Botulinum toxin for axillary hyperhidrosis.

Botulinum toxin is a safe and effective treatment option for axillary hyperhidrosis. Although its pathophysiology is not clear and somewhat controversial, the beneficial effect of neuromodulators in inhibiting localized sweating temporarily is well known. Before the procedure, correct identification of the affected area is mandatory to avoid wastage of drug and neglect of target areas, and to enhance efficacy, as the hyperhidrotic location may not match the hairy axillary region.

Recurrence of acute myeloid leukemia in cryptorchid testis: case report.

A 23-year-old male with a history of bone marrow transplant for acute myeloid leukemia. He presented a large mass in the right inguinal region 5 years ago. Upon physical examination, right-sided cryptorchidism was observed.

Superficial mycoses at the Hospital do Servidor Público Municipal de São Paulo between 2005 and 2011.

Background: Superficial mycoses are fungal infections limited to the outermost layers of the skin. Dermatophytic filamentous fungi and yeasts are the major causative agents of these mycoses. Dermatophytosis is one of the clinical conditions caused by fungal infections most commonly found in dermatological practice.

Longitudinal melanonychias.

Melanonychia is black or brown pigmentation that appears in the fingernails and toenails. The pigment can come from exogenous sources, such as bacteria or fungal infection, tar, or blood. Endogenous causes include aberrant melanin production in the nail bed, resulting in a longitudinal presentation.

Atypical manifestation of vestibular schwannoma.

Introduction Vestibular schwannoma (also known as acoustic neuroma) is a benign tumor whose cells are derived from Schwann sheaths, which commonly occurs from the vestibular portion of the eighth cranial nerve. Furthermore, vestibular schwannomas account for ∼8% of intracranial tumors in adults and 80 to 90% of tumors of the cerebellopontine angle. Its symptoms are varied, but what stands out most is a unilateral sensorineural hearing loss, with a low index of speech recognition.

Consensus on melanonychia nail plate dermoscopy.

This statement, focused on melanonychia and nail plate dermoscopy, is intended to guide medical professionals working with melanonychia and to assist choosing appropriate management for melanonychia patients. The International Study Group on Melanonychia was founded in 2007 and currently has 30 members, including nail experts and dermatopathologists with special expertise in nails. The need for common definitions of nail plate dermoscopy was addressed during the Second Meeting of this Group held in February 2008.

An observational and descriptive study of the epidemiology of and therapeutic approach to onychomycosis in dermatology offices in Brazil.

Background: Onychomycosis is a type of fungal infection that accounts for over 50% of all onycopathies. Some authors consider superficial mycosis the most difficult to be treated. Very few studies have been carried out in order to assess the epidemiology of onychomycosis in Brazil.

Glabellar contraction patterns: a tool to optimize botulinum toxin treatment.

Background: Botulinum toxin is a well-established treatment for dynamic glabellar lines. A previous study evaluated the existence of glabellar contraction "patterns," according to the predominance of eyebrow approximation, depression, or elevation movements, namely "U," "V," "convergent arrows," "omega," and "inverted omega."

Objectives: To confirm contraction patterns in the adult population for a better treatment approach and to verify whether changes occur after repeated treatment.

Tangential Biopsy Thickness versus Lesion Depth in Longitudinal Melanonychia: A Pilot Study.

Longitudinal melanonychia can be caused by melanocyte activation (hypermelanosis) or proliferation (lentigo, nevus or melanoma). Histopathologic examination is mandatory for suspicious cases of melanomas. Tangential biopsy of the matrix is an elegant technique avoiding nail plate dystrophy, but it was unknown whether the depth of the sample obtained by this method is adequate for histopathologic diagnosis.

Sister Mary Joseph's nodule: a sign of internal malignancy.

The umbilicus can be affected by various skin diseases including metastasis of internal malignancies, at which point it is known as Sister Mary Joseph's Nodule. The authors report a case of Sister Mary Joseph's Nodule as the first sign of internal malignancy and highlight the importance for the dermatologist to recognize the condition.

Handling botulinum toxins: an updated literature review.

Background: Botulinum toxin (BoNT) has been in use since the late 1970s, and over the last 20 years, its use has been extended to new indications in various areas of medicine. During these years of clinical use, some of the initial ideas have changed, and others have remained stable along with increasing experience with and knowledge about BoNTs.

Objective: To review the literature and prescribing information on all of the available products and to update the concept of handling toxins (preparations, reconstitution, storage, sterility, and dilution).

Dermatologists' accuracy in early diagnosis of melanoma of the nail matrix.

Objective: To measure and compare the accuracy of 4 different clinical methods in the diagnosis of melanoma in situ of the nail matrix among dermatologists with different levels of clinical experience.

