Indução percutânea de colágeno no tratamento de cicatrizes de acne: relato de técnica
DOI:
https://doi.org/10.52076/eacad-v4i3.441Palavras-chave:
Acne; Cicatriz; Hidroxiapatita de cálcio; Colágeno.Resumo
As cicatrizes resultantes das lesões de acne podem levar à problemas psicológicos e sociais. O objetivo de estudo foi relatar um caso de tratamento de cicatrizes de acne associando a hidroxiapatita de cálcio diluída e subcisão, à técnica de indução percutânea de colágeno com infusão de ativos com toxina botulínica e peelings - PROTOCOLL®, finalizado com preenchimento de ácido hialurônico. Trata-se de um paciente saudável, com cicatrizes permanentes decorrentes da acne. A hidroxiapatita de cálcio 30% foi diluída na proporção 1:1 com anestésico, e distribuída na camada subdérmica com auxílio de uma cânula logo após a realização da subcisão. Posteriormente, o PROTOCOLL® foi realizado utilizando um dispositivo de administração composto por microagulhas isoladas, a fim de proporcionar a penetração dos ativos desejados em várias profundidades na epiderme e na derme. As cicatrizes de acne melhoraram com o protocolo proposto, promovendo mínimo tempo de inatividade e satisfação da paciente. A associação de técnicas na redução das cicatrizes de acne se mostrou promissora em relação às técnicas usuais.
Referências
Agarwal, N., Gupta, L. K., Khare, A. K., Kuldeep, C. M., & Mittal, A. (2015). Therapeutic Response of 70% Trichloroacetic Acid CROSS in Atrophic Acne Scars. Dermatologic Surgery, 41(5), 597–604. https://doi.org/10.1097/DSS.0000000000000355
Antonio, C. R., Antonio, J. R., Trídico, L. A., & Fernandes, T. É. A. (2014). Botulinum toxin: a review of its applicability in diseases within the reach of dermatologists. Surgical & Cosmetic Dermatology, 6(3), 268–276.
Artzi, O., Cohen, S., Koren, A., Niv, R., & Friedman, O. (2020). Dual-plane hyaluronic acid treatment for atrophic acne scars. Journal of Cosmetic Dermatology, 19(1), 69–74. https://doi.org/10.1111/jocd.12991
Badim, J. (1965). Keloid versus hypertrophic cicatrix. Revista Brasileira de Cirurgia, 49(6), 333–339. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/5846641
Bagatin, Hassun, & Talarico. (2009). Revisão sistemática sobre peeling quimico. Surgical e Cosmetic Dermatology, 1(1), 37–46.
Barcat, J. A. (2018). Answers by heart: hypertrophy and healing. Medicina, 78(2), 139–141. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/29659367
Bhalla, M., & Thami, G. P. (2006). Microdermabrasion: Reappraisal and brief review of literature. Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.], 32(6), 809–814. https://doi.org/10.1111/j.1524-4725.2006.32165.x
Bhargava, S., Cunha, P. R., Lee, J., & Kroumpouzos, G. (2018). Acne Scarring Management: Systematic Review and Evaluation of the Evidence. American Journal of Clinical Dermatology, 19(4), 459–477. https://doi.org/10.1007/s40257-018-0358-5
Biesman, B. S., Cohen, J. L., DiBernardo, B. E., Emer, J. J., Geronemus, R. G., Gold, M. H., Lehman, A. S., Pilcher, B. K., Monheit, G. D., Schlesinger, T. E., & Teller, C. F. (2019). Treatment of Atrophic Facial Acne Scars With Microneedling Followed by Polymethylmethacrylate-Collagen Gel Dermal Filler. Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.], 45(12), 1570–1579. https://doi.org/10.1097/DSS.0000000000001872
Cao, Y., Yang, J., Zhu, X., Zhu, J., Chang, H., Guo, S., Luo, D., & Zhou, B. (2018). A Comparative In Vivo Study on Three Treatment Approaches to Applying Topical Botulinum Toxin A for Crow’s Feet. BioMed Research International, 2018, 1–9. https://doi.org/10.1155/2018/6235742
De Almeida, A. T., Figueredo, V., Da Cunha, A. L. G., Casabona, G., Costa De Faria, J. R., Alves, E. V., Sato, M., Branco, A., Guarnieri, C., & Palermo, E. (2019). Consensus Recommendations for the Use of Hyperdiluted Calcium Hydroxyapatite (Radiesse) as a Face and Body Biostimulatory Agent. Plastic and Reconstructive Surgery - Global Open, 7(3), 1–9. https://doi.org/10.1097/GOX.0000000000002160
