Elisangela Samartin Pegas Pereira

Assessment of clinical effects and safety of an oral supplement based on marine protein, vitamin C, grape seed extract, zinc, and tomato extract in the improvement of visible signs of skin aging in men

Background Skin aging is a natural process that may be aggravated by environmental factors. Topical products are the conventional means to combat aging; however, the use of oral supplements is on the rise to assist in the management of aged skin. Objective The purpose of this study was to assess the effects and safety of an oral supplement containing (per tablet) marine protein (105 mg), vitamin C (27 mg), grape seed extract (13.75 mg), zinc (2 mg), and tomato extract (14.38 mg) in the improvement of skin aging in men. Methods This single-center, open-label, quasi-experimental clinical study enrolled 47 male subjects, aged 30–45 years, with phototypes I–IV on the Fitzpatrick scale. Subjects received two tablets of the oral supplement for 180 consecutive days. Each subject served as their own control. Clinical assessments were made by medical personnel and by the subjects, respectively. Objective assessments were carried out through pH measurements, sebumetry, corneometry, ultrasound scanning, skin biopsies, and photographic images. Results Forty-one subjects (87%) completed the study. Clinical improvements on both investigator- and subject-rated outcomes were found for the following parameters: erythema, hydration, radiance, and overall appearance (P<0.05). The objective measurements in the facial skin showed significant improvements from baseline in skin hydration (P<0.05), dermal ultrasound density (P<0.001), and reduction of skin pH (P<0.05). No statistical improvement in relation to sebum was found. The photographic assessment showed an improvement in the overall appearance. The results of the objective measurements were found to be correlated with the subjects’ satisfaction by an increase of collagen and elastic fibers. Conclusion The use of an oral supplement based on a unique biomarine complex, vitamin C, grape seed extract, zinc, and tomato extract produced improvements in the signs of skin aging in men.

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).

Stewart Treves Syndrome

Stewart-Treves Syndrome is characterized by the presence of lymphangiosarcoma on limb extremities. Rare, it occurs in 0.5% of patients who have undergone radical mastectomy with axillary node dissection. The main cause is chronic lymphedema with endothelial and lymphatic differentiation, with no direct relationship to breast cancer. Seven years after a radical right-side mastectomy with lymph node dissection and adjuvant therapy, the patient developed a lesion on her right arm. The dermatological examination revealed an erythematous nodule with bleeding surface on chronic right forearm lymphedema. After the biopsy, a lymphangiosarcoma on chronic lymphedema was diagnosed. Infrequent, this syndrome is relevant because of its associated mortality. Early diagnosis is important to improve survival and reduce complications.

Six-Month Comparative Analysis Monitoring the Progression of the Largest Diameter of the Sweating Inhibition Halo of Different Botulinum Toxins Type-A

Background Excessive sweating is a clinical condition that can be improved with type-A botulinum toxin (BTX-A). Objectives To evaluate and compare the largest diameter of sweating inhibition halo (SIH) of 5 different commercially available BTX-A, in five different doses, in a 6-month-long clinical evaluation. Methods Twenty-five adult female volunteers were injected in the dorsal trunk area with both 100 units (100UI) and 500 units (500UI) BTX-A products, reconstituted in a ratio of 1:2.5, respectively. Products were applied in five different concentrations (1:2.5U, 2:5U, 3:7.5U, 4:10U, and 5:12.5U). After 30, 60, 90, 120, 150, and 180 days, a starch-iodine test was performed to obtain the largest diameter of each SIH. Results The higher the number of units used, the larger the SIH p<0.05 for all BTX-A. However, Botox®, Botulift®, Dysport®, and Prosigne® have pretty likewise SIH along the study, with some few differences for some doses and months between one and another. However, Xeomin® is the BTX-A with the smallest SIH, in comparison with all others, in any dose and period. Conclusions Differences were observed among all brands of BTX-As, based on dose and time after injection. Xeomin® provides the smallest SIH in comparison with others BTX-A.

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.

Evaluation of Clinical Safety and Effectiveness of Hyaluronic Acid-based Temporary Dermal Filler Used in Nasolabial Folds

Basis: Hyaluronic acid-based temporary dermal filler are used in the treatment of facial folds and wrinkles. Objectives: Evaluate the effectiveness and safety of Rennova®, a hyaluronic acid-based filler used in nasolabial folds. Methods: An open label, single-center, phase IV, prospective, observational clinical study, with duration of 360 days, totaling 11 visits. The study included 30 female volunteers, between 30 and 60 years of age, presenting nasolabial folds classified as 3 and 4 according to the Wrinkle Severity Rating Scale and skin phototypes I to V, according to the classification of Fitzpatrick. The effectiveness was subjectively evaluated using the wrinkle severity scale and the Global Aesthetic Improvement Scale and objectively analyzed suing photographs and biopsies. The volunteers gave their opinions about the procedure and results in a questionnaire. The safety was evaluated by observing adverse events; pain, discomfort and local sensitivity; tolerability and biopsies. Results: In the beginning of the study, 76% of the volunteers presented moderate wrinkles and 24% severity. At the end, 8% presented severe, 56% moderate and 36% mild wrinkles. The adverse events with positive causal nexus were: local erythema/edema, ecchymosis, hematoma and local pain. They presented mild to moderate intensity, short to medium duration. Conclusions: In relation to the wrinkle severity rating scale and global aesthetic improvement scale, the results were satisfactory (p<0.05). The adverse events with positive causal nexus were temporary and the biopsy did not show any inflammatory process, which demonstrates the product safety.