A Retrospective Analysis of Safety in Participants Treated with a Hybrid Hyaluronic Acid and Calcium Hydroxyapatite Filler.

Background: Limited long-term safety data are published on HA/CaHA/L, a hybrid dermal filler combining hyaluronic acid (HA), calcium hydroxyapatite (CaHA), and lidocaine (L). Methods: This retrospective multicenter study assessed treatment-emergent adverse events (TEAEs) in adults treated with HA/CaHA/L. The full analysis set (FAS) included eligible consented adults (N = 403); the long-term safety analysis (LTSA) set included FAS participants with greater than or equal to 12-months HA/CaHA/L exposure (n = 243). Results: Participants were majority female (94.0%), with Fitzpatrick skin phototypes II/III (80.1%) and a mean age of 50.1 years. Most participants (86.4%) received one HA/CaHA/L treatment. The median time between participants' first HA/CaHA/L treatment and chart review was 15.4 months. Participants received a mean of 2.2 mL (0.5-8.9 mL) filler per treatment. Treated areas were predominantly malar (71.2%) and mandible (69.7%) regions. Most participants (95.0%) had one or more aesthetic treatments other than HA/CaHA/L [eg, other dermal fillers (84.1%), botulinum toxin (63.3%)]. Nineteen (4.7%) FAS participants had 20 documented TEAEs; most (3.5%, n = 14 participants) were mild in severity. Twelve TEAEs in 11 participants (2.7%) were related to HA/CaHA/L: induration (three, 0.7%), edema (3, 0.7%), and implant site nodules (five, 1.2%), which were noninflammatory and likely related to product placement. Among the LTSA, 15 (6.2%) participants had 16 documented TEAEs (six edema, five implant site nodules, one inflammation, three skin induration, one hypersensitivity); most were mild in severity. Nine TEAEs in eight participants (3.3%) were HA/CaHA/L-related. No treatment-emergent serious AEs were reported. Conclusion: The data from this noninterventional retrospective study support the favorable longer term (>12 month) safety profile of HA/CaHA/L.

Skin Remodeling Using Hyaluronic Acid Filler Injections in Photo-Aged Faces.

BACKGROUND: Hyaluronic acid (HA) filler is an important dermatological procedure. Although many studies have reported clinical improvement with this procedure, histology with morphometric evidence is not well documented. OBJECTIVE: To evaluate the clinical and histological results of a HA filler injection and to quantify dermis remodeling at 3 and 9 months after HA injections into aged faces. MATERIALS AND METHODS: Twenty patients were enrolled in this study. Hyaluronic acid filler was injected into the nasolabial folds and preauricular regions of the patients. Skin biopsies of the preauricular regions were performed before the procedure and at 3 and 9 months after the procedure. RESULTS: Sixteen women (aged 40-50 years) completed the clinical study and demonstrated improvement for 12 months. Twenty patients completed the histologic studies. Morphologic evaluation showed increases in the epidermal layers. The morphometric study showed a statistically significant increase in collagen fibers at 3 and 9 months after the procedure (34.2% ± 31.5% and 39.5% ± 39.7%, respectively, p < .05). CONCLUSION: Sustained clinical results for HA filler can be explained not only by the presence of HA gel on the dermis but also by the dermal remodeling induced by HA filler injected into the face.

Carcinoma epidermoide do pênis: estudo clínico-patológico de 34 casos / Squamous cell carcinoma of the penis: clinicopathologic study of 34 cases

