Side-by-side comparison of areas with and without cellulite depressions using magnetic resonance imaging.

BACKGROUND: Cellulite is characterized by alterations in the relief of the skin surface. Magnetic resonance imaging (MRI) is recognized as a reliable technique for measuring adipose volume according to body site and for the visualization of the subcutaneous structures. OBJECTIVE: To compare subcutaneous tissue in areas with and without cellulite on the buttocks of same subjects using a noninvasive technique. METHODS AND MATERIALS: Thirty female patients with cellulite on the buttocks underwent MRI. An area with cellulite and another without cellulite on the contralateral buttock were selected. Two soft gelatin capsules of different sizes were used as skin markers to differentiate the areas with and without cellulite. RESULTS: Fibrous septa were visualized in 96.7% of the area with cellulite depressions; most of them were ramified (73.3%) and presented a high-intensity signal on T2 images (70%). All fibrous septa found in the examined areas were perpendicular to the skin surface. The average fibrous septa thickness was 2.18 +/- 0.89 in the area with cellulite and 0.27 +/- 0.64 in the area without cellulite. CONCLUSION: Results of the MRI analysis showed that cellulite depressions on the buttocks were significantly associated with the presence of underlying fibrous septa.

Inguinal, or Hexsel's hyperhidrosis.

Inguinal Hyperhidrosis (IH) is a focal and primary form of hyperhidrosis in which the individual has intense sweating in the inguinal region. It usually appears in adolescence, not later than the age of 25, in the most cases, and continues into adulthood. With a sample of 26 patients we described Inguinal Hyperhidrosis (IH). Fifty percent of the patients have a positive family history of this condition or other forms of focal or generalized hyperhidrosis, which suggests a familial pattern. Biopsies performed on the inguinal area in a patient with IH and control patient showed normal histology. Excessive perspiration in the inguinal area significantly affects the quality of life of the patients. It is an embarrassing condition that produces large wet stains on the clothes, therefore making daily activities difficult and compromising the emotional, professional and social life of the affected patients. The therapies commonly used for other forms of focal hyperhidrosis are not yet referred in the literature specifically for IH. Intradermal injections from botulinum toxin provide positive results for the patients and controls the sweating for 6 months or more. It is a simple, safe and effective treatment for this condition and the results significantly improve the quality of life of the affected individuals.

Hyperhidrosis and botulinum toxin / Hiperidrose e Toxina Botulínica

Excessive sweating is a severe condition. It can interfere with an individual’s life in a most profound way. Because of the implications of excessive sweating this is read as a signal, which is always negative. In consequence, these individuals can virtually lead a social shut-in life. Traditional treatment of excessive sweating has not been satisfactory. Ablative procedures aimed at the axilla such as surgical excision have been effective but at the risk of scarring. Other procedures have been less effective. There has not been any effective treatment for excessive palmar and plantar sweating. It is with this background that the effectiveness of botulinum toxin in the treatment of excessive sweating was recognized. This began with the treatment of Frey’s syndrome but it was soon realized that BTX would reduce excessive sweating from whatever cause. Early efforts were clumsy but effective. Since this beginning, there has been extensive research done in this area which has greatly contributed to the improve treatment of individuals with hyperhidrosis

Liquid injectable silicone: history, mechanism of action, indications, technique, and complications.

Medical grade liquid injectable silicone can be used for soft tissue augmentation to correct and replace lost volumes of the subcutaneous tissue. It is potentially a permanent tissue augmentation agent and is the most effective filler for certain indications. This article presents the history, mechanism of action, indications and contraindications, technique, and the possible complications of silicone and their treatment.

Multicenter, double-blind study of the efficacy of injections with botulinum toxin type A reconstituted up to six consecutive weeks before application.

BACKGROUND: It is recommended that botulinum toxin be used immediately or within 2 weeks after its reconstitution because its efficacy might be compromised by prolonged storage. OBJECTIVES: To evaluate the efficacy of botulinum toxin type A (BTX-A) reconstituted over 6 consecutive weeks for the treatment of glabellar frown lines. METHODS: Four vials of BTX-A were reconstituted each of 7 days over a period of 6 weeks, totaling 28 vials, corresponding to seven reconstitution dates. During this period, the BTX-A was stored according to the manufacturer's instructions. On the day after the last reconstitution, all of the reconstituted vials were injected in patients from four dermatologic centers taking part in this study. A total of 88 patients were treated on the same day and were followed every 2 weeks for 4 months. All patients were photographed at all stages. A number of professionals assessed the efficacy of reconstituted BTX-A based on the reduction of the maximum frowning capacity of the treated muscles. RESULTS: Of the 88 patients who were selected, 3 were excluded. Three forms of evaluation were applied, and no statistically significant differences were found in the results presented. CONCLUSION: BTX-A may be applied up to 6 weeks after reconstitution without losing its effectiveness. Other factors, which are probably individual, may influence the response to BTX-A injections.

Hiperidrose e Toxina botulínica / Hyperhidrosis and Botulinum Toxin

O suor excessivo é uma condição severa, que pode interferir na vida de um indivíduo de maneira profunda. Por suas implicações, o suor excessivo é sempre visto como um aspecto negativo. Consequentemente, esses indivíduos podem levar uma vida social reclusa. O tratamento tradicional para o suor excessivo não tem sido satisfatório. Procedimentos ablativos realizados nas axilas, como excisões cirúrgicas, têm sido eficazes, porém com o risco de formação de cicatrizes. Outros procedimentos são menos satisfatórios. Não havia nenhum tratamento efetivo para a sudorese excessiva palmar e plantar. Foi com base nestas experiências que a eficácia da toxina botulínica no tratamento da sudorese foi reconhecida. Iniciou-se com o tratamento da síndrome de Frey, mas rapidamente percebeu-se que a TB-A poderia reduzir o suor excessivo qualquer que fosse a causa. Os esforços iniciais foram rudimentares, mas eficazes. Têm sido realizadas pesquisas extensivas nesta área, o que tem contribuído enormemente para a melhora no tratamento de indivíduos com hiperidrose

Tratamento da hipomelanose gotada idiopática por dermabrasäo localizada / Treatment of the idiopathic guttate hypomelanosis by localized dermabrasion

FUNDAMENTOS - A hipomelanose gotada idiopática é dermatose freqüente, inestética, de causa desconhecida e de poucas opçöes terapêuticas. OBJETIVOS - Propor um tratamento eficaz para a hipomelanose gotada idiopática por dermabrasäo localizada. PACIENTES e MÉTODOS - No periódo de fevereiro de 1995 a março de 1996, vinte pacientes do sexo feminimo com idade entre 19 e 66 anos e diagnóstico clínico de hipomelanose gotada idiopática foram tratadas por dermabrasäo localizadas e acompanhadas. Utilizou-se aparelho portátil de baixa rotaçäo e lixas adamantinas apropriadas para o procedimento, permitindo a abrasäo seletiva das lesöes. A abrasäo foi epidérmica e realizada na faixa de 10.000 a 15.000 rpn, sem anestesia local. CONCLUSÄO - O método mostrou-se rápido, simples, efetivo, seguro, reproduzível e de baixo custo e risco.