El-Domyati, M., Barakat, M., Awad, S., Medhat, W., El-Fakahany, H., & Farag, H. (2015). Microneedling Therapy for Atrophic Acne Scars: An Objective Evaluation. The Journal of Clinical and Aesthetic Dermatology, 8(7), 36–42. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26203319
Erbağci, Z., & Akçali, C. (2000). Biweekly serial glycolic acid peels vs. long-term daily use of topical low-strength glycolic acid in the treatment of atrophic acne scars. International Journal of Dermatology, 39(10), 789–794. https://doi.org/10.1046/j.1365-4362.2000.00076.x
Farber, S. E., Epps, M. T., Brown, E., Krochonis, J., McConville, R., & Codner, M. A. (2020). A review of nonsurgical facial rejuvenation. Plastic and Aesthetic Research, 2020. https://doi.org/10.20517/2347-9264.2020.152
Goldberg, D. J., Amin, S., & Hussain, M. (2006). Acne scar correction using calcium hydroxylapatite in a carrier-based gel. Journal of Cosmetic and Laser Therapy : Official Publication of the European Society for Laser Dermatology, 8(3), 134–136. https://doi.org/10.1080/14764170600891632
Goodman, G. J. (2012). Treating scars: addressing surface, volume, and movement to expedite optimal results. Part 2: more-severe grades of scarring. Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.], 38(8), 1310–1321. https://doi.org/10.1111/j.1524-4725.2012.02439.x
Gozali, M. V., & Zhou, B. (2015). Effective treatments of atrophic acne scars. The Journal of Clinical and Aesthetic Dermatology, 8(5), 33–40. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26029333
Grando, S. A., & Zachary, C. B. (2018). The non-neuronal and nonmuscular effects of botulinum toxin: an opportunity for a deadly molecule to treat disease in the skin and beyond. The British Journal of Dermatology, 178(5), 1011–1019. https://doi.org/10.1111/bjd.16080
Griffiths, C., Russman, A. N., Majmudar, G., Singer, R. S., Hamilton, T. A., & Voorhees, J. J. (1993). Restoration of Collagen Formation in Photodamaged Human Skin by Tretinoin (Retinoic Acid). New England Journal of Medicine, 329(8), 530–535. https://doi.org/10.1056/NEJM199308193290803
Hesseler, M. J., & Shyam, N. (2019). Platelet-rich plasma and its utility in the treatment of acne scars: A systematic review. Journal of the American Academy of Dermatology, 80(6), 1730–1745. https://doi.org/10.1016/j.jaad.2018.11.029
Hession, M. T., & Graber, E. M. (2015). Atrophic acne scarring: a review of treatment options. The Journal of Clinical and Aesthetic Dermatology, 8(1), 50–58. http://www.ncbi.nlm.nih.gov/pubmed/25610524
Jeong, S.-Y., Park, J.-H., Lee, Y.-S., Kim, Y.-S., Park, J.-Y., & Kim, S.-Y. (2020). The Current Status of Clinical Research Involving Microneedles: A Systematic Review. Pharmaceutics, 12(11). https://doi.org/10.3390/pharmaceutics12111113
Kamila, M. Z.-P., & Helena, R. (2020). The effectiveness of ferulic acid and microneedling in reducing signs of photoaging: A split-face comparative study. Dermatologic Therapy, 33(6), e14000. https://doi.org/10.1111/dth.14000
Khunger, N., & IADVL Task Force. (2008). Standard guidelines of care for chemical peels. Indian Journal of Dermatology, Venereology and Leprology, 74 Suppl, S5-12. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18688104
Koo, S. H., Yoon, E. S., Ahn, D. S., & Park, S. H. (2001). Laser punch-out for acne scars. Aesthetic Plastic Surgery, 25(1), 46–51. https://doi.org/10.1007/s002660010094
Koren, A., Isman, G., Cohen, S., Bar Ilan, E., Salameh, F., Sprecher, E., & Artzi, O. (2019). Efficacy of a combination of diluted calcium hydroxylapatite-based filler and an energy-based device for the treatment of facial atrophic acne scars. Clinical and Experimental Dermatology, 44(5), e171–e176. https://doi.org/10.1111/ced.13952
Kravvas, G., & Al-Niaimi, F. (2017). A systematic review of treatments for acne scarring. Part 1: Non-energy-based techniques. Scars, Burns & Healing, 3, 2059513117695312. https://doi.org/10.1177/2059513117695312
Kravvas, G., & Al-Niaimi, F. (2018). A systematic review of treatments for acne scarring. Part 2: Energy-based techniques. Scars, Burns & Healing, 4, 2059513118793420. https://doi.org/10.1177/2059513118793420
