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Vernal S, De Paula NA, Bollela VR, Lerner EA, Roselino AM. Pemphigus foliaceus and sand fly bites: assessing the humoral immune response to the salivary proteins maxadilan and LJM11. Br J Dermatol 2020; 183:958-960. [PMID: 32407578 DOI: 10.1111/bjd.19221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- S Vernal
- Dermatology, Department of Clinical Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - N A De Paula
- Laboratory of Dermatology Section, Department of Clinical Medicine, University Hospital, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - V R Bollela
- Infectious Diseases, Department of Clinical Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - E A Lerner
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - A M Roselino
- Dermatology, Department of Clinical Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Wambier CG, Struecker TA, Durski LN, de Araújo AG, Wambier SPF, Cappel MA, Vernal S, Roselino AM. Image Gallery: A case of pemphigus vulgaris following Simulium spp. (Diptera) bites. Br J Dermatol 2018; 176:e100. [PMID: 28504401 DOI: 10.1111/bjd.15393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- C G Wambier
- Department of Medicine, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - T A Struecker
- Department of Medicine, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - L N Durski
- Department of Medicine, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - A G de Araújo
- Department of Medicine, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - S P F Wambier
- Department of Medicine, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - M A Cappel
- Department of Dermatology, Mayo Clinic, Jacksonville, FL, U.S.A
| | - S Vernal
- Division of Dermatology, Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - A M Roselino
- Division of Dermatology, Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
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Gomes CM, Cesetti MV, de Morais OO, Mendes MST, Roselino AM, Sampaio RNR. The influence of treatment on the development of leishmaniasis recidiva cutis: a 17-year case-control study in Midwestern Brazil. J Eur Acad Dermatol Venereol 2014; 29:109-14. [PMID: 24655077 DOI: 10.1111/jdv.12473] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 02/18/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND The recurrence of American cutaneous leishmaniasis (ACL) in patients experiencing a long-term cure is often called leishmaniasis recidiva cutis (LRC). LRC is considered an unusual form of ACL. OBJECTIVE This study aims to estimate the incidence of LRC in ACL patients evaluated at a tertiary dermatologic centre in Midwestern Brazil. We also aim to evaluate the association between various treatment regimens and the development of LRC using multivariate analysis in a case-control study. METHODS We performed a 17-year epidemiological study using data from patients treated at our dermatologic centre from July 1994 to December 2011. A retrospective analysis was then performed to estimate risk and protective factors related to clinical presentation. We also assessed the influence of treatment regimens in the development of LRC. RESULTS The incidence of LRC among ACL patients was 1.34%. The analysis included 105 patients; 82 patients (78%) were in the control group, and 23 patients (22%) were in the LRC case group. The data analysis indicated that the standard treatment N-methylglucamine antimoniate (N-MA) reduced the development of LRC in bivariate (odds ratio (OR) = 0.34; 95% CI = 0.13-0.91) and multivariate analyses (OR = 0.16; 95% CI = 0.03-0.86; P = 0.03). However, no differences in LRC incidence were observed when the standard treatment N-MA and alternative drugs, such as pentamidine and amphotericin B, were considered (OR = 0.47; 95% CI = 0.16-1.35) CONCLUSION: We conclude that the standard treatment N-MA, as proposed by the Brazilian Ministry of Health, is effective in the prevention of LRC. Although other drugs have shown promising results in LRC, more scientific evidence is needed to assess their efficacy compared with N-MA.
