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Abstract Objective: To examine whether the DDAH2 promoter polymorphisms -1415G/A (rs2272592), -1151A/C (rs805304) and -449G/C (rs805305), and their haplotypes, are associated with PE compared with normotensive pregnant women, and whether they affect ADMA levels in these groups. Methods: A total of 208 pregnant women were included in the study and classified as early-onset (N=57) or late-onset PE (N =49), and as normotensive pregnant women (N = 102). Results: Pregnant with early-onset PE carrying the GC and GG genotypes for the DDAH2 -449G/C polymorphism had increased ADMA levels (P=0.01). No association of DDAH2 polymorphisms with PE in single-locus analysis was found. However, the G-C-G haplotype was associated with the risk for late-onset PE. Conclusion: It is suggested that DDAH2 polymorphisms could affect ADMA levels in PE, and that DDAH2 haplotypes may affect the risk for PE.

Hormonal changes added to extrinsic exposure factors, including socio-environmental and lifestyle factors, affect the quality of life of climacteric women. Symptoms during the climacteric are variable, and most women are not aware that menopause affects the skin. Among the perceived changes, there is an increase in dryness, roughness, sagging, and atrophied skin. This article reviews the relationship between exposure and menopause, focusing on helping dermatologists to guide patients on preventive care and treatments to improve skin and quality of life in menopause.

Background: The increased demand for cosmetic facial treatments is a universal reality, and Brazil is the second country with the most procedures. Quality of life questionnaires can help assess results objectively and reveal data not yet explored in the scientific literature. Thus, the process of translation, adaptation, and validation of questionnaires is necessary for data universalization. Objective: To translate, adapt and validate a specific questionnaire to assess facial cosmetics procedures in Brazilian Portuguese. Methods: After choosing the Skin Rejuvenation Outcome Evaluation (SROE) questionnaire, the translation process started. A literal translation was performed, with the subsequent synthesis of the versions. Then, a team of experts conducted the reverse translation and final validation. The data obtained were statistically analyzed for validation. Results: The final version was called "Avaliação dos Resultados de Rejuvenescimento da Pele" (ARRP). The Cronbach’s resulted in values above 0.70, showing good internal consistency. The Intraclass Correlation Coefficient was 0.995 (p

Abstract Background: Vitiligo is a muco-cutaneous, autoimmune, localized, or disseminated disease, which manifests through hypochromic or achromic macules, with loss in quality of life. The prevalence of vitiligo in Brazil was determined to be 0.54%. There is no on-label medication for its treatment. To date, no Brazilian consensus on the treatment of vitiligo had been written. Objectives: The objective of this group of Brazilian dermatologists with experience in the treatment of this disease was to reach a consensus on the clinical and surgical treatment of vitiligo, based on articles with the best scientific evidence. Methods: Seven dermatologists were invited, and each was assigned two treatment modalities to review. Each treatment (topical, systemic, and phototherapy) was reviewed by three experts. Two experts reviewed the surgical treatment. Subsequently, the coordinator compiled the different versions and drafted a text about each type of treatment. The new version was returned to all experts, who expressed their opinions and made suggestions for clarity. The final text was written by the coordinator and sent to all participants to prepare the final consensus. Results/Conclusion: The experts defined the following as standard treatments of vitiligo: the use of topical corticosteroids and calcineurin inhibitors for localized and unstable cases; corticosteroid minipulse in progressive generalized vitiligo; narrowband UVB phototherapy for extensive forms of the disease. Surgical modalities should be indicated for segmental and stable generalized vitiligo. Topical and systemic anti-JAK drugs are being tested, with promising results.

Atrophic acne scars are persistent and undesirable sequelae that have a negative cosmetic and psychosocial impact on patients. This issue becomes more delicate when such scars are located in the presternal region due to the risk of hypertrophic scars appearing when performing these procedures in the area. The literature has long recognized the role of insulin in promoting protein and fat synthesis. Insulin properties as a growth factor to treat these sequelae seems logical and has proved cosmetically satisfying, with quality of life improvement.

Introdução: Com frequência, pacientes solicitam avaliação e tratamento para o rejuvenescimento das regiões perioral e periorbitária. Na maioria das vezes, é preciso usar uma combinação de procedimentos para que o resultado atenda às expectativas. Objetivo: Por meio de um estudo prospectivo, unicêntrico e comparativo, comparar o rejuvenescimento das regiões perioral e periorbital, após tratamento com peeling químico médio com fenol 88% com ou sem a aplicação prévia de toxina botulínica. Métodos: O peeling regional de fenol 88% foi utilizado em 16 pacientes; em oito delas houve aplicação de toxina botulínica duas semanas antes. A avaliação foi feita por meio de fotografias padronizadas e escalas de avaliação por médicos e pacientes. Resultados: A avaliação global por médicos e pacientes no 45º dia foi considerada excelente ou boa para todas as pacientes, com pequena vantagem para o tratamento combinado na região periorbital. Conclusão: A combinação desses dois procedimentos de custo relativamente baixo, muitas vezes negligenciado pelos dermatologistas, resultou na melhora significativa das alterações do envelhecimento dessas áreas.