Lee, J. B., Chung, W. G., Kwahck, H., & Lee, K. H. (2002). Focal treatment of acne scars with trichloroacetic acid: chemical reconstruction of skin scars method. Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.], 28(11), 1017–1021; discussion 1021. https://doi.org/10.1046/j.1524-4725.2002.02095.x
Leheta, T. M., Abdel Hay, R. M., & El Garem, Y. F. (2014). Deep peeling using phenol versus percutaneous collagen induction combined with trichloroacetic acid 20% in atrophic post-acne scars; a randomized controlled trial. The Journal of Dermatological Treatment, 25(2), 130–136. https://doi.org/10.3109/09546634.2012.674192
Minh, P. P. T., Bich, D. D., Hai, V. N. T., Van, T. N., Cam, V. T., Khang, T. H., Gandolfi, M., Satolli, F., Feliciani, C., Tirant, M., Vojvodic, A., & Lotti, T. (2019). Microneedling Therapy for Atrophic Acne Scar: Effectiveness and Safety in Vietnamese Patients. Open Access Macedonian Journal of Medical Sciences, 7(2), 293–297. https://doi.org/10.3889/oamjms.2019.098
Nguyen, T. T., & Park, J. H. (2018). Human studies with microneedles for evaluation of their efficacy and safety. Expert Opinion on Drug Delivery, 15(3), 235–245. https://doi.org/10.1080/17425247.2018.1410138
Nilforoushzadeh, M. A., Lotfi, E., Heidari-Kharaji, M., Nickhah, N., Alavi, S., & Mahmoudbeyk, M. (2020). Comparing cannula-based subcision with the common needle method: A clinical trial. Skin Research and Technology : Official Journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI), 26(1), 39–44. https://doi.org/10.1111/srt.12761
Permatasari, F., Hu, Y., Zhang, J., Zhou, B., & Luo, D. (2014). Anti-photoaging potential of Botulinum Toxin Type A in UVB-induced premature senescence of human dermal fibroblasts in vitro through decreasing senescence-related proteins. Journal of Photochemistry and Photobiology. B, Biology, 133, 115–123. https://doi.org/10.1016/j.jphotobiol.2014.03.009
Rivera, A. E., & Spencer, J. M. (2007). Clinical aspects of full-thickness wound healing. Clinics in Dermatology, 25(1), 39–48. https://doi.org/10.1016/j.clindermatol.2006.10.001
Rullan, P. P., Olson, R., & Lee, K. C. (2020). A Combination Approach to Treating Acne Scars in All Skin Types: Carbolic Chemical Reconstruction of Skin Scars, Blunt Bi-level Cannula Subcision, and Microneedling A Case Series. Journal of Clinical and Aesthetic Dermatology, 13(5), 19–23.
Sadick, N. S., & Palmisano, L. (2009). Case study involving use of injectable poly-L-lactic acid (PLLA) for acne scars. The Journal of Dermatological Treatment, 20(5), 302–307. https://doi.org/10.1080/09546630902817879
Shuo, L., Ting, Y., KeLun, W., Rui, Z., Rui, Z., & Hang, W. (2019). Efficacy and possible mechanisms of botulinum toxin treatment of oily skin. Journal of Cosmetic Dermatology, 18(2), 451–457. https://doi.org/10.1111/jocd.12866
Sumita, J. M., Bagatin, E., & Leonardi, G. R. (2017). Tretinoin peel: A critical view. Anais Brasileiros de Dermatologia, 92(3), 363–366. https://doi.org/10.1590/abd1806-4841.201755325
Williams, H. C., Dellavalle, R. P., & Garner, S. (2012). Acne vulgaris. Lancet (London, England), 379(9813), 361–372. https://doi.org/10.1016/S0140-6736(11)60321-8
Wohlrab, J., & Kreft, D. (2014). Niacinamide - mechanisms of action and its topical use in dermatology. Skin Pharmacology and Physiology, 27(6), 311–315. https://doi.org/10.1159/000359974
Wollina, U. (2015). Midfacial rejuvenation by hyaluronic acid fillers and subcutaneous adipose tissue--a new concept. Medical Hypotheses, 84(4), 327–330. https://doi.org/10.1016/j.mehy.2015.01.023
Zhang, H., Tang, K., Wang, Y., Fang, R., & Sun, Q. (2021). Use of botulinum toxin in treating rosacea: A systematic review. Clinical, Cosmetic and Investigational Dermatology, 14, 407–417. https://doi.org/10.2147/CCID.S307013
Zhu, J., Ji, X., Xu, Y., Liu, J., Miao, Y.-Y., Zhang, J.-A., Luo, D., & Zhou, B.-R. (2017). The efficacy of intradermal injection of type A botulinum toxin for facial rejuvenation. Dermatologic Therapy, 30(1). https://doi.org/10.1111/dth.12433
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