Flávia Ravelli

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I am Dermatologist at University of Santo Amaro - São Paulo/ Brazil, where I am responsible for the pediatric and pregnancy patients with dermatological issues.Subjects of interest: dermatology of pregnancy, pediatric and neonatology dermatology, general dermatology.

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Andre Braz

Lia Dantas

Inês Maria Silva Luís

Faculdade de Medicina Dentária da Universidade do Porto

Jane France Augusto Bahouth

Sergio Azevedo

Universidade de Brasília - UnB

marisa gonzaga cunha

Atena Editora

ederson constantino

University Of Sorocaba - UNISO

Samira Yarak

Edileia Bagatin

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Papers by Flávia Ravelli

Preenchimento profundo do sulco lacrimal com ácido hialurônico

Surgical Cosmetic Dermatology, 2011

Trabalho realizado na clínica privada das autoras-São Paulo (SP), Brasil. Conflitos de interesse:... more Trabalho realizado na clínica privada das autoras-São Paulo (SP), Brasil. Conflitos de interesse: Nenhum Suporte financeiro: Nenhum RESU MO A aparência resultante da protusão da gordura orbital, agravada com discromia local, é esteticamente desagradável e piora com o envelhecimento. O objetivo deste trabalho é relatar o tratamento do sulco lacrimal de 15 pacientes com preenchimento de ácido hialurônico. O produto foi introduzido profundamente através de retroinjeção. Onze pacientes (73%) demonstraram satisfação após o procedimento. Dois casos (13%) apresentaram edema na região, um (6%) passou a salientar a hipercromia das pálpebras inferiores, e outro (6%) apresentou irregularidade na superfície cutânea preenchida, sendo tratado com hialuronidase. Essa técnica demonstrou bons resultados sem complicação grave. Palavras-chave: ácido hialurônico; rejuvenescimento; órbita; pele. ABS TRACT The protrusion of the orbital fat, aggravated by local dyschromia, causes an unpleasant aesthetic appearance, which worsens with age. This study describes 15 cases of treating the tear trough with hyaluronic acid filling. The substance was deeply injected through retro injection. Eleven patients (73%) were satisfied with the procedure. Two cases (13%) presented edema in the treated area, one case (6%) developed hyperchromia of the lower eyelids, and another (6%) developed an irregularity on the cutaneous surface in the area that was filled, and was treated with hyaluronidase. This technique demonstrated good results, with no serious complications.

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Neuroma encapsulado em paliçada − simulando carcinoma basocelular: Relato de caso

Surgical Cosmetic Dermatology, 2013

Trabalho realizado em clinica privada-São Paulo (SP), Brasil Suporte Financeiro: Nenhum Conflito ... more Trabalho realizado em clinica privada-São Paulo (SP), Brasil Suporte Financeiro: Nenhum Conflito de Interesses: Nenhum RESU MO Os neuromas encapsulados em paliçada são tumores neurais solitários da pele caracterizados pela presença de feixes compactos e paralelos de fascículos de células de Schwann. Apresenta-se um caso desse tumor, confirmado por exame anatomopatológico, em paciente do sexo feminino, de 55 anos, que relatou mácula hipocrômica de crescimento que evoluiu para pápula de superfície lisa e em domo, com telangiectasias, simulando carcinoma basocelular. Ter conhecimento dessa entidade é importante para a realização de diagnósticos diferenciais com outras lesões, em especial com o CBC, tumores de apêndice cutâneo, nevos e cistos epidérmicos. Palavras-chave: neuroma; neoplasias cutâneas; células de Schwann.