Introduction: Rosacea is a chronic inflammatory skin disease. The intradermal application of botulinum toxin (BT) has been studied as a therapeutic option for patients who struggle to manage flushing and/or persistent facial erythema. There is no standard protocol for BT application in rosacea. Objective: To evaluate the effectiveness of botulinum toxin application on erythematotelan-giectatic rosacea. Methods: Pilot study with case series. We applied intradermal BT in 10 patients with a diagnosis of rosacea and symptoms of persistent erythema and/or facial flushing. Patients received 10 to 15 injections per hemiface (1 unit of onabotulinum BT per injection) and 0 to 5 injections in the nasal region, totaling 25 to 35 units per patient. Results: Seventy-five percent of the patients presented a reduction in flush and erythema intensity. The follow-up time was three months, and no serious adverse events were observed. Conclusions: The therapeutic arsenal to control erythema and facial flushing of rosacea, especially refractory to the usual treatment, should consider the intradermal application of BT type A.

A aplicação de toxina botulínica nos pacientes com sequela de paralisia de Bell é uma terapia auxiliar de extrema valia para a redução da sincinesia e de assimetrias faciais. A paralisia de Bell é a causa mais comum de paralisia do neurônio motor facial. Após a fase de paralisia dos músculos da face, o quadro pode evoluir com assimetria facial e sincinesia. No tratamento da sincinesia, as injeções pontuais no músculo orbicular e platisma aliviam os espasmos. A aplicação seletiva na hemiface não acometida objetiva reduzir a assimetria facial e seu impacto social negativo, com melhora da qualidade de vida.

Background: The extraction of impacted mandibular third molars is a frequent dental surgery, interfering with patients’ quality of life. Ultrasonic surgery is an alternative to osteotomy with conventional rotary instruments. This study compares postoperative signals and symptoms after extracting impacted mandibular third molars using ultrasonic surgery or conventional rotary osteotomy. Methods: A pilot randomized controlled clinical trial was conducted. Thirty patients were randomly divided into the test group (ultrasonic technique) and a control group (conventional rotatory technique). All surgeries were timed. Swelling parameters, trismus and paraesthesia were evaluated on the day of surgery and the third, fifth and seventh postoperative days. Intraoperative bleeding was evaluated during surgery. Postoperative pain was evaluated daily by the patient through a visual analogue scale and the number of ingested analgesics. Results: Pain, swelling and trismus present beneficial results with the ultrasonic technique but without statistical significance. Intraoperative bleeding was significantly lower with ultrasonic surgery (t(28) = 3.258; p = 0.003). Operating time was significantly higher in extractions involving osteotomy and cutting crown and roots either with the conventional technique (p = 0.020) or ultrasonic technique (p = 0.039). Regardless of the surgical difficulty, no statistically significant results were detected between techniques regarding the procedure duration. Conclusions: The beneficial postoperative signs and symptoms make ultrasonic surgery a favourable therapeutic option, especially when the integrity of noble anatomical structures is the most important risk factor. Further studies with larger samples are needed to support the use of piezosurgery as a valid option for impacted mandibular third molar extraction.

Introduction: Brazil has presented alarming and growing data on infection and deaths from SARS-CoV-2. There are more than 4 500 000 confirmed cases and more than 137 000 deaths ranking second in the world ranking of infected people. In addition to the involvement of the respiratory, cardiovascular, renal and neurological systems, this virus also causes non-specific skin lesions in same patients. Little is known about the pathophysiology of cutaneous involvement. At this moment, we cannot predict a difference in prognosis based on skin lesions. Methods: We conducted an observational case study of 25 patients affected by SARS-CoV-2 who had dermatological lesions. We described the clinical and epidemiological characteristics of each case, demonstrating the polymorphism of the skin lesions and also making a correlation with the chronology of presented systemic symptoms. Results: Twenty five cases of COVID-19 with cutaneous manifestations (urticaria, erythematous rash, maculopapular eruption, pruritus, erythema multiforme-like lesions, dyshidrotic eczema) were observed during, after and before systemic symptoms. A few cases with skin involvement were also observed as isolated symptoms of the viral infection. These data demonstrate the clinical polymorphism related to skin involvement of patients infected with SARS-CoV-2, emphasizing the importance of clinical suspicion by dermatologists when handling suspected cases in the current epidemiological scenario. Conclusion: Although the number of cases in the world stage seems to be regressing, infection by SARS-CoV-2 will be part of the dermatologist's daily routine. As long as we do not have a widely available vaccine and the pandemic takes on an endemic profile, we need to be aware of these manifestations, not only for the proper diagnosis, indication of patient isolation, as well as all the necessary biosafety procedures in dermatology clinics.

