Rosacea is a chronic dermatological condition with a centrofacial disposition that is manifested by the appearance of erythematous lesions, accompanied by papulo-pustular eruptions, telangiectasias and flushes (vasomotor hot flashes).

As etiopathogenic factors were involved vascular abnormalities, digestive disorders, immunological factors, demodex folliculorum and Helicobacter pylori, rosacea mainly affecting people with light skin (phototypes I and II), female (between 30-50 years) , but shows more aggressive manifestations in males. The condition begins with the appearance of an erythema accompanied by the sensation of stinging and heat (flush) on the forehead, cheeks, nose and chin. The succession of episodes increases progressively in frequency and intensity, until a permanence of the symptomatology is reached.

Cuperosis can be induced and aggravated by alcohol consumption, spicy foods, emotional stress and heat.

Rosacea is classified into 4 stages:

• stage I-erythematous-telangiectasia (rosacea);
• stage II-papulo-pustular, stage III-fibrosis-rhinophyma;
• stage IV-ocular.

In the treatment of rosacea, it is very important to thoroughly investigate the patient, in order to identify and remove the triggers and favoring the disease. Depending on the stage of the disease, the specialist will opt for the appropriate general and topical (local) drug treatments.

Alopecia (hair loss) is a medical condition manifested by the absence of hair, either only on the scalp or on the entire surface of the body.

The most well-known types of alopecia are diffuse non-androgenetic gain, androgenetic alopecia, area alopecia (pelada) and scar alopecia. Diffuse alopecia gained non-androgenetic is the thinning of hair adornment caused by diffuse hair loss that occurs postpartum, postabortion, after cosmetic aggression or severe stress. Androgenetic alopecia (Hippocratic baldness) is facilitated by androgenic hormones on a predisposing genetic background, and in alopecia area are involved immunological factors, endocrine diseases, dermatological diseases, genetic factor and mental factor. Scarring alopecia is the loss of hair due to pathological processes that destroy the pilo-sebaceous follicle and leave scars.

After establishing the final diagnosis, the specialist can opt for different types of treatment according to the patient's wishes: topical vasodilators in solution applied topically or with the help of mesotherapy technique, intralesional corticosteroid injections, systemic antiandrogens, own plasma therapy, hair transplantation.

The patient is also advised to use appropriate hair care products, to avoid mechanical or chemical aggression of the scalp, hair and to follow a diet rich in zinc, iron, selenium, biotin.

Eczema or dermatitis is an itchy condition characterized by erythema, vesiculation, blistering, crusting, flaking and sometimes lichenification.

Eczema can be classified into:

• Exogenous eczema (irritated dermatitis-orthoergic dermatitis), contact eczema (allergic), symmetrical contact eczema;
• Mixed eczema (exo / endogenous) - numeral eczema, dyshidrosis eczema, microbial eczema, fissure eczema, stasis eczema, seborrheic dermatitis;
• Constitutional eczema (atopic dermatitis).

Irritation dermatitis (orthoergic dermatitis)

It is frequently encountered, predominating the professional (chemical) one.

Depending on the irritant, its concentration and the duration of contact of the substance on the skin, the clinical manifestations will be different.

Contact dermatitis (allergic)

It is due to cell-mediated hypersensitivity (type IV reaction), favored by humidity, temperature, wind, excessive sweating, non-compliance with hygiene.

Sensitization can occur in chromates, nickel, cobalt, rubber, plastics, medicines, detergents, some vegetables (carrots, onions, garlic, tomatoes), fruits (lemons, oranges), cosmetics.

Systemic contact dermatitis

It is determined by the appearance of lesions after the introduction by systemic route (oral, transcutaneous, intramuscular, intravenous) of some allergens (Ex. Penicillin, Neomycin, Terbinafine, Ketoprofen, Heparin, etc.)

Numerical eczema

Microbial infections (staphylococci), traumas (physical or chemical), medicines, etc. are considered as determining causes.

Dyshydrosis and dyshidrosis eczema

Triggering factors include sweating secretions, stress, drug allergies, etc.

Eczema fissure

This condition is also known as cracker, asthma or winter eczema.

The location of choice of lesions is the anterior face of the calves, affects the elderly and occurs frequently during the winter.