FUNDAMENTOS: No Brasil, a incidência do câncer do pênis é de 8,3 casos/100.000 habitantes, contrastando com 0,7 na Europa e nos Estados Unidos. Em 95 por cento dos casos, trata-se do carcinoma epidermoide. Em geral, é diagnosticado tardiamente. OBJETIVOS: Descrever as características clínico-patológicas do carcinoma epidermoide do pênis, registradas no Hospital entre 1978 e 2004. MÉTODOS: Estudo observacional transversal. Incluíram-se os casos de carcinoma epidermoide do pênis, confirmados histologicamente. Avaliaram-se, pessoalmente, os pacientes que atenderam à convocação para o estudo, enquanto os demais tiveram seus dados pesquisados nos prontuários médicos. RESULTADOS: Registraram-se 34 pacientes com carcinoma epidermoide do pênis: 8 in situ e 26 invasivos, com idade média de 54,7 12,5 anos, respectivamente. A± 22,4 e 64,7 ±, (este trecho ficou truncado e não consegui entendê-lo. Será que o autor poderia revisá-lo?!) A glande foi acometida em 91,1 por cento dos casos e o prepúcio, em 41,1 por cento. Os carcinomas epidermoides in situ exibiam pápulas ou eritema e erosão, geralmente menores do que 2 cm. Os invasivos mostravam úlceras e/ou vegetações, geralmente únicas, e maiores do que 2 cm. Dos CE invasivos, 80,8 por cento eram bem diferenciados; metade encontrava-se no estágio I TNM e o restante, do II ao IV; 16 pacientes tiveram o pênis amputado e 3 faleceram. CONCLUSÕES: O câncer do pênis é raro, acomete adultos de todas as faixas etárias e o tratamento pode ser agressivo. O aspecto clínico inespecífico das lesões iniciais, o insuficiente treinamento médico em lesões dermatológicas e a carência de rotinas de investigação diagnóstica, tratamento e acompanhamento destes casos contribuem para o mau prognóstico desta neoplasia.

BACKGROUND: In Brazil, the incidence of penile cancer is 8.3 cases per 100,000 population, in contrast to 0.7 in Europe and the United States. 95 percent of these cases correspond to squamous cell carcinoma (SCC). It is usually diagnosed late. OBJECTIVES: To describe the clinicopathologic features of squamous cell carcinoma of the penis registered at the Hospital between 1978 and 2004. METHODS: A cross-sectional observational study. We included cases of squamous cell carcinoma of the penis that were histologically confirmed. Those patients who responded to the study call were evaluated in person, while others had their data researched in medical records. RESULTS: 34 patients with squamous cell carcinoma of the penis were registered: 8 in situ and 26 invasive, with a mean age of 54.7 ± 22.4 and 64,7 ± 12.5 years, respectively. Glans cancer was involved in 91.1 percent of the cases and the foreskin in 41.1 percent. SCC in situ exhibited papules or erythema and erosion, usually smaller than 2 cm. Invasive SCC was characterized by ulcers and/or vegetation, usually single and bigger than 2 cm. Of the invasive cases, 80.8 percent were well differentiated; half was in the TNM stage I and the remaining in stages II to IV. 16 patients had their penis amputated, and 3 died. CONCLUSIONS: Cancer of the penis is rare and affects adults of all ages and treatment can be aggressive. The nonspecific clinical appearance of early lesions, insufficient medical training in skin lesions and lack of routine diagnostic investigation, treatment and follow up of these cases contribute to the poor prognosis of this neoplasm.

Avaliação da eficácia do licopeno, beta- caroteno e Lactobacillus johnsonii no tratamento de manutenção do melasma durante o verão: um estudo comparativo / Efficacy evaluation of lycopene, beta-carotene and lactobacillus johnsonii in the maintenance treatment of melasma during the summer: a compartive study