Objetivo: Apresentar as percepções de profissionais de saúde e da população em geral com relação à forma de obtenção de órgãos, em especial a abordagem de mercado. Métodos: Buscamos apresentar os dados relativos à percepção dos participantes de forma desinteressada e com a inclusão do envolvimento de necessidade pessoal ou familiar para obtenção de órgãos para fins de transplante, utilizando a abordagem de mercado. Para atender aos objetivos deste estudo, foi elaborado um questionário para coletar a opinião dos participantes. Sua distribuição foi realizada pessoalmente de forma aleatória, e também foi elaborada uma versão eletrônica divulgada via página no Facebook. A análise das respostas obtidas foi discutida ao nível de 5% de significância e consideradas significativas quando o valor de p foi

Esta carta traz uma reflexão surgida a partir da palestra da professora Fatimata Ly, da University Cheikh Diop de Dakar (África), no último Congresso da Academia Europeia de Dermatologia, em Paris. A professora F. Ly proferiu a palestra Depigmentation: when, where and how. O tom de pele uniforme é um dos critérios de beleza. Esta carta não diz respeito aos pacientes que chegam ao consultório médico e que são cuidadosamente acompanhados e monitorados por dermatologistas criteriosos. Ela quer chamar a atenção para os indivíduos que não chegam aos consultórios, que repetem prescrições de conhecidos ou que mantêm por tempo indefinido uma prescrição realizada por dermatologista numa consulta pontual. Recentemente, participei, de forma anônima, de fóruns de “discussão” na internet de pessoas leigas sobre melasma. A intensidade e a velocidade do compartilhamento em relação àquilo que eles aconselham são expressivas. A criatividade é enorme ao sugerirem usar produtos que podem causar algum dano. Entre os clareadores mais utilizados estão esteroides, hidroquinona, mercúrio e ácidos. Há que se realizar uma campanha de conscientização da população em relação aos perigos de se utilizarem despigmentantes cutâneos sem indicação precisa do médico dermatologista.

Objective of this work by evaluating the effect of nitrogen on forage yield and morphogenesis of elephant grass cv. Pioneer. The experimental design was randomized blocks with five replications, totaling 20 experimental units. Treatments consisted of four nitrogen levels (100, 200, 300 and 400 kg ha-1 yr-1). The experiment was conducted under irrigated conditions. Evaluative cuts were made at 50 cm soil with values of light interception (95%) without pre-defined intervals. It was observed that N fertilization increased significantly (P

The objective of this study was to evaluate the rate of leaf appearance, leaf elongation rate, number of green leaves, length of blade and stem of Brachiaria brizantha cv. Marandu under different nitrogen levels and two residue heights. A randomized block design was used in a 4 x 2 factorial scheme, four doses of nitrogen (100, 200, 300 and 400 kg N ha-1 year-1) and two residue heights (5 and 15 cm). There was significant interaction between residue height and nitrogen levels for leaf appearance rate (P> 0.05) of signal grass, which was influenced negatively and linearly (P< 0.05) by the residue heights being observed an average reduction of 28.20% from lower to higher residue. There was no interaction (P> 0.05) between the levels of nitrogen x residue height on the number of green leaves. The dosage that provided the highest stalk in the residue height of 5 cm was of 271.5 kg N ha -1. An increase of 0.0745 cm tiller -1 day-1 for 1 kg of N ha -1 applied to height of 15 cm of residue was observed. Nitrogen fertilization contributes positively to growth and development of rates of appearance and leaf extension. The management of pasture of Brachiaria brizantha cv. Marandu with 5 cm of residue and fertilization with 100 kg N ha -1 provided better answer morphogenic traits.

5 Singh S, Neema S, Vasudevan B. A pilot study to evaluate effectiveness of botulinum toxin in treatment of androgenetic alopecia in males. Keywords: Androgenetic alopecia; botulinum toxin EN Androgenetic alopecia botulinum toxin 2093 2095 3 06/23/21 20210701 NES 210701 Androgenetic alopecia (AGA) is the most common form of alopecia in men and women. [Extracted from the article]