RESUMO
BACKGROUND AND OBJECTIVE: There is no validated instrument to assess the clinical severity of striae distensae. Here, we aimed to develop a striae distensae severity scale. MATERIAL AND METHODS: After a Delphi-based consensus, 15 items related to striae severity were assessed in 110 areas (breasts, abdomen, and buttocks) from 45 participants. The items were analyzed through a partial least squares model to select the most important variables. To assess the reliability of the scale, 43 areas were retested. RESULTS: Of the 110 areas evaluated, 34 were breasts, 24 abdomens, and 52 buttocks. Striae were considered mild in 30% of the evaluations, moderate in 33%, severe in 21%, and extremely severe in 16%. The final model was composed by: width of the widest striae, width of the striae with the most frequent pattern, atrophy, number of affected quadrants, distribution (multiple or isolated), hypo or hyperchromia and topography. The scores of the scale demonstrated a high correlation with the clinical classification (rho = 0.77). There was a high agreement in the scores from the reassessed areas (intraclass correlation coefficient = 0.90). CONCLUSION: An objective and reliable scale to assess the clinical severity of striae distensae on the breasts, abdomen, and buttocks was developed.
Assuntos
Estrias de Distensão , Abdome , Mama , Nádegas , Humanos , Reprodutibilidade dos Testes , Estrias de Distensão/diagnósticoRESUMO
BACKGROUND: Calcium hydroxylapatite (CaHA) is effective for dorsal hand rejuvenation. Higher dilutions are used for biostimulation with fewer side effects. OBJECTIVE: To evaluate the efficacy and safety of 2 techniques of diluted CaHA injection for dorsal hand treatment. METHODS: A prospective, evaluator-blinded study was performed to compare (side-to-side) techniques for treating the dorsum of the hands with diluted CaHA: deep fat lamina or subdermal injection. Fifteen women with aging grades between 1 and 3 on the MHGS (Merz hand grading scale) were enrolled and followed up for 24 weeks. The outcomes were a histological analysis of collagen, skin viscoelasticity, high-frequency ultrasound parameters, MHGS score, and the global aesthetic improvement scale (GAIS) score. RESULTS: Improvement in the MHGS and GAIS scores (p < .01) was observed, with no difference between techniques (p > .05). Skin viscoelasticity measures and ultrasonography for dermal parameters improved for both treatments (p < .01). The mean total collagen density increased from the baseline for both techniques (p < .01). Pain during the procedure as well as adverse effects within the follow-up did not differ between treatments (p > .4). The overall satisfaction was 12% greater for the subdermal technique (p < .05). CONCLUSION: Diluted CaHA improves the skin quality of aging hands with a safe profile, without substantial differences between the techniques.
Assuntos
Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Durapatita/administração & dosagem , Dor Processual/diagnóstico , Pele/efeitos dos fármacos , Colágeno/análise , Preenchedores Dérmicos/efeitos adversos , Durapatita/efeitos adversos , Estética , Feminino , Seguimentos , Mãos , Humanos , Injeções Subcutâneas/efeitos adversos , Injeções Subcutâneas/métodos , Pessoa de Meia-Idade , Medição da Dor , Dor Processual/etiologia , Satisfação do Paciente , Estudos Prospectivos , Rejuvenescimento , Pele/química , Envelhecimento da Pele/efeitos dos fármacos , Envelhecimento da Pele/fisiologia , Resultado do TratamentoRESUMO
Trichotillomania is considered a behavioral disorder and is characterized by the recurring habit of pulling one's hair, resulting in secondary alopecia. It affects 1% of the adult population, and 2 to 4.4% of psychiatric patients meet the diagnostic criteria. It can occur at any age and is more prevalent in adolescents and females. Its occurrence in childhood is not uncommon and tends to have a more favorable clinical course. The scalp, eyebrows and eyelashes are the most commonly affected sites. Glutamate modulating agents, such as N-acetylcysteine, have been shown to be a promising treatment. N-acetylcysteine acts by reducing oxidative stress and normalizing glutaminergic transmission. In this paper, we report a case of trichotillomania with an excellent response to N-acetylcysteine.
Assuntos
Acetilcisteína/uso terapêutico , Antioxidantes/uso terapêutico , Tricotilomania/tratamento farmacológico , Alopecia/diagnóstico , Alopecia/etiologia , Criança , Diagnóstico Diferencial , Humanos , Masculino , Tricotilomania/diagnósticoRESUMO
Abstract: Trichotillomania is considered a behavioral disorder and is characterized by the recurring habit of pulling one's hair, resulting in secondary alopecia. It affects 1% of the adult population, and 2 to 4.4% of psychiatric patients meet the diagnostic criteria. It can occur at any age and is more prevalent in adolescents and females. Its occurrence in childhood is not uncommon and tends to have a more favorable clinical course. The scalp, eyebrows and eyelashes are the most commonly affected sites. Glutamate modulating agents, such as N-acetylcysteine, have been shown to be a promising treatment. N-acetylcysteine acts by reducing oxidative stress and normalizing glutaminergic transmission. In this paper, we report a case of trichotillomania with an excellent response to N-acetylcysteine.