BOTOX and Dysport presented similar levels of safety and efficacy in the treatment of primary axillary hyperhidrosis when a conversion factor of 1:3 was used.

A 70-year-old white Brazilian woman from a rural area had a 2-year history of a painful lesion on her left toe. The lesion increased progressively in size followed by toenail destruction. She was treated with systemic antibiotics for secondary bacterial infection several times without any clinical response. Physical examination showed an erythematous swelling on the first toe with an irregular 2.5 cm ulcer with a raised edge that was infiltrating and destroying the toenail. The bottom of the ulcer was granular and partially covered with a crust (Fig. 1). Laboratory studies showed a strong positive Montenegro intradermal reaction (2.5 mm). Other intradermal reactions were also performed, such as purified protein derivative (PPD) and sporotrichin, which were negative. On X-ray examination of the left foot, bone destruction of the distal phalanx of the first toe and a soft tissue swelling were observed (Fig. 2). A biopsy was taken and the histologic picture showed a chronic inflammatory change with tuberculoid-type granuloma and necrosis suggesting leishmaniasis, although parasites were not observed. Based on the clinical, histologic, and immunologic aspects, we concluded that this was a case of leishmaniasis. Methylglucamine (Glucantime) was introduced at a total dose of 17 g of the salt (10 mg/kg daily for 40 days). Immediately after the start of treatment, the lesion began to improve, and 4 months later the lesion had healed completely and the dystrophic nail had started to grow (Fig. 3).

Introduction: Nicolau syndrome, also known as livedo-like dermatitis or embolia cutis medicamentosa, is a rare complication usually after intra-muscular or intra-articular injection of various drugs. It is difficult to find photographic documentation of this syndrome from the initial stages due to its rarity and unpredictable evolution. Case presentation: We report the case of a 54-year-old Portuguese woman who developed Nicolau Syndrome after a traumatic finger injury with a sewing needle. She developed an ulcer and cutaneous necrosis. She was treated with surgical debridement, antibiotic, analgesics and sterile dressings. The ulcer healed completely within 18 weeks with scarring. Conclusions: Although Nicolau syndrome develops very rarely, it is an important cause for morbidity. It is an iatrogenic condition. The Nicolau Syndrome following a traumatic injury with a needle without drugs, as far as we know, has never been reported in the published literature especially with photographic records from the beginning of the process.