Seborrheic dermatitis

It is an erythematous-squamous disease that can be caused by oval pityrosporum, hormonal factors, stress and / or genetic predisposition.

The treatment of eczema consists according to the form and classification in the administration of antihistamines, dermatocorticoids, keratolytics, antibiotic therapy in case of lesion infection, phototherapy, climatotherapy and psychotherapy.

Psoriasis is a chronic inflammatory dermatosis that can occur at any age and can affect both men and women.

Factors involved in the onset and worsening of this condition may be genetic predisposition (20-40% of cases), bacterial infections, Pytirosporum ovale infection, viral infections, drugs (lithium salts, beta blockers, NSAIDs, tetracyclines, amiodarone, digoxin, etc.), trauma, psychogenic factors (stress, emotional shocks), alcohol and smoking.

Psoriasis vulgaris

It represents 2/3 of the cases of psoriasis and is clinically manifested by the appearance of erythematous plaques covered with white-pearly, multi-layered scale that detaches easily.

Depending on the location, the following were highlighted:

• scalp psoriasis
• facial psoriasis
• fold psoriasis (reverse psoriasis)
• palmoplantar psoriasis
• mucosal psoriasis

The shape and size of the lesions were described:

• punctate psoriasis (squamous, millimeter lesions)
• follicular psoriasis (erythematous-squamous follicular papules, 2-4 mm in diameter)
• drip psoriasis - preceded by an infectious episode or vaccination
• psoriasis nevid
• numular psoriasis
• figured psoriasis
• psoriasis in plaques and placards
• universal psoriasis

Erythrodermic psoriasis

The patients have an altered general condition, are feverish, have generalized and intense itching and massive flaking. The risk is dehydration, infections and vascular decompensation.

Arthropathic psoriasis (psoriatic arthritis)

Represents 5-7{4cb4085f53b8f383f0eeec872334f9e4685179a027a61df2422d536e5b23b707} of cases of psoriasis. It is more common in the age group between 36-45 years.

Types of arthropathic psoriasis

• asymmetric oligoarthritis
• dominant distal interphalangeal involvement
• arthropathic psoriasis of the mutilating type
• symonegative symmetric polyarthritis
• axial shape (spondylitis / sacroiliitis)
• form with isolated spinal cord injury
• mixed, peripheral and axial shape

Psoriasis treatment

The treatment will be adapted to the form of the disease, the duration of evolution and the age of the patient.

The aim will be to eliminate the triggering or aggravating factors, to mentally rebalance the patient (psychotherapy), as well as to adopt a hypocaloric and / or hypoglycemic regime.

Local treatment (topical) consists in the administration of Keratolytics, cignolin, tars, dermatocorticoids, vitamin D3 derivatives, calcineurin inhibitors.

Systemic treatment consists of the administration of Methotrexate, Cyclosporine, Retinoids, etc.

LASER treatment (Light Amplification by Stimulated Emission of Radiation) is an amplification of light by stimulated radiation emission. Specifically, it is about electromagnetic radiation with wavelengths between 100 nanometers and 2 millimeters. Depending on the intensity of the LASER radiation, both the biological effects and their medical, diagnostic or therapeutic indications vary.

The dose and frequency of treatment can be adjusted to produce the desired effect, and are determined by the physician. Even if the duration is a few minutes, the effect is felt right from the first sessions.

Thus, laser therapy involves the removal of wrinkles, pore reduction, attenuation to disappearance of post-acne scars, post-chickenpox, post-traumatic and significant improvement of skin texture and removal of unsightly venectasis.

The treatment is ideal for anyone looking for a therapeutic option with the lowest possible recovery time for excellent, highly visible and fast results.

During the recovery period, the skin may look red and swollen as after a sunburn, the appearance gradually improving in a few days, as the skin heals.

Dermatoscopy (epiluminescent microscopy) is a fast, non-invasive, high-accuracy diagnostic method that is used to examine the superficial structural details of the skin.

It is a method used in the early diagnosis of skin tumors and in the identification of dysplastic skin pigmented lesions, with a risk of malignant transformation.

