. Furthermore, esthetic outcome was satisfactory. The treatment of choice is oral corticosteroids and management should be individualized and should include careful follow-up to monitor possible adverse effects.