No abstract

Psoriasis is a chronic inflammatory skin disease characterized by recurrent events. Its prevalence around the world is approximately 1-3%. 1,2 It´s estimated that 80-90% of patients with psoriasis will present with nail disorders throughout their lives. 2,3 Studies have shown that nail psoriasis is the causes a significant social problem, often associated with pain. 2 Different therapeutic options can be found for nail psoriasis, which include topical medication, intralesional treatment, systemic therapy, conventional therapies with immunobiological drugs, as well as non-pharmacological treatments. 2,3 Methotrexate (MTX) is a folic acid analogue, responsible for inhibiting the synthesis of deoxyribonucleic acid. 2,3 A literature review shows that intralesional MTX has been successfully used for several indications with no complications reported. The treatment of nail psoriasis has still yielded unsatisfactory results, leading doctors to search for more effective therapeutic approaches. 2 Case 1. We report a 45-year-old female patient with nail dystrophy for 2 years referred for onychomycosis treatment. She presented with exuberant subungual hyperkeratosis and discrete cupuliform depressions, in addition to erythema, periungual edema, and pain in the right hallux (Figure 1). No changes were observed in the other nails. We observed no other alterations on physical examination. Direct mycological examination, repeated weekly for 4 weeks, was always negative. MRI of the hallux confirmed the

Brazil ranked second in the world for the number of aesthetic procedures in 2019. Five case reports of delayed hypersensitivity reaction to hyaluronic acid dermal filler against COVID-19 vaccines are presented. Additional vaccination for new variants, including omicron, will be necessary, therefore aesthetic professionals should be aware of this possibility and advise patients accordingly.

This is a review and update article on antinuclear antibodies assays, in particular the antinuclear factor, in which are approached histological and epidemiological aspects, physiopathogenesis, identification methods, their specificities and interpretation, correlating them to their applicability in the dermatologist's and general clinician's clinical practice.

Phyma is the last stage of rosacea and is due to chronic inflammation and edema. It can affect nose (rhinophyma), chin (gnatophyma), forehead (metophyma), ears (otophyma) and eyelids (blepharophyma). Rhinophyma is the most frequent location and there are few reports about gnatophyma. We report the case of a female patient, 41 years old, who had an infiltrated, erythematous, edematous plaque around the chin and lower lip for two years. Histopathology showed perivascular lymphocytic infiltrate, hypertrophied follicles and sebaceous glands, dilated vessels and fibrosis. She was treated with oral tetracycline, oral ivermectin and metronidazole cream with a satisfactory response. The clinical, histopathological and therapeutic response correlation confirmed the diagnosis of gnatophyma, a rare variant of phyma.