Adilson Costa

Molecular basis of photoaging

As a result of the increase in life expectancy, the study of the organic process of aging has been stimulated. Skin ageing, which reflects the signs of time, is a time-dependent process of progressive deterioration that can be intensified by sun exposure, which is known as photoaging. The damage of radiation on various cell structures and on the skin results in molecular and morphological changes to these components. Many research studies are performed to try to minimize the effects of photoaging; however, the main strategy to manage it is still prevention, which will only be achieved once we learn about the mechanisms involved in the process.

Acne and diet: truth or myth?

Numerous studies were published over the last 50 years to investigate whether diet is associated with the etiology of acne. Although older studies well known by dermatologists that refute the association between acne and diet exist, their scientific foundation is weak. New articles have recently brought to light evidence contrary to previous findings. Therefore, we would like to investigate whether diet, directly or indirectly, influences one or more of the four fundamental etiopathogenic pillars of acne: (1) hyperproliferation of basal keratinocytes, (2) increase of sebaceous production, (3) colonization by Propionibacterium acnes, and (4) inflammation.

Clinical, biometric and ultrasound assessment of the effects of daily use of a nutraceutical composed of lycopene, acerola extract, grape seed extract and Biomarine Complex in photoaged human skin

BACKGROUNDnThe use of nutraceuticals has become frequent in the cutaneous approach to photoaging.nnnOBJECTIVESnTo assess the clinical efficacy of a nutraceutical product composed of lycopene, acerola extract, grape seed extract and Biomarine ComplexT in photoaged human skin.nnnMETHODSn50 women, from 35 to 60 years of age, phototypes I to III, were assessed. For 120 days, they associated the nutraceutical product with the use of a sunscreen FPS15. On days 0 (D0), 30 (D30), 60 (D60), 90 (D90) and 120 (D120) they were evaluated and underwent Medical Assessments and Self-Assessment and cutaneous biometric analyses (corneometry, sebumetry and pH-metry) in the skin of the left zygomatic region and the upper medial side region of the left arm; on days 0 (D0), 30 (D30) and 120 (D120) the skin of the same regions was analyzed by ultrasound. On days 0 (D0) and 120 (D120) skin biopsies were performed in the areas where instrumental evaluation was performed (to evaluate collagen and elastic fibers).nnnRESULTSnThere was an improvement of the general status of the skin of all volunteers by the Medical and Volunteer Self- Assessments; increased parameters of cutaneous hydration, reduction of pH, increasing of ultrasound density and a histological increment of collagen and elastic fibers (both on the face and arm); there was a reduction of seborrhea (only on the face)nnnCONCLUSIONSnThe daily use of a nutraceutical product containing lycopene, acerola extract, grape seed extract and Biomarine ComplexT showed an important adjuvant effect to counteract skin photoaging.

Mycobacterium chelonae cutaneous infection in a patient with mixed connective tissue disease

Around 50 mycobacteria species cause human disease. Immunosuppressive states predispose to non-tuberculous mycobaterium infection, such as Mycobacterium chelonae: AFB, non-tuberculous, fast growth of low virulence and uncommon as a human pathogen. It may compromise the skin and soft tissues, lungs, lymph nodes and there is also a disseminated presentation. The diagnosis involves AFB identification and culture on Agar and Lowenstein-Jensen medium base. A 41-year-old female with MCTD (LES predominance) is reported, presenting painless nodules in the right forearm. She denied local trauma. Immunosuppressed with prednisone and cyclophosphamide for 24 months. Lesion biopsy has demonstrated positive bacilloscopy (Ziehl-Neelsen stain) and M.chelonae in culture (Lowenstein-Jensen medium base), therefore clarithromycin treatment has been started (best therapy choice in the literature).

Multicenter study for efficacy and safety evaluation of a fixeddose combination gel with adapalen 0.1% and benzoyl peroxide 2.5% (Epiduo® for the treatment of acne vulgaris in Brazilian population

BACKGROUND The current options for the treatment of acne vulgaris present many mechanisms of action. For several times, dermatologists try topical agents combinations, looking for better results. OBJECTIVES To evaluate the efficacy, tolerability and safety of a topical, fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel for the treatment of acne vulgaris in the Brazilian population. METHODS This is a multicenter, open-label and interventionist study. Patients applied 1.0 g of the fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel on the face, once daily at bedtime, during 12 weeks. Lesions were counted in all of the appointments, and the degree of acne severity, overall improvement, tolerability and safety were evaluated in each visit. RESULTS From 79 recruited patients, 73 concluded the study. There was significant, fast and progressive reduction of non-inflammatory, inflammatory and total number of lesions. At the end of the study, 75.3% of patients had a reduction of >50% in non-inflammatory lesions, 69.9% in inflammatory lesions and 78.1% in total number of lesions. Of the 73 patients, 71.2% had good to excellent response and 87.6% had satisfactory to good response. In the first week of treatment, erythema, burning, scaling and dryness of the skin were frequent complaints, but, from second week on, these signals and symptoms have reduced. CONCLUSION The fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel is effective, safe, well tolerated and apparently improves patient compliance with the treatment.

Ultraviolet A photosensitivity profile of dexchlorpheniramine maleate and promethazine‐based creams: Anti‐inflammatory, antihistaminic, and skin barrier protection properties

Unwanted side effects such as dryness, hypersensitivity, and cutaneous photosensitivity are challenge for adherence and therapeutical success for patients using treatments for inflammatory and allergic skin response.

Cosmetic Procedures in Menopause

The skin of a menopausal woman is likely to undergo structural changes; these changes are the reasons why patients in menopause are responsible for much of the demand for cosmetic procedures. The use of botulinum toxin, fillers, chemical peels and laser can help these patients face this period and improve their appearance. Some of these procedures have been used since the past centuries, and others are new technologies for the treatment of the aging skin. The cosmetic approach to menopausal patients should be global, considering all specific anatomic aspects of skin aging during menopause. During treatment, the patient should be made aware of the results that may be actually achieved, as well as any possible complications arising from the relevant procedure.

Menopause and Cosmeceuticals

Skin aging is due to extrinsic and intrinsic factors that converge, leading to macro- and microscopic alterations. Histologically, there are a loss of dermal collagen and decreased lipid production, leading to a thinning of the skin. This process is enhanced by the effect of cumulative sun exposure and oxidative damage caused by pollution, stress, and smoking. These changes manifest as wrinkles, loss of elasticity, dryness, and texture changes in mature skin.

Skin and Menopause

Skin aging is attributed to extrinsic and intrinsic factors which intersect, leading to macro- and microscopic alterations. Histologically, there is a loss of dermal collagen and decreased lipid production, leading to a thinning of the skin. This process is exacerbated by the effect of cumulative sun exposure and oxidative damage caused by pollution, stress, and smoking. These changes manifest as wrinkles, loss of elasticity, dryness, and texture changes in mature skin.

Changes in Nails Caused by Aging

Nail aging is a natural process. It causes changes in their characteristics and physiology, making them susceptible to disorders that are more common in individuals over the age of 50.