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BACKGROUND: The aesthetic treatment based on fillers with hyaluronic acid presents an increasing demand in the present day because it is considered a safe and minimally invasive procedure. In the management of adverse effects or more severe complications of hyaluronic acid-based fillers, hyaluronidase is the treatment of choice. AIMS: To demonstrate efficacy in reversibility and safety in the treatment of HA complications. PATIENTS/METHODS: It is a retrospective study article that reports the use of hyaluronidase in the main undesirable effects of fillers in 114 patients in a private dermatological clinic from 2015 to 2018. RESULTS: The target of the application was 51 cases of overcorrection (45%), 50 cases of Tyndall effect (44%), and 13 late nodules (11%). When we evaluated the areas where HYAL was injected, we found that the area with the most indication of the application of the product was the eyelid region (58 injections). CONCLUSION: This study concluded that HYAL is a safe and effective drug in the management of mild adverse events of HA applications with no severe side effects in our protocol of use.

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Angiolymphoid hyperplasia with eosinophilia is a rare and benign vascular tumor whose etiology remains uncertain. It clinically presents itself by angiomatous papules or nodules located on the head and neck. Many controversies in the literature are found in relation to angiolymphoid hyperplasia with eosinophilia and Kimura's disease - its main differential diagnosis - due to their clinical and histopathological similarities. However, currently, most studies agree that they are distinct diseases. The present case illustrates a characteristic description of angiolymphoid hyperplasia with eosinophilia and also highlights the main differences with Kimura's disease.

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Introdução: O uso do ácido hialurônico para correções estéticas cresceu exponencialmente nos últimos anos. O ultrassom de pele mostra-se método eficaz para identificação do preenchedor e suas complicações. Um tipo particular de efeito adverso, caracterizado por edema tardio e persistente, de caráter intermitente, vem sendo observado ultimamente. Objetivo: Caracterizar uma complicação tardia após preenchimento facial com ácido hialurônico. Métodos: Selecionaram-se exames de ultrassom da pele realizados em clínica privada de outubro de 2016 a julho de 2017, encaminhados para avaliação de complicação após preenchedores. Questionários foram enviados aos médicos solicitantes para coleta de dados clínicos. Resultados: Em 108 exames foram identificados 33 casos de edema local associado à presença de ácido hialurônico. Episódios de edema foram referidos como recorrentes, na área previamente afetada ou em outro sítio de injeção. Conclusão: Os autores propõem nomenclatura específica: edema tardio intermitente e persistente para agrupar as reações adversas tardias ao ácido hialurônico, que se traduzem por edema local tardio, de caráter intermitente, deflagrado por gatilhos específicos e que persiste enquanto houver a presença do ácido hialurônico no tecido.

Introduction: The use of hyaluronic acid fillers (HA) for esthetic corrections has exponentially grown in recent years. Skin ultrasound (US) is an effective method to identify the filler and its complications. A particular type of adverse effect, characterized by late, persistent edema of an intermittent nature, has been lately observed. Objective: To describe a delayed complication due to easy HA fillers, named by the authors as Persistent, Intermitent Delayed Swelling (PIDS). Methods: From October 2016 to July 2017, US examinations performed at Cavallieri Clinic were selected and referred for evaluation of post-filler complications. Questionnaires were sent to requesting physicians for clinical data collection. Results: Of 108 exams, 33 cases of local subcutaneous edema associated with the presence of HA fillers were identified. Episodes of edema were referred to as recurrent, in the previously affected area, or at another injection site. Conclusion: The authors propose a specific nomenclature: PIDS to refer to this late adverse reaction to HA fillers, which includes delayed and intermittent local swelling, triggered by specific conditions, that persists for as long the HA remains in the subcutaneous tissue.

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Abstract Angiolymphoid hyperplasia with eosinophilia is a rare and benign vascular tumor whose etiology remains uncertain. It clinically presents itself by angiomatous papules or nodules located on the head and neck. Many controversies in the literature are found in relation to angiolymphoid hyperplasia with eosinophilia and Kimura's disease - its main differential diagnosis - due to their clinical and histopathological similarities. However, currently, most studies agree that they are distinct diseases. The present case illustrates a characteristic description of angiolymphoid hyperplasia with eosinophilia and also highlights the main differences with Kimura's disease.

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Cicatrizes decorrentes de queimadura acarretam grandes danos físicos e emocionais aos pacientes. Seu tratamento permanece um desafio na prática clínica. O uso atual de tecnologias a laser e luz, como o laser ablativo fracionado e a luz intensa pulsada (LIP), tem se mostrado eficaz na recuperação estética e funcional da pele acometida. Este trabalho tem por objetivo a demonstração do resultado do tratamento de cicatriz de queimadura extensa com LIP e laser ablativo fracionado Erbium: YAG a partir do relato de caso de uma paciente de 38 anos vítima de queimadura por chama direta aos 6 anos de idade. A paciente apresentou melhora clínica significativa no aspecto estético e funcional da lesão. O uso desses métodos combinados apresenta resultados favoráveis para o tratamento desses casos.

Scars resulting from burning causes great physical and emotional damage to patients. Its treatment remains a challenge in clinical practice. Current use of laser and light technologies, such as fractional ablative laser and intense pulsed light (ILP), have been shown to be effective in aesthetic and functional recovery of affected skin. This work aims to demonstrate the results of the treatment of extensive burn scarring with ILP and fractional ablative laser Erbium:YAG relating the case report of a 38-year-old female victim of direct flame burn at 6-years-old. The patient presented significant clinical improvement in the aesthetic and functional aspect of the lesion. The use of these combined methods presents favorable results for the treatment of these cases.

Las cicatrices resultantes de quemaduras causan grandes daños físicos y emocionales a los pacientes. El tratamiento sigue siendo un reto en la práctica clínica. El uso actual de tecnologías láser y de luz, tales como el láser ablativo fraccionado y la luz pulsada intensa (LPI) han demostrado ser herramientas eficaces para la recuperación estética y funcional de la piel afectada. Este trabajo tiene como objetivo mostrar el resultado del tratamiento de una cicatriz extensa por quemadura usando LPI y láser ablativo fraccional Erbio:YAG a partir del caso clínico de una paciente de 38 años de edad víctima de quemaduras por fuego directo (llama) a los 6 años de edad. La paciente mostró una mejoría clínica significativa en el aspecto estético y funcional de la lesión. El uso de estos métodos combinados mostró resultados favorables para el tratamiento de este tipo de casos.

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