ABSTRACT
BACKGROUND: Melasma is a chronic dermatosis that impacts the patient's quality of life and can present considerable challenges in terms of effective treatment. OBJECTIVE: To evaluate the effectiveness, tolerability, and safety of 5% cysteamine combined with 4% nicotinamide in female subjects with melasma. METHODS: This single-center, single-arm, prospective, open-label study evaluated patients with melasma using a combination cream of 5% cysteamine and 4% nicotinamide in a progressive regimen (60 min in the first month, 120 min in the second month, and 180 min in the third month). RESULTS: Overall, 35 treated subjects exhibited reduced modified Melasma Area and Severity Index (mMASI) (p < 0.001) and decreased MelasQoL scores (p < 0.001), accompanied by improved brightness, luminosity, homogeneity, and spot intensity (p < 0.001). Photographic and colorimetric analysis revealed smaller spots and improved homogeneity. LIMITATIONS: Adherence to progressive daily treatment could not be evaluated long-term. CONCLUSION: A combination cream comprising 5% cysteamine and 4% nicotinamide was effective, tolerable, and safe for treating melasma.
Subject(s)
Cysteamine , Drug Combinations , Melanosis , Niacinamide , Severity of Illness Index , Adult , Female , Humans , Middle Aged , Young Adult , Administration, Cutaneous , Cysteamine/administration & dosage , Cysteamine/adverse effects , Melanosis/drug therapy , Melanosis/diagnosis , Niacinamide/administration & dosage , Niacinamide/adverse effects , Prospective Studies , Quality of Life , Skin Cream/administration & dosage , Skin Cream/adverse effects , Treatment OutcomeABSTRACT
BACKGROUND: Excessive androgenesis in the skin promotes sebaceous hyperproduction which is the onset of acne vulgaris pathogenesis. Free fatty acids and lipid accumulation in the glandular infundibulum culminates in microbiota imbalance, triggering inflammatory response and follicular hyperkeratinization. AIMS: The purpose of this work was to present an alternative cosmetic treatment for acne skin care, focusing on the prevention of sebaceous gland dysregulation. METHODS: Insulin-stimulated human sebocytes were treated with noncytotoxic concentrations of a DTRW cosmetic formulation. After 6 days of incubation, cell lysates were collected for testosterone, 5α-reductase, and dyhidrotestosterone (DHT) quantitation. In parallel, cells were stained with Oil Red O to measure sebum production. RESULTS: Human sebocytes were incubated with insulin to mimic a seborrheic microenvironment with overproduction of intracellular lipids and fatty acids. Concomitant incubation of cell cultures with DRTW was able to promote a 52.97% reduction in intracellular lipid content. The anti-androgenic properties of DRTW had been proved by the reductions of testosterone (↓59.90%), 5α reductase (↓59.34%), and DHT (↓55.98%) levels in sebocyte cultures also stimulated with insulin. CONCLUSION: The results indicate a promising action of DRTW cosmetic formulation in preventing the development of acne lesions by mechanisms involving the modulation of cutaneous androgenesis and consequently the control of sebum overproduction, considered one of the leading causes of acne.
Subject(s)
Acne Vulgaris , Sebum , Acne Vulgaris/drug therapy , Androgens , Humans , Sebaceous Glands , SkinABSTRACT
Este estudo demonstrou o resultado clínico e histológico do tratamento com laser fracionado não ablativo de paciente com poroqueratose actínica superficial disseminada. A paciente recebeu sete sessões de laser 1340-nm Nd:YAP, com intervalos de quatro a cinco semanas. Biópsias e fotos foram realizadas antes e após o tratamento, o qual foi bem tolerado e trouxe melhora do eritema e da textura das lesões. O seguimento foi de um ano. O exame anatomopatológico após o tratamento revelou pouca modificação da lamela cornoide.
This study demonstrated the clinical and histologic result of the treatment of one disseminated superficial actinic porokeratosis patient with non-ablative fractional laser. The patient was treated with seven sessions of 1340-nm Nd:YAP laser, with 4 or 5 week-intervals. Biopsies and photographs were performed before and after treatment, which was well tolerated and lead to improvement in the erythema and texture of the lesions. There was a 1-year follow-up. Histopathologic examination after treatment revealed little changes in the cornoid lamella.