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Affiliation(s)
- C M Gomes
- Department of Dermatology, Universidade de Brasília, Brasília, Brazil; Laboratório de Dermatomicologia, Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília Brazil
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Santos GM, Kückelhaus SA, Roselino AM, Chaer WK, Sampaio RNR. Leishmania (Viannia) braziliensis is the main species causing cutaneous leishmaniasis in the Federal District of Brazil. J Venom Anim Toxins Incl Trop Dis 2012. [DOI: 10.1590/s1678-91992012000300012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
Leishmaniasis is a parasitic disease with diverse clinical manifestations, and considered a public health problem in endemic countries such as Brazil. Mucosal lesions usually involve the upper respiratory tract, with a predilection for nose and larynx. Oral involvement is unusual and in most cases it becomes evident after several years of resolution of the original cutaneous lesions. Oral lesions classically appear as mucosal ulcerations, mainly in the hard or soft palate. This report describes the clinicopathological data of 11 cases of mucocutaneous leishmaniasis with oral manifestations. Two cases of Leishmania (Viannia) braziliensis and one case of Leishmania (Leishmania) amazonensis were confirmed by polymerase chain reaction-restriction fragment length polymorphism or DNA sequencing in mucosal samples.
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Affiliation(s)
- A C F Motta
- Division of Dermatology, Department of Medical Clinics, Faculty of Medicine of Ribeirão Preto, University of Sao Paulo, Sao Paulo, Brazil
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Rosatelli TB, Roselino AM, Dellalibera-Joviliano R, Reis ML, Donadi EA. Increased activity of plasma and tissue kallikreins, plasma kininase II and salivary kallikrein in pemphigus foliaceus (fogo selvagem). Br J Dermatol 2005; 152:650-7. [PMID: 15840094 DOI: 10.1111/j.1365-2133.2005.06427.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pemphigus foliaceus (PF) is an autoimmune blistering disease of unknown aetiology, which is endemic in Brazil. Although the pathogenesis of PF is still unknown, proteins of the contact system have been implicated. OBJECTIVES As the components of the kinin system may interact with those of the contact system, in this study we evaluated the plasma levels of high-molecular-weight kininogen (HK) and low-molecular-weight kininogen (LK), and the activity of plasma kallikrein, tissue kallikrein and kininase II in plasma of patients with PF presenting with Nikolsky's sign. As kidneys and salivary glands are relevant sources of tissue kallikrein for plasma, we also evaluated urinary/salivary kallikrein and urinary kininase II activities. METHODS Fifteen patients and 15 age- and sex-matched controls were studied. Kininogen levels were determined by enzyme-linked immunosorbent assay, and the activities of kallikreins and kininase II were determined using selective chromogenic substrates. RESULTS Compared with controls, plasma HK levels were decreased (P = 0.031), whereas the activities of plasma kallikrein, tissue kallikrein and kininase II in plasma, and the activity of salivary kallikrein, were increased in patients (P < 0.001 for each comparison). Plasma levels of LK and the activities of urinary kallikrein and urinary kininase II were not significantly different from controls. CONCLUSIONS Diminished levels of HK associated with increased activities of plasma kallikrein and kininase II indicate that the kinin system is activated at the systemic level in PF. As active plasma kallikreins may act on some proteins of the contact system, it is possible that the enzyme may contribute to blister formation. The further observation of an increased tissue kallikrein activity at the systemic and saliva levels may be interpreted as a systemic reflex of skin inflammation. Whether the activation of the kinin system is a cause or a consequence of blister formation needs further clarification.
