Tratamentos estéticos e cuidados dos cabelos: uma visão médica (parte 2) / Hair care: a medical overview (part 2)

Neste artigo, os autores complementam o primeiro trabalho sobre a pesquisa dermatológica dos tratamentos estéticos capilares. O alisamento capilar defi nitivo com os principais alisantes legalizados ­ hidróxidos de sódio e lítio, hidróxido de guanidina e tioglicolato de amônio ­, suas diferenças, mecanismos de ação, indicações e segurança para a saúde são aqui abordados. O artigo ainda discute sobre o uso ilegal e indiscriminado de produtos do grupo dos aldeídos (formaldeído e glutaraldeído) nos salões de cabeleireiro no Brasil, suas implicações legais e em saúde pública, sua carcinogenicidade e a identifi cação dos referidos registros junto à ANVISA. Também são estudados os xampus e agentes condicionadores indicados para tratamento da haste capilar. Ao fi nal, são discutidas as implicações dos tratamentos capilares em geral, para a saúde do fi o e do couro cabeludo.

The authors complement the fi rst article on the approach of dermatological aesthetic hair treatments. This article addresses the ultimate hair straightening with major straightening legalized ­ sodium, lithium and guanidine hydroxides and ammonium thioglycolate ­, their differences, mechanisms of action, indications and safety to human health. Besides these straighteners, we discuss the illegal and indiscriminate use of hairdressers salons in Brazil in the group of aldehydes (formaldehyde and glutaraldehyde) for smoothing hair. This study focuses its legal implications and public health, carcinogenic potencial and the identifi cation of such fi lings with ANVISA. Also studied the shampoos and conditioning agents indicated for treatment of the hair shaft. Finally, we discuss the implications of hair care in general health of the hair shaft and the scalp.

Tratamentos estéticos e cuidados dos cabelos: uma visão médica (parte 1) / Hair care: a medical overview (part 1)

Dúvidas sobre a ação dos cosméticos capilares sobre a saúde do corpo e dos cabelos são cada vez mais frequentes nas consultas dermatológicas. Os médicos dermatologistas necessitam enriquecer o conhecimento a respeito, não somente, das doenças do couro cabeludo, como também das interações moleculares dos cosméticos usados na fibra capilar, incluindo a influência de tais produtos quando absorvidos pelo epitélio do couro cabeludo. A cada dia, aumentam as consultas médicas para esclarecimento de quais técnicas e produtos químicos são mais indicados para permitir que os cabelos sofram as alterações desejadas de seu aspecto natural e, ao mesmo tempo, mantenhamse saudáveis e belos. Neste artigo, dividido em duas partes, abordamos a fisiologia dos cabelos, sua estrutura e natureza química, os agentes usados para seu alisamento, sua coloração, higiene e seu tratamento estético e as consequências que tais procedimentos podem ter na saúde em geral, incluindo sua segurança no uso durante a gravidez e lactação.

Doubts concerning the action of hair cosmetics and the health of both body and hair are very frequent in the dermatological visits. Dermatologists need no only to enrich the knowledge of scalp diseases but also of molecular interactions of cosmetics used in hair fi ber, including the infl uence of such products when absorbed by the epithelium of the scalp. The amount of medical visits increases every day to fi nd out which techniques and chemical products are best indicated to enable the desired changes in hair from its natural appearance and, at the same time, to keep the hair healthy and beautiful. In this article, divided in two parts, we discuss the hair physiology, structure and chemical nature, as well as the agents used for its smoothing, coloring, hygiene and cosmetic treatment, and the consequences that such procedures can have on overall health, including their use safety during pregnancy and lactation.

Dermoscopy findings of alopecia areata in an African-American patient.

BACKGROUND: Dermoscopy has been established as an indispensable tool in the diagnosis and follow up of hair disorders. In alopecia areata, dermoscopy of active disease shows yellow dots, dystrophic hairs, as well as cadaverized (black dots) and exclamation mark hairs. Alopecia areata has been reported to occur equally among races, however, until date, there are no published data regarding dermoscopic findings in African-American patient. MAIN OBSERVATION: We report a case of scalp dermoscopy of alopecia areata in an African-American patient that shows a diffuse honeycomb-like pigmented network, few yellow dots and white dots. CONCLUSION: This case shows that skin color may affect dermoscopic findings in alopecia areata. In our African-American patient with alopecia areata dermoscopy showed a diffuse honeycomb-like pigmented network, which was previously considered characteristic for androgenic alopecia and white dots, which were considered characteristic for cicatricial alopecia. Further studies are needed to elucidate the presence of white dots in alopecia areata.

The use of monoclonal antibody (rituximab) in the treatment of type II mixed cryoglobulinemia.

Anti-CD20 monoclonal antibody has been successfully used to treat several self-immune diseases. The authors report the case of a 71 year-old female patient under the use of pegylated form of interferon á associated with ribavirin for the treatment of hepatitis C, who, after concluding the therapeutic program - negative Polymerase Chain Reaction (PCR) - developed a severe cutaneous vasculitis, receiving the diagnostic of type II mixed cryoglobulinemia. Four sessions of plasmapheresis were prescribed along the period of 11 days, with no result. The choice made was to administer anti-CD 20 monoclonal antibody (rituximab), 375 mg/m(2), per week, during four consecutive weeks. One could observe fast recovery from the purpura, as well as total remission of urticaria.

The use of monoclonal antibody (Rituximab) in the treatment of type II mixed cryoglobulinemia

Anti-CD20 monoclonal antibody has been successfully used to treat several self-immune diseases. The authors report the case of a 71 year-old female patient under the use of pegylated form of interferon á associated with ribavirin for the treatment of hepatitis C, who, after concluding the therapeutic program - negative Polymerase Chain Reaction (PCR) - developed a severe cutaneous vasculitis, receiving the diagnostic of type II mixed cryoglobulinemia. Four sessions of plasmapheresis were prescribed along the period of 11 days, with no result. The choice made was to administer anti-CD 20 monoclonal antibody (rituximab), 375 mg/m², per week, during four consecutive weeks. One could observe fast recovery from the purpura, as well as total remission of urticaria.