Subject(s)
Therapeutics , PorokeratosisSubject(s)
Laser Therapy/methods , Lasers, Gas/therapeutic use , Striae Distensae/surgery , Abdomen/surgery , Collagen/radiation effects , Collagen/ultrastructure , Elastic Tissue/radiation effects , Elastic Tissue/ultrastructure , Female , Humans , Patient Satisfaction , Pregnancy , Pregnancy Complications/surgery , Prospective StudiesABSTRACT
Striae distensae are atrophic dermal scars associated with psychosocial stress. Several treatments have been used but there is no gold standard until now. Fractional photothermolysis has been described as a successful and safe method to treat scars. In this description, we report 4 patients (Fitzpatrick phototype IV) who developed striae distensae after long-term use of topical corticosteroids and were successfully treated with fractional nonablative 1540 nm Erbium: glass laser.
Subject(s)
Lasers, Solid-State/therapeutic use , Low-Level Light Therapy/methods , Striae Distensae/radiotherapy , Administration, Cutaneous , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/adverse effects , Cosmetic Techniques/instrumentation , Humans , Low-Level Light Therapy/instrumentation , Striae Distensae/etiologyABSTRACT
A estria atrófica cutânea ou striae distensae (SD) é dermatose muito comum, constituindo causa frequente de consulta ao dermatologista. Devido a seu caráter inestético, pode trazer importantes consequências psicossociais e na qualidade de vida. O objetivo do trabalho foi revisar as possibilidades de tratamento preconizadas na literatura para estrias recentes e antigas. Diante da multiplicidade de fatores etiológicos envolvidos, a literatura é divergente e ampla sobre o tratamento.
Cutaneous atrophic striae (or striae distensae) is a very common skin condition that frequently motivates dermatological consultations. Due to its unaesthetic appearance, it can have a significant impact on patients' psychosocial status and quality of life. This study reviews the literature involving possible treatments for more recent and older cutaneous striae or stretch marks. Given the great number of etiological factors involved, the literature is abundant and divergent regarding the treatment of the condition.
ABSTRACT
A fototermólise fracionada foi desenvolvida como alternativa aos lasers ablativos, efetivos e com alto risco de complicações, e aos lasers não ablativos, de eficácia limitada. Tem sido utilizada com bons resultados em diversas condições dermatológicas. Relata-se o caso de paciente com cicatriz atrófica secundária a trauma, localizada na região paranasal esquerda, que foi tratado com laser fracionado não ablativo Erbium Glass de 1550nm e evoluiu com melhora importante da lesão.
Fractional photothermolysis was developed as an alternative to ablative lasers (which are effective but pose a high risk of complications) and non-ablative lasers (which have limited effectiveness). Fractional photothermolysis has been successfully used in diverse dermatological conditions. This study describes the case of an Asian male patient with atrophic scarring secondary to trauma in the left paranasal region, who underwent treatment with 1,550 nm non-ablative fractional Erbium Glass laser, which led to a significant improvement in the lesion. This case corroborates the use of less-invasive procedures in difficult-to-treat dermatoses and in treating Asian skin types safely and effectively.
ABSTRACT
Nos últimos anos, o uso de preenchedores para tratamento de rítides e aumento do volume facial cresceu consideravelmente. Há atualmente diferentes tipos de preenchedores, divididos em temporários, semipermanentes (permanência de no mínimo 18 meses no tecido) e permanentes, também classificados conforme a composição do material (colágeno, ácido hialurônico, ácido polilático, polimetilmetacrilato, hidroxiapatita); o ácido hialurônico pode ser sintético ou de origem animal. Dos diversos produtos, o ácido hialurônico (preenchedor reabsorvível, temporário) tem sido um dos mais utilizados. Ainda não há disponível no mercado substância ideal, pura e livre de efeitos colaterais. O objetivo do trabalho é auxiliar o reconhecimento dos efeitos colaterais com uso de preenchedor à base de ácido hialurônico. Isso permite diagnóstico e tratamento precoces, diminuindo a morbidade e sequelas dos pacientes.
The use of fillers for treatment of rhytids and facial volume enlargement has grown considerably in recent years. The various filler types used currently can be classified into temporary, semi-permanent (permanence of at least 18 months in the tissue) and permanent. Fillers can also be classified according to their composition (collagen, hyaluronic acid, polylactic acid, polymethylmethacrylate, hydroxyapatite). Moreover, the hyaluronic acid may be of synthetic or animal origin. Hyaluronic acid (temporary resorbable filler) has been one of the most frequently used substances. There is no ideal, pure and commercially available substance that is free of side effects. This study evaluates the side effects of using hyaluronic acid-based fillers in order to enable early diagnosis and treatment, and reduce morbidity and sequelae among patients.
