CSBD 2022: Rediscovering skin repair with biotic pre and post

CSBD: Check the summary of the 75th Congress of the Brazilian Society of Dermatology

Between the 25th and 28th of August, the Congress of the Brazilian Society of Dermatology took place in São Paulo. The event brought scientific updates in Clinical, Surgical and Cosmiatry Dermatology. Check out below what was most important to be discussed at this year’s CSDB.

See too:

CSBD: Highlights of the Brazilian Congress of Dermatology [podcast]

CSBD 2022: Pathophysiological aspects of skin barriers [vídeo]

CSBD 2022: Rediscovering skin repair with biotic pre and post

A very interesting fact discussed in a panel on acne is that the Orders for takeaway meals have grown 160% in the last two years, with the most ordered foods having a high glycemic index, which may explain, at least in part, the worsening of acne in the post-pandemic period.

Peculiarities about oral isotretinoin were discussed, as a variety of studies on its post-rhinoplasty use. There are some studies published in the literature, but there is still no consensus on whether there is a real benefit and on the dose or time of use, which can vary from 0.25 to -0.5mg/kg/day for up to 6 months. Possible effects include reducing the thickness of the dermis and hypodermis and improving the appearance and texture of the skin. For the management of mucocutaneous adverse events of oral isotretinoin, some authors suggest the association of omega 3 or antihistamines such as desloratadine and levocetirizine.

In atopic dermatitis, the greatest challenge of topical treatment is the use of inadequate amounts of moisturizer. A 12-year-old patient would need to use the equivalent of 255g of moisturizer per week, which is far from what we see in clinical practice. The specialist Johannes Ring, from Germany, also reinforced the role of empathy as the secret of a good doctor, especially in the management of chronic diseases such as atopic dermatitis.

As for hair, the Thelopecia ffrontal ffibrosing disease (AFF), an emerging disease, had its treatment widely discussed. Contrary to what was thought, specialist Carolina Fechini concluded in her recently defended doctoral thesis that there is no correlation between histological and dermoscopic criteria for AFF activity. That is, basing the therapeutic decision only on trichoscopic criteria does not seem to be the best strategy, since the absence of findings on trichoscopy does not exclude inflammatory activity on histology.

First-line treatment includes a drug with anti-inflammatory action associated with a 5a-reductase inhibitor, a strategy that should be reassessed at 3 months (clinically) and at 6 months ( clíuniquely and photographically), to redefine behavior. Another novelty was the description of triscoscopic findings of the AFF in the eyebrows, with the presence of hairs in different directions being an important landmark.

In acute telogen effluvium, always look for triggers: assess history of covid-19, emotional state, febrile illnesses, infection, start and end of Minoxidil use, thyroid disorders, hormone use, dietary changes, among others.

The importance of the skin barrier was also a topic widely discussed throughout the Congress. A symposium was attended by specialists Daniela Pimentel and Flávia Ravelli, in addition to physician Marco Rocha, and addressed the importance of using healing agents after the procedure. The combination of healing agents, antioxidants and humectants combined with post-biotic action is useful in dermatological therapy in post-procedure care, leading to the reduction of adverse events such as dehydration, persistent erythema, dermatitis, infections, depigmentation, unsightly scars and acneiform eruption.

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