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Hipotermia terapêutica em parada cardiorrespiratória

cibersaude.com.br

Hipotermia terapêutica em parada cardiorrespiratória. Therapeutic hypothermia after cardiac arres... more

Interventions for morphea

Protocols, 1996

BACKGROUND Morphea (morphoea) is an immune-mediated disease in which excess synthesis and deposit... more BACKGROUND Morphea (morphoea) is an immune-mediated disease in which excess synthesis and deposition of collagen in the skin and underlying connective tissues results in hardened cutaneous areas. Morphea has different clinical features according to the subtype and stage of evolution of the disease. There is currently no consensus on optimal interventions for morphea. OBJECTIVES To assess the effects of treatments for people with any form of morphea. SEARCH METHODS We searched the following databases up to July 2018: the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, LILACS, and five trial registers. We checked the reference lists of included studies for further references to relevant randomised controlled trials. SELECTION CRITERIA Randomised controlled trials of topical, intralesional, or systemic treatments (isolated or combined) in anyone who has been clinically diagnosed by a medical practitioner with any form of morphea. Eligible controls were placebo, no intervention, any other treatment, or different doses or duration of a treatment. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. The primary outcomes were global improvement of disease activity or damage assessed by a medical practitioner or by participants, and adverse effects. Secondary outcomes were improvement of disease activity and improvement of disease damage. We used GRADE to assess the quality of the evidence for each outcome. MAIN RESULTS We included 14 trials, with a total of 429 randomised participants, aged between 3 and 76 years. There were juvenile and adult participants; over half were female, and the majority had circumscribed morphea, followed by linear scleroderma. The settings of the studies (where described) included a dermatologic centre, a national laboratory centre, paediatric rheumatology and dermatology centres, and a university hospital or medical centre.The studies evaluated heterogenous therapies for different types of morphea, covering a wide range of comparisons. We were unable to conduct any meta-analyses. Seven studies investigated topical medications, two evaluated intralesional medications, and five investigated systemic medications. The study duration ranged from seven weeks to 15 months from baseline.We present here results for our primary outcomes for our four key comparisons. All of these results are based on low-quality evidence.The included studies were at high risk of performance, detection, attrition, and reporting bias.Global improvement of disease activity or damage after treatment may be higher with oral methotrexate (15 mg/m², maximum 20 mg, once a week, for 12 months or until disease flare) plus oral prednisone (1 mg/kg a day, maximum of 50 mg, in a single morning dose, for three months, and one month with gradually decreased dose until discontinuation) than with placebo plus oral prednisone in children and adolescents with active morphea (linear scleroderma, generalised morphea or mixed morphea: linear and circumscribed) (risk ratio (RR) 2.31, 95% confidence interval (CI) 1.20 to 4.45; number needed to treat for an additional beneficial outcome (NNTB) 3; 1 randomised controlled trial (RCT); 70 participants, all juvenile). This outcome was measured 12 months from the start of treatment or until flare of the disease. Data were not available separately for each morphea type. There may be little or no difference in the number of participants experiencing at least one adverse event with oral methotrexate (26/46) or placebo (11/24) (RR 1.23, 95% CI 0.75 to 2.04; 1 RCT; 70 participants assessed during the 12-month follow-up). Adverse events related to methotrexate included alopecia, nausea, headache, fatigue and hepatotoxicity, whilst adverse events related to prednisone (given in both groups) included weight gain (more than 5% of body weight) and striae rubrae.One three-armed RCT compared the following treatments: medium-dose (50 J/cm²) UVA-1; low-dose (20 J/cm²) UVA-1; and narrowband UVB phototherapy. There may be little or no difference between treatments in global improvement of disease activity or damage, as assessed through the modified skin score (where high values represent a worse outcome): medium-dose UVA-1 phototherapy versus low-dose UVA-1 group: MD 1.60, 95% CI -1.70 to 4.90 (44 participants); narrowband UVB phototherapy versus medium-dose UVA-1 group: MD -1.70, 95% CI -5.27 to 1.87 (35 participants); and narrowband UVB versus low-dose UVA-1 group: MD -0.10, 95% CI -2.49 to 2.29 (45 participants). This RCT included children and adults with active morphea (circumscribed morphea, linear scleroderma (with trunk/limb variant and head variant), generalised morphea, or mixed morphea), who received phototherapy five times a week, for eight weeks. Outcomes were measured at eight weeks from the start of treatment.Safety data, measured throughout treatment, from the same RCT (62 participants) showed that treatment with UVA-1 phototherapy may…