Design: Twelve cases of melanonychias (5 melanomas and 7 nonmelanomas) were presented following 4 successive steps: (1) clinical evaluation, (2) evaluation according to the ABCDEF rule, (3) dermoscopy of the nail plate, and (4) intraoperative dermoscopy. At each step, the dermatologists were asked to decide if the lesion was a melanoma.

Diffusion characteristics of botulinum neurotoxin products and their clinical significance in cosmetic applications.

Over the past decade, growth in the number and types of aesthetic procedures performed using botulinum neurotoxin has increased, along with the number of these products. As more options, along with emerging counterfeit agents, become available to clinicians, differences among preparations need to be considered in order to ensure optimal outcomes for patients. Once injected into the muscle, botulinum neurotoxin distributes within that tissue to produce the desired local effects.

The product of platelet and neutrophil counts (PN product) at presentation as a predictor of outcome in children with meningococcal disease.

Background: Despite improvement in the treatment of Neisseria meningitidis infection, meningococcal diseases (MD) are still an important cause of morbidity and mortality around the world. This study assessed the performance of the product of platelet and neutrophil counts (PN product) at the time of presentation to hospital as a predictor of outcome in children with MD.

Methods: Retrospective evaluation of children with clinical MD admitted to two paediatric intensive care units in Brazil.

Procedural sedation for insertion of central venous catheters in children: comparison of midazolam/fentanyl with midazolam/ketamine.

Background: There is a lack of studies evaluating procedural sedation for insertion of central venous catheters (CVC) in pediatric patients in emergency departments or pediatric intensive care units (PICU). This study was designed to evaluate whether there is a difference in the total sedation time for CVC insertion in nonintubated children receiving two sedation regimens.

Methods: Patients were prospectively randomized to receive either midazolam/fentanyl (M/F) or midazolam/ketamine (M/K) i.

Pilot study comparing the diffusion of two formulations of botulinum toxin type A in patients with forehead hyperhidrosis.

Background: Different formulations of botulinum toxin type A (BoNTA) may have different diffusion characteristics.

Objective: The objective was to compare the diffusion characteristics of two formulations of BoNTA.

Materials And Methods: A total of 20 patients with forehead hyperhidrosis received four injections of BoNTA in their forehead (one medial and lateral injection of one formulation randomly assigned to one forehead side, one medial and lateral injection of the other formulation to the other forehead side).

Nail abrasion.

Certain diseases of the nail complex cause hyperkeratosis or alterations of the shape of the nail plate. These conditions may be painful, may decrease the penetration of topical medicaments and may be ugly. The nail plate abrasion, performed with dermabrader device or sandpaper, has application in patients suffering from onychomycosis, psoriasis, subnail infections and haematomas.

Treatment of transverse overcurvature of the nail with a plastic device: measurement of response.

Background: Transverse overcurvature of the nail is a painful condition that has been treated by conservative and/or surgical methods.

Objectives: We sought to evaluate the efficacy of a plastic device for treatment of transverse overcurvature of the nail and to use a practical method (plaster mold) to evaluate follow-up of nail widening during and after treatment.

Methods: Twenty-five patients with transverse overcurvature of the nail were treated with placement of a plastic device.

Foreign body in ear, nose and oropharynx: experience from a tertiary hospital.

Unlabelled: The occurrence of foreign bodies in otorhinolaryngology is reason of constant searches for emergency services.

Objective: To value the incidence of patients with foreign body, to analyze the clinical situation and the treatment in these cases.

Method: The prospective study was realized in 81 patients with diagnosis of foreign body of nose, ear or oropharynx in the otorhinolaryngology service of the Hospital do Servidor Público Municipal de São Paulo between april/2003 and march/2005.

High doses of riboflavin and the elimination of dietary red meat promote the recovery of some motor functions in Parkinson's disease patients.

Abnormal riboflavin status in the absence of a dietary deficiency was detected in 31 consecutive outpatients with Parkinson's disease (PD), while the classical determinants of homocysteine levels (B6, folic acid, and B12) were usually within normal limits. In contrast, only 3 of 10 consecutive outpatients with dementia without previous stroke had abnormal riboflavin status. The data for 12 patients who did not complete 6 months of therapy or did not comply with the proposed treatment paradigm were excluded from analysis.

Foam during reconstitution does not affect the potency of botulinum toxin type A.

Background: Among factors that may affect the potency of botulinum toxin A (Botox), it is said that foam, together with bubbles, may cause surface denaturation of the toxin.

Objective: To determine whether the muscle relaxation effect of Botox is preserved and has the same duration when it is reconstituted in the presence of foam.

Methods: Six female volunteers, aged 42 to 56 years old, were treated for glabellar and periocular wrinkles.