A number of factors can lead to the appearance of new skin lesions or to the modification of pre-existing skin lesions, such as: prolonged and repeated exposure to ultraviolet rays without applying creams with UV protection factor with SPF 50+, genetic predisposition, hormonal influences.

Dermatoscopy allows the visualization and examination of all pigment lesions, which can be evaluated and diagnosed as follows:

• benign lesions (no risk of tumor transformation);
• atypical / dysplastic lesions (with potential risk of tumor transformation, tumor precursor lesions);
• malignant lesions (various types of skin tumors).

Following the dermatoscopic examination, the specialist doctor makes a map of all the pigmentary lesions, which will be completed during each medical check-up that is recommended to be performed at an interval of 6 months.

Following the identification of a potentially dysplastic or malignant nevus, the specialist will recommend to the patient the excision of the lesion and the histopathological examination, indispensable for the definite diagnosis.

This method offers the possibility to identify precancerous lesions, tumors in the early stages, to make the differential diagnosis between different types of skin tumors.

Dermatoscopic evaluation is recommended in the following situations:

• people with light skin, blond hair and blue eyes and numerous nevi or sunspots;
• people with dysplastic nevi;
• people with a personal or family history of malignant melanoma;
• people who practice prolonged and periodic exposure to ultraviolet rays, who have not used sunscreens and who have frequently suffered sunburn;
• in the case of nevi (moles) that have changed color, shape, size, texture and have grown rapidly (in a few weeks-months) or have been traumatized.

Acne is a dermatosis found at about 80% of adolescents, representing the main clinical manifestation of seborrheic syndrome. This condition can have a very strong psychosocial resonance, leading even to anxiety and depression.

Among the factors favoring this condition can be incriminated genetic predisposition, increased sebaceous secretion, abnormal keratinization of the excretory duct of the sebaceous glands, hormonal factors, immune factors, as well as stress, drugs, cosmetics, diet.

The main forms of acne are:

• Acne vulgaris (Juvenile polymorphic acne);
• Acne conglobata;
• Acne fulminans;
• Professional acne;
• Neonatal acne;
• Childhood acne.
• Mechanical acne.

Taking into account the severity of the disease, the response to treatment and the degree of tolerability of each patient, the therapy will be individualized.

Post-acne scars are the result of defective healing of acne lesions.

There are 5 known types of scars

• Ice Pick - depressions about 2 mm deep, small in diameter, located on the forehead, cheeks, chin
• Boxcar - vertical scars, with a larger diameter, located on the forehead and cheeks
• Rolling - scars with a linear appearance
• Hypertrophic scars
• Postinflammatory hyperpigmentation - represents hyperpigmented spots (spots) resulting from acne lesions.
• Treatment options:

Chemical peel - is the procedure by which various acids are applied to the skin in varying concentrations. Peels can be superficial, medium or deep.

DermaPen - is a device consisting of 12 micro needles that performs numerous microincisions with the role of stimulating fibroblasts, so as to form new collagen and elastin fibers

Dermatological roller - is a cylindrical device consisting of 600 very thin needles. It will puncture the skin in different directions, thus stimulating the formation of a more uniform dermal tissue.

PRP (Platelet Rich Plasma) - Vampire therapy that injects autologous plasma rich in growth factors, extremely beneficial in skin recovery

Filling with filler - fillers are used (hyaluronic acid)

IPL (intense pulsed light) is one of the newest and most efficient technologies in medical aesthetics. History began to be written many years ago, when the action of strong light on the hair was first observed. However, technology has advanced extremely much, so that nowadays IPL finds its utility in many dermatological problems. The principle of action is similar to that of the laser - the emission of a very intense light pulse that is absorbed by various skin structures.

The IPL technique allows the selection of certain wavelengths that act specifically on different structures. Once absorbed, the light is transformed into heat, causing the root of the hair to be destroyed.

After the first treatment with IPL, the hairs will be removed in a proportion of approximately 60% of their total. The treatment is repeated until they are 100% eliminated. The sessions are usually scheduled every 4 weeks, but the specialist will determine the frequency of interventions depending on each patient.

IPL technology successfully treats erythema and telangiectasias in rosacea, melasma (skin hyperpigmentation), Civatte poikiloderma, lentigines.