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Affiliation(s)
- T B Rosatelli
- Dermatology, Department of Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes 3900, Monte Alegre, 14049-900, Ribeirão Preto, SP, Brazil
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Rosatelli JB, Roselino AM. Hyper-IgE, eosinophilia, and immediate cutaneous hypersensitivity to insect antigens in the pruritic papular eruption of human immunodeficiency virus. Arch Dermatol 2001; 137:672-3. [PMID: 11346359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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Chiossi MP, Roselino AM. Endemic Pemphigus foliaceus ("Fogo selvagem"): a series from the Northeastern region of the State of São Paulo, Brazil, 1973-1998. Rev Inst Med Trop Sao Paulo 2001; 43:59-62. [PMID: 11340476 DOI: 10.1590/s0036-46652001000200001] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Endemic Pemphigus Foliaceus (EPF) is a bullous autoimmune skin disease whose incidence used to be high in the State of São Paulo (SP), Brazil, during the forties, but has declined thereafter. OBJECTIVES to report a series of EPF patients from the northeastern region of SP. METHODS a retrospective study concerning demographic and epidemiological data of patients seen from 1973 to 1998 was conducted at the University Hospital, Faculty of Medicine of Ribeirão Preto, SP. RESULTS bullous disease was diagnosed in 340 patients, 245 with EPF (72.1%), 9.4 cases per year, 60.4% females, and 70.2% white, 7 to 82 year-old (29.4% in their teens); 46.9% lived in the rural zone. Concerning profession, housewives predominated among women (67.6%) and agricultural workers among men (40.2%). The time of disease was less than 1 year in 62.0% of cases, followed by 1 and 5 years (27%), and more than 5 years for the remaining patients (11%). 36.7% of patients were referred by the Direção Regional de Saúde (DIR) XVIII of Ribeirão Preto, with the largest number of cases being from Ribeirão Preto and Batatais: 33.3% and 23.3%, respectively; 22% from DIR XIII (Franca); 13.5% from DIR VII (Araraquara); 2.9% from DIR IX (Barretos); 4.1% from other DIRs of SP, and 20.8% from other States (16.7% from Minas Gerais). Thirteen (5.3%) patients reported occurrence of the disease in some relative, and 4 (1.6%) in neighbors. CONCLUSIONS the present data characterize the northeastern region of the state of São Paulo as a remaining endemic focus of EPF.
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Affiliation(s)
- M P Chiossi
- Division of Dermatology, Department of Medical Clinics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, SP, Brazil
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Abstract
BACKGROUND The immunopathogenic mechanism of the pruritic papular eruption (PPE) of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is poorly understood, and the objective of the present study was to determine the concentration of the serum cytokines interleukin-2 (IL-2), IL-4, IL-5, IL-10, IL-12, and gamma-interferon (gamma-IFN) in an attempt to recognize the pattern of CD4+/CD8+ lymphocytes occurring in this dermatosis. MATERIALS AND METHODS The study was conducted on 11 HIV-positive PPE patients, matched for sex and age with eight HIV-infected patients with no dermatosis and 10 healthy HIV-negative individuals. Cytokines were quantified by enzyme-linked immunoabsorbent assay (ELISA) using monoclonal antibodies (R & D Systems) and the data were analyzed by the Mann-Whitney, Kruskall-Wallis, and Spearman correlation tests. RESULTS An increased concentration of IL-2 was observed in both the HIV-positive (77.65 pg/mL, P < 0.001) and PPE (20.42 pg/mL, P < 0.05) groups when compared with the HIV-negative group (9.50 pg/mL). The IL-2 concentration was significantly higher (P < 0.05) in the HIV-positive group than in the PPE group. Similarly, the gamma-IFN concentration was higher in the HIV-positive (14.97 pg/mL) and PPE (12.67 pg/mL) groups when compared with the HIV-negative group (8.58 pg/mL). The IL-12 concentration was similar in the PPE and HIV-positive groups (1.82 and 1.68 pg/mL, respectively), but higher than in the HIV-negative group (1.17 pg/mL). The same occurred with IL-5 (17.78, 17.79, and 15.74 pg/mL, respectively). There was no significant difference in IL-4 concentration among the PPE, HIV-positive, and HIV-negative groups (10.95, 7.88, and 10.16 pg/mL, respectively), and the same was observed for IL-10 (22.41, 21.13, and 20.92, respectively). There was a negative correlation between serum gamma-IFN concentration and peripheral CD4+ lymphocyte number (r = - 0.6256) in the PPE group (P < 0.05). CONCLUSIONS The lower levels of IL-2 and gamma-IFN and the negative correlation between gamma-IFN and peripheral CD4+ lymphocytes may indicate an early phase of immunosuppression in PPE.