Nutraceuticals in Dermatology

Clinical Approaches and Procedures in Cosmetic Dermatology

Águas Termais: Da Balneoterapia À Genômica

Surgical & Cosmetic Dermatology, 2021

Oral Photoprotection

by Flávia Ravelli and Humberto Ponzio

Clinical Approaches and Procedures in Cosmetic Dermatology

Better understanding of molecular damage caused by solar radiation has led to the growing study o... more Better understanding of molecular damage caused by solar radiation has led to the growing study of molecules with antioxidant and antiinflammatory activity against photodamage. Oral use of these substances is considered an important coadjutant in photoprotection strategy, due to two general mechanisms: prevention and mitigation of photodamage. Coming from nutrients, such as vitamins and functional foods, or herbal extracts, and, more recently, probiotics, molecules with oral photoprotection action have antioxidant action, protecting especially from damage to DNA and protein and lipid structures, but they can also prevent or mitigate UV-induced inflammation, acting on the epidermis and dermis. An increase in the minimal erythema dose has also been shown with some associations of nutrients. Although the level of evidence varies considerably between the molecules studied and described, the most-used active constituents with proven safety and efficacy under systemic use are presented below. These molecules act most often in association, providing a synergistic effect that also allows reduction of their respective concentrations and, consequently, greater tolerability for use.

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Mastocitose cutânea difusa congênita bolhosa

Deep-fill of the tear trough with hyaluronic acid

Conflitos de interesse: Nenhum Suporte financeiro: Nenhum RESU MO A aparência resultante da protu... more Conflitos de interesse: Nenhum Suporte financeiro: Nenhum RESU MO A aparência resultante da protusão da gordura orbital, agravada com discromia local, é esteticamente desagradável e piora com o envelhecimento. O objetivo deste trabalho é relatar o tratamento do sulco lacrimal de 15 pacientes com preenchimento de ácido hialurônico. O produto foi introduzido profundamente através de retroinjeção. Onze pacientes (73%) demonstraram satisfação após o procedimento. Dois casos (13%) apresentaram edema na região, um (6%) passou a salientar a hipercromia das pálpebras inferiores, e outro (6%) apresentou irregularidade na superfície cutânea preenchida, sendo tratado com hialuronidase. Essa técnica demonstrou bons resultados sem complicação grave. Palavras-chave: ácido hialurônico; rejuvenescimento; órbita; pele.

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Chemical and Physical Sunscreens

Daily Routine in Cosmetic Dermatology, 2016

Nutraceuticals in Dermatology

Daily Routine in Cosmetic Dermatology, 2016

Oral Photoprotection

Daily Routine in Cosmetic Dermatology, 2016

Brazilian Consensus on Photoprotection

Anais Brasileiros de Dermatologia, 2014

0596, crea ted in 1925, is publis hed bimonthly by the Brazilian Society of Dermatology and is de... more 0596, crea ted in 1925, is publis hed bimonthly by the Brazilian Society of Dermatology and is devo ted to the dis se mi na tion of origi nal, pre viously unpu blis hed tech ni cal-scien ti fic research papers or reviews of der ma to lo gic and/or rela ted topics. ❑ The con cepts and opi nions emit ted in the arti cles are the exclu si ve res pon si bi lity of the authors and in the adver ti se ments they are the exclu si ve res pon si bi lity of the adver ti sers. ❑ All the arti cles are avai la ble in English on the site www.anais de der ma to lo gia.org.br ❑ Full repro duc tion of the papers in any form or of any type is not per mit ted without writ ten autho ri za tion. Partial cita tions are per mit ted as long as the full refe ren ce to the sour ce is given. ❑ Information for authors appears only in the first issue of each volu me and is avai la ble on the web si te of the Anais at www.anais de der ma to lo gia.org.br Authors should con sult these ins truc tions befo re sub mit ting manus cripts to this Journal.

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Interventions for morphea

by Flávia Ravelli and Virginia Trevisani

Protocols, 1996

Preenchimento profundo do sulco lacrimal com ácido hialurônico

Surgical Cosmetic Dermatology, 2011

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Neuroma encapsulado em paliçada − simulando carcinoma basocelular: Relato de caso

Surgical Cosmetic Dermatology, 2013

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Hipotermia terapêutica em parada cardiorrespiratória

cibersaude.com.br