Cutaneous side effects in antimalarial users are frequent. Xerosis and hyperpigmentation are the most common findings.

BACKGROUND: Actinic cheilitis, a common disease caused by chronic solar exposure and tobacco use, is considered a premalignant lesion with potential to develop into squamous cell carcinoma. Some of the available treatments are invasive, have unaesthetic results and require multiple sessions. OBJECTIVE: To assess the efficacy of a therapy and its cosmetic results. METHODS: In this uncontrolled clinical trial a single photodynamic therapy (PDT) session using 16% methyl-aminolevulinate was performed on actinic cheilitis of the lower lip. A standardized questionnaire was applied in order to assess the clinical improvement from the patients' point of view and the satisfaction with the treatment. Anatomopathological evaluation was performed before the treatment and two months afterwards. RESULTS: The sample was composed of 19 patients (10 males and 9 females), phototypes I to III, with average age of 62 years. Main adverse effects were: sudden pain, scabs, herpes flare-up, and edema. The average score of pain during the procedure was 5,8+2,9. At the final assessment the patients reported improvement of 80% and satisfaction of 85% (p<0.01). Anatomopathological analysis showed a significant decrease of dysplasia (p=0.03) in spite of its presence in 84% of cases. There was no significant correlation between the level of dysplasia with either the subjective impression of clinical improvement (p=0.82) or with the patients' final satisfaction (p=0.96). CONCLUSION: PDT is effective in the treatment of actinic cheilitis, but it is associated with a significant level of pain. Due to the persistence of dysplasia, more research needs to be done in order to define the ideal number of sessions for the effective treatment of these lesions.

Unilateral nevoid telangiectasia is a rare vascular dermatosis, characterized by areas of superficial telangiectases distributed in a linear unilateral pattern. It was described in 1899 by Zeisler and Blascko. Several theories where developed in order to explain its etiopathogenesis. The most widely accepted is the one which establishes its probable association with an increase in the estrogen levels. There are two types: congenital and acquired. The latter is associated with hepatopathies in male patients. The acquired form is rarely observed in healthy men, with a few cases reported in the medical literature, and its etiology is unknown. This study reports the case of a healthy young man with acquired unilateral nevoid telangiectasia, without any comorbidities, clinical and /or laboratory findings indicative of hyperestrogenism. Keywords: Estrogens; Liver Diseases; Telangiectasis Resumo: A Telangiectasia Nevoide Unilateral é uma dermatose vascular rara, caracterizada por áreas de telangiectasia superficial, em uma distribuição linear unilateral, descrita, em 1899, por Zeisler e Blaschko. Diversas teorias foram desenvolvidas para explicar sua etiopatogenia, sendo a provável (e a mais fundamentada) a relação com elevação dos níveis de estrogênio. Há duas formas: a congênita e a adquirida. Esta, geralmente, se relaciona a hepatopatias, em pacientes do sexo masculino. Em homens hígidos, a ocorrência da forma adquirida é rara, com poucos relatos na literatura, sendo sua causa desconhecida. Este trabalho tem como objetivo relatar um caso de telangiectasia nevoide unilateral adquirida em homem jovem, sem comorbidades, alterações clínicas e/ou laboratoriais sugestivas de hiperestrogenismo. Palavras-chave: Estrogênios; Hepatopatias; Telangiectasia INTRODUÇÃOUnilateral nevoid telangiectasia is a rare vascular dermatosis, characterized by areas of superficial telangiectases distributed in a linear unilateral pattern, described in 1899 by Zeisler e Blaschko.1 Since then, less than a 100 cases have been described in the medical literature 2 . Several theories were developed in order to explain its etiopathogenesis. The most widely accepted is the one which establishes its probable association with an increase in the estrogen levels. There are two types: congenital and acquired. The first is prevalent in men through dominant autosomal inheritance and the second in women, in association with physiological and pathological conditions of hyperestrogenism. 1The acquired type, in male patients, is generally related to hepatopathies . The occurrence of this type among healthy men is rare and its cause remains unknown.

Abstract:The co-existence of systemic lupus erythematosus and porphyria although rare has been known for a long time. This association forces the physician to make a careful differential diagnosis of the bullous lesions that might appear in such patients and to be careful when prescribing certain drugs such as chloroquine. This drug, when used in the regular doses for treating lupus, may cause hepatotoxicity in patients.suffering from porphyria. It is described here the case of a patient with lupus who developed bullous lesions compatible with porphyria cutanea tarda. Keywords: Antibodies, antinuclear; Lupus erithematosus, systemic; Porphyrias; Porphyria cutanea tarda Resumo: A associação de lúpus eritematoso sistêmico e porfiria, embora rara, é conhecida de longa data. Ela obriga o médico a realizar um cuidadoso diagnóstico diferencial das lesões bolhosas nesses pacientes e tomar cuidados com a prescrição de certas drogas, como a cloroquina. Esta, nas doses habituais para tratamento do lúpus, pode causar hepatotoxicidade em pacientes com porfiria. Descreve-se o caso de uma paciente com lúpus que desenvolveu lesões bolhosas compatíveis com porfiria cutânea tardia.

Melasma, as a pigmentation disorder, induces significant stress to the patients and its recurrent nature remains a challenge in clinical practice. Treatment is based on a variety of mechanisms to prevent and/or stop the pigment production process by destroying the deposited pigment for removal or release, by peeling cells to improve their turnover, and by reducing inflammation. The use of appropriate devices and correct settings are crucial in the treatment of melasma. Cases unresponsive to topical bleaches or chemical peels should be referred for laser therapy. It is important that a maintenance therapy to avoid the recurrence of melasma be indicated. In this paper, we review energy-based devices for melasma treatment.