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Affiliation(s)
- J M Aires
- Division of Dermatology and Division of Infectious Diseases, Department of Clinical Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Martinelli AL, Zago MA, Roselino AM, Filho AB, Villanova MG, Secaf M, Tavella MH, Ramalho LN, Zucoloto S, Franco RF. Porphyria cutanea tarda in Brazilian patients: association with hemochromatosis C282Y mutation and hepatitis C virus infection. Am J Gastroenterol 2000; 95:3516-21. [PMID: 11151887 DOI: 10.1111/j.1572-0241.2000.03369.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Porphyria cutanea tarda (PCT) is commonly associated with iron overload and hepatitis C virus (HCV) infection. Association between hemochromatosis C282Y or H63D mutations and PCT has been observed, although not uniformly, and iron overload is also commonly found in chronic HCV hepatitis. The aim of the present study was to investigate the frequency of C282Y and H63D mutations and HCV infection in Brazilian patients with PCT and their relationship with iron overload. METHODS Twenty-three patients (19 men) aged 39.6 +/- 11.1 yr were studied. All had dermatological lesions of PCT and high levels of urinary uroporphyrin. HCV infection and iron overload were investigated. DNA samples were analyzed for the presence of HFE mutations. RESULTS The frequency of C282Y was significantly higher in PCT patients than in 278 healthy individuals (17.4% vs 4%, odds ratio = 5.1, 95% confidence interval 1.5-17.6, p = 0.02), whereas no difference was observed regarding the H63D mutation (30.4% vs 31%, odds ratio = 1, 95% confidence interval 0.4-2.4, p = 1). Biochemical tests in PCT patients showed iron overload with transferrin saturation = 47.3 +/- 20.7% and ferritin = 566.8 +/- 425 ng/ml. Fifteen of 23 (65.2%) patients had HCV infection and alcohol ingestion was observed in 17 of 23 (73.9%). CONCLUSIONS PCT patients exhibited evidence of iron overload, a high frequency of HCV, and an association with C282Y mutation. These data further support the notion that both acquired and inherited factors contribute to the occurrence of PCT, and indicate that screening for C282Y may be justified in PCT patients.
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Affiliation(s)
- A L Martinelli
- Department of Clinical Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
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Souza CS, Roselino AM, Figueiredo F, Foss NT. Lucio's phenomenon: clinical and therapeutic aspects. Int J Lepr Other Mycobact Dis 2000; 68:417-25. [PMID: 11336069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
We report four cases of necrotizing reactions of the Lucio's phenomenon type, an entity rarely observed in Brazil despite the high prevalence of leprosy. Clinical, histopathological and therapeutic aspects are described and compared to those reported in the literature for cases classified as diffuse, non-nodular lepromatous leprosy with Lucio's phenomenon.
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Affiliation(s)
- C S Souza
- Division of Dermatology, Department of Internal Medicine, University Hospital, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes 3900, 14048-900 Ribeirao Preto, SP, Brazil.
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Abstract
Pemphigus foliaceus (PF) is characterized by acantholysis determined by IgG4 binding to desmoglein I, a 160-kDa desmosomal glycoprotein. To investigate the immunopathological aspects of Brazilian PF, we determined levels of serum cytokines in patients with PF. Twenty-five patients with PF and a control group consisting of 10 healthy individuals were studied. Serum IL-2, IL-4, IL-5, IL-10, IL-12 and IFN-gamma were measured in the two groups by ELISA. The median concentration of IL-2 was lower in PF patients compared to the control group (0.45 and 9.50 pg/ml, respectively), as also was the concentration of IL-4 (0.26 and 10.16 pg/ml, respectively). The same was observed for IL-5 (7.94 and 15.74 pg/ml, respectively) and for IFN-gamma (5.90 and 8.58 pg/ml, respectively). For IL-10 and IL-12, higher concentrations were observed in PF compared to the control group (IL-10: 24.76 and 20.92; IL-12: 2.92 and 1.17 pg/ml, respectively). Considering the Th1/Th2 paradigm, it seems that a Th2 profile, mainly represented by IL-10, predominates in PF.
