Carlos Roberto Antonio

Nanotechnology in Dermatology

The scientific community and general public have been exposed to a series of achievements attributed to a new area of knowledge: Nanotechnology. Both abroad and in Brazil, funding agencies have launched programs aimed at encouraging this type of research. Indeed, for many who come into contact with this subject it will be clear the key role that chemical knowledge will play in the evolution of this subject. And even more, will see that it is a science in which the basic structure is formed by distilling different areas of inter-and multidisciplinary knowledge along the lines of new paradigms. In this article, we attempt to clarify the foundations of nanotechnology, and demonstrate their contribution to new advances in dermatology as well as medicine in general. Nanotechnology is clearly the future.

The association of fractional CO2 laser 10.600nm and photodynamic therapy in the treatment of onychomycosis

BACKGROUND Onychomycosis is a fungal infection of the nails caused in most cases by dermatophytes Trichophyton rubrum and Trichophyton mentagrophytes. Despite numerous available antifungal drugs for therapy of this infection, the cure rate is low, with high rates of relapse after treatment and side effects. OBJECTIVES To present a new option for the treatment of onychomycosis, in search of a more effective and rapid method than conventional ones. METHODS Patients underwent two sessions of CO2 fractional laser 10.600nm associated with photodynamic therapy. Mycological and digital photography were performed before and after the treatment. RESULTS McNemar test with continuity correction and degrees of freedom = 1: for clinical cure rate, 13.06, with p=0.00005; for mycological cure, 17.05, with p=0.00005; 72% felt fully satisfied with the procedure. CONCLUSIONS The use of fractional CO2 laser 10.600nm associated with photodynamic therapy can be effective in the treatment of onychomycosis, decreasing the risk of systemic lesions that may be triggered with prolonged use of oral antifungals.

Epidemiological study of 740 areas treated with cryolipolysis for localized fat

Introduction: A non-invasive alternative for the treatment of localized fat is cryolipolysis that, by freezing adipocytes, reduces fat volume in the region where the procedure was performed. Objective: To statistically describe the experience of a referral center for this procedure. Methods: A cross-sectional study with 251 patients undergoing cryolipolysis was carried out with the epidemiological analysis of patient data. Results: Thirty-eight males and 213 females underwent the procedure, with a total number of 740 treated areas. The anterior abdomen (lower third) was the most popular region, with 45.30% of cases. Eighty-eight percent were satisfied or very satisfied with the result. Nearly all cases required 2 or more sessions to achieve this degree of satisfaction. Conclusions: Cryolipolysis is a noninvasive method for the selective reduction of fat that has shown efficacy in reducing the subcutaneous tissue, with minimal and reversible side effects in this study

Malignant Acanthosis nigricans associated with early diagnosis of liver cancer

Dear editor, Acanthosis nigricans is a skin condition characterized by symmetrical hyperpigmented, velvety, papillomatous plaques that tend to affect flexural and intertriginous areas, although it can affect any part of the body. The diagnosis of acanthosis nigricans is based on the clinical aspect of the lesions and can be classified into benign or malignant. The former is the most common and is usually associated to endocrinological disorders (type 2 diabetes, acromegaly, Cushing syndrome, hypothyroidism and insulin resistance), as well as congenital abnormalities or drugs.1 The malignant form is associated to internal neoplasms.2 Malignant acanthosis nigricans was first described in 1890 by Pollitzer, who noted an association with a gastrointestinal tumor.3 It is characterized as a paraneoplastic skin condition of intra-abdominal malignancies and, contrary to benign acanthosis nigricans, it has a sudden onset, rapid course and extensive skin involvement. Its etiology is associated to tumor-produced substances that stimulate keratinocytes, melanocytes and fibroblasts, being transforming growth factor (TGF-α) the main substance involved because it acts in the epidermis through the epidermal growth factor receptor (EGF-1).4 Even though the neoplasm most frequently associated to acanthosis nigricans is gastric adenocarcinoma (56-61%), associations with ovarian, endometrium, cervix, breast, testicle, lung, kidney, pancreatic, liver, esophagus, prostate, thyroid, pharynx carcinoma, among other, were already described.5 The malignancy can be identified before, during or after the onset of skin lesions.5 In most cases, they occur concomitantly (61.3%), however, in 17.6% of cases, the lesions occur before the malignancy and in 21% of cases, after the tumor is identified.4 We report the case of a patient with malignant acanthosis nigricans that preceded the diagnosis of the neoplasm, contributing to the early diagnosis of the tumor. Female 53-year-old patient presented with the complaint of a 5-month history of progressive brown, isolated lesions on her skin located on the axillae, between her breasts, back, buttocks and internal aspect of the thighs. The patient also complained of malaise for 1 month.

Androgenetic alopecia treatment: associating 1550nm erbium-glass laser with drug injections of active principles

Introduction: Introduction: Androgenetic alopecia is the most common type of hair loss in men and women. Nowadays, medication based treatments are the most frequently used nevertheless they yield poor results. More recently, the use of lasers has been proposed to treat this condition. At the same time, the infiltration of medications in the scalp has also been growing as a therapeutic option, although there are few scientific studies on this treatment modality. Objective: To evaluate the results of using 1,550nm Erbium-Glass laser associated with the injection of active principles (minoxidil, finasteride, growth factors and a vitamin complex) for the treatment of male and female androgenetic alopecia. Methods: A retrospective study was carried out with patients with androgenetic alopecia diagnosis, who underwent monthly sessions of the proposed combination therapy. The results were evaluated by means of comparative photographs taken before and after the treatment period and the assessment of the patients’ opinion. Results: Sixty-two patients were treated with 3 to 14 sessions; 48.39% of patients had mild improvement, and 46.77% had significant improvement. The vast majority (96.77%) was satisfied with the treatment. The patients who were very satisfied with the outcomes underwent a greater number of sessions (more than six, on average). Conclusions: The association of 1,550nm Erbium-Glass laser therapy with the injection of active principles in the scalp is an effective and safe option for the treatment of androgenetic alopecia.