Melasma is a skin pigmentation disorder characterized by irregular brownish macules, symmetrically distributed in photoexposed areas, most commonly on the face. It is more common in women, with a higher phototype (III-IV) and in fertile age. Due to the high prevalence, the predominantly facial involvement, and the high index of therapeutic recurrence, melasma has an important impact on quality of life, being a frequent cause of dermatological consultations. 1,2 The exact pathophysiology of melasma is not yet known.However, some triggering factors are already well described, such as ultraviolet radiation, pregnancy, use of hormonal therapies, photosensitizing medications, inflammatory stimuli, and stressful events. Genetic factors are also involved, evidenced by the high prevalence of associated family history.

Scleromyxedema or lichen myxedematosus is a rare papular mucinosis of chronic and progressive course and unknown etiology. It is commonly associated with monoclonal gammopathy and may show extracutaneous manifestations, affecting the heart, lung, kidney, and nerves. The diagnosis is based on four criteria: generalized papular and sclerodermoid lesions; mucin deposition, fibroblast proliferation, and fibrosis in the histopathology; monoclonal gammopathy; and no thyroid disorders. This article reports the case of a scleromyxedema patient with a recent history of acute myocardial infarction and monoclonal gammopathy.

Ectodermal dysplasias are conditions that present primary defects in two or more tissues of ectodermal origin and can be classified as hypohidrotic and hidrotic. Hidrotic ectodermal dysplasia or Clouston syndrome is an autosomal dominant genodermatosis and appears as a triad of clinical findings: palmoplantar keratoderma, nail dystrophy, and hypotrichosis. The hair is sparse and brittle. The nails become thickened and dystrophic, which is an essential characteristic of the syndrome. The diagnosis is made based on clinical findings. This study reports a case of a patient who began with changes in hair, nails and palmoplantar keratoderma in early childhood.

Morbihan Syndrome is a rare entity with unknown etiology. It is clinically characterized by chronic erythematous edema on the face - especially in the middle and upper third of the face - and creates abnormal facial contours that are initially intermitent but become permanent with the development of the syndrome. The histopathology is nonspecific and its therapy is a major challenge due to poor response to the various treatment options. We present the case of a male patient with a five-month-history of disease.

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.

Oculocutaneous albinism (OCA) is a genetic disorder characterized by skin, hair, and eye hypopigmentation due to a reduction or absence of melanin. Clinical manifestations include vision problems and a high susceptibility to skin cancer. In its non-syndromic form, OCA is associated with six genes and one chromosomal region. Because OCA subtypes are not always clinically distinguishable, molecular analysis has become an important tool for classifying types of OCA, which facilitates genetic counseling and can guide the development of new therapies. We studied eight Brazilian individuals aged 1.5-18 years old with clinical diagnosis of OCA. Assessment of ophthalmologic characteristics showed results consistent with albinism, including reduced visual acuity, nystagmus, and loss of stereoscopic vision. We also observed the appearance of the strabismus and changes in static refraction over a 2-year period. Dermatologic evaluation showed that no participants had preneoplastic skin lesions, despite half of the participants reporting insufficient knowledge about skin care in albinism. Wholeexome and Sanger sequencing revealed eight different mutations: six in the TYR gene and two in the SLC45A2 gene, of which one was novel and two were described in a population study but were not previously associated with the OCA phenotype. We performed two ophthalmological evaluations, 2 years apart; and one dermatological evaluation. To the best of our knowledge, this is the first study to perform clinical followup and genetic analysis of a Brazilian cohort with albinism. Here, we report three new OCA causing mutations.

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Calcium hydroxylapatite (CaHA) is intended to volumize and to stimulate neocollagenesis, and it is effective to treat facial and extrafacial regions. This study was conducted with 5 patients with an aged cervical region. Photographs and biopsies were performed before treatment and 5 months later. The filler was injected into the subdermal plane of the anterior cervical region. Photos were analyzed by 10 dermatologists and the patient satisfaction was questioned. According to the specialists there was a reduction in aging (p = 0.001), although there was no difference between the patient satisfaction scores (p = 0.576). Histology showed that the collagen fibers were thick and irregular in both pre and post treatment, but in most cases, we noticed more compact collagen and elastic fibers afterwards, with new areas of horizontalization. CaHA is effective in improving the appearance and the biostimulation of collagen in the cervical region.