Introdução: O melasma, hipermelanose adquirida bastante freqüente, pode ser tratado com medicamentos tópicos, porem, alguns estudos têm demonstrado que os antioxidantes orais poderiam diminuir os efeitos deletérios da radiação ultravioleta sobre a pele. Objetivo: Avaliar o resultado da evolução do melasma com o emprego de antioxidantes orais e fotoprotetor anti-UVA/ UVB durante os meses do verão no Rio de Janeiro, época em que a doença recidiva com mais freqüência. Métodos: Foi realizado um estudo com 68 pacientes com melasma que concordaram em substituir o tratamento anterior pelo proposto. Foram divididas em 2 grupos aleatoriamente: o grupo A fez uso de 1 cápsula/ dia do nutriconcentrado, além do fotoprotetor 3/ 3 horas; o grupo B fez uso apenas do fotoprotetor. Foram fotografadas e avaliadas com base da Escala de Hiperpigmentação de Taylor e no MASI, e os dados submetidos à análise estatística. Resultados: O estudo teve início em dezembro/ 2010 e término em março/ 2011. O grupo A apresentou redução de 8,5% do melasma pela escala de Taylor e de 19,5% pelo MASI (p<0,001). No grupo B, houve piora do melasma em relação à Escala de Taylor e melhora de 4,6% pelo MASI. Conclusões: O uso de um nutriconcentrado contendo beta-caroteno, licopeno e Lactobacillus johsonii associado à FPS 60 foi eficaz como tratamento do melasma durante o verão, com significância estatística em relação à redução do Índice de Gravidade e Área do Melasma.

Introduction: Melasma, a very frequent acquired hypermelanosis can be treated topically, however some studies have shown that oral antioxidants could reduce the deleterious effects of ultraviolet radiation on the skin. Objective: To evaluate the effects of oral antioxidants and UVA/UVB sunscreen on the development of melasma during the summer months in Rio de Janeiro (RJ), Brazil ? a period when the condition recurs more frequently. Methods: Patients (n = 68) with melasma were randomized to receive one capsule/day of the nutri-concentrate (containing lycopene, beta-carotene and Lactobacillus johnsonii) and apply sunscreen every 3 hours (Group A) or sunscreen only (Group B). The patients were photographed and evaluated according to the Taylor Hyperpigmentation Scale and the Melasma Area Severity Index. Results: The study was conducted from December 2010 to March 2011. Group A presented reductions in melasma of 8.5% on the Taylor scale and 19.5% on the Melasma Area Severity Index (p < 0.001). In Group B, the melasma worsened on the Taylor scale and improved 4.6% on the Index. Conclusions: The use of a nutri-concentrate containing beta-carotene, lycopene and Lactobacillus johsonii combined with an SPF 60 sunscreen was an effective treatment for melasma during the summer. The treatment had a statistically significant reduction according to the Melasma Area Severity Index.

Squamous cell carcinoma of the penis: clinicopathologic study of 34 cases.

BACKGROUND: In Brazil, the incidence of penile cancer is 8.3 cases per 100,000 population, in contrast to 0.7 in Europe and the United States. 95% of these cases correspond to squamous cell carcinoma (SCC). It is usually diagnosed late. OBJECTIVES: To describe the clinicopathologic features of squamous cell carcinoma of the penis registered at the Hospital between 1978 and 2004. METHODS: A cross-sectional observational study. We included cases of squamous cell carcinoma of the penis that were histologically confirmed. Those patients who responded to the study call were evaluated in person, while others had their data researched in medical records. RESULTS: 34 patients with squamous cell carcinoma of the penis were registered: 8 in situ and 26 invasive, with a mean age of 54.7 ± 22.4 and 64,7 ± 12.5 years, respectively. Glans cancer was involved in 91.1% of the cases and the foreskin in 41.1%. SCC in situ exhibited papules or erythema and erosion, usually smaller than 2 cm. Invasive SCC was characterized by ulcers and/or vegetation, usually single and bigger than 2 cm. Of the invasive cases, 80.8% were well differentiated; half was in the TNM stage I and the remaining in stages II to IV. 16 patients had their penis amputated, and 3 died. CONCLUSIONS: Cancer of the penis is rare and affects adults of all ages and treatment can be aggressive. The nonspecific clinical appearance of early lesions, insufficient medical training in skin lesions and lack of routine diagnostic investigation, treatment and follow up of these cases contribute to the poor prognosis of this neoplasm.