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Affiliation(s)
- D M Zeoti
- Divisão de Dermatologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Abstract
A strong association between hepatitis C virus (HCV) infection and porphyria cutanea tarda (PCT) has been observed, but the implications of the viral infection in the metabolism of porphyrins in patients without clinical manifestations of PCT are not known. The levels of porphyrin in plasma and uroporphyrin (URO) and coproporphyrin (COPRO) in 24-hour urine were measured in 156 patients with chronic HCV infection showing no clinical evidence of PCT. Levels of URO higher than the upper limit were observed in 35 of 156 patients (22.4%). The range and the mean values +/- standard deviation were 26-1,196 microg/24 hours and 82 +/- 204 microg/24 hours. Increased levels of COPRO and plasma porphyrin were observed in 12 of 156 patients (7.7%) and 2 of 156 patients (1.3%) respectively. There were no differences between patients with increased URO levels and patients with normal URO levels in terms of gender, age, risk factors for HCV infection, alcohol abuse, or hepatitis B viral infection. Transferrin saturation (p = 0.040), gamma glutamyl transpeptidase (p < 0.0001), aspartate aminotransferase (p = 0.006), and alanine aminotransferase (p = 0.040) were significantly higher in patients with abnormal URO than in patients with normal URO. The frequency of cirrhosis was higher, but not significantly different, in patients with increased URO (16.7%) compared with patients with normal URO (3.8%). The authors demonstrated that even without a clinical manifestation of PCT it is possible to detect abnormalities in the metabolism of porphyrins in patients with chronic HCV infection. The implications of these findings deserve additional investigation.
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Affiliation(s)
- A L Martinelli
- Department of Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
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Abstract
Pruritic papular eruption (PPE) is a common inflammatory cutaneous lesion observed only in HIV/AIDS patients. Since kinin is an important mediator in inflammation, we evaluated the levels of total kininogen (TKg), low and high molecular weight kininogen (LKg and HKg, respectively) and the activity of kallikrein in plasma of 11 patients (median age = 31.4) with AIDS and PPE (PPE+), eight patients (median age = 31.5) with AIDS without PPE (PPE-) and in 12 control individuals (median age = 32.9) with anti-HIV negative serum. Kininogens were measured by ELISA and expressed in median (m) of BK Equivalent/ml plasma and the kallikrein by its activity upon selective chromogenic substrate, and expressed as U kallikrein/ml of plasma. TKg or LKg concentrations in PPE+ patients (m = 4.11 and 4.5) and in PPE- patients (m = 6.23 and 4.54) were significantly higher when compared to control (m = 2.10 and 1.17). Compared to controls PPE- patients presented similar values of HKg (m = 0.78 and 0.61), whereas PPE+ patients presented undetectable values. Plasma kallikrein activity was significantly decreased in PPE+ and PPE- (m = 0.6 and 0.89, respectively) when compared with control individuals (m = 2.23).
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Affiliation(s)
- M L Reis
- Laboratory of Pharmacology, Faculty of Pharmaceutical Science, University of São Paulo, Ribeirão Prêto, SP, Brazil.
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Rodrigues ML, Costa RS, Souza CS, Foss NT, Roselino AM. Nephrotoxicity attributed to meglumine antimoniate (Glucantime) in the treatment of generalized cutaneous leishmaniasis. Rev Inst Med Trop Sao Paulo 1999; 41:33-7. [PMID: 10436668 DOI: 10.1590/s0036-46651999000100007] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Pentavalent antimonials have became of basic importance for the treatment of leishmaniasis. Their most severe side effects have been reported to be increased hepatic enzyme levels and electrocardiographic abnormalities. Nephrotoxicity has been rarely related. OBSERVATIONS We report a case of generalized cutaneous leishmaniasis involving a 50-year old male patient who was submitted to treatment with meglumine antimoniate (Glucantime). He developed acute renal failure (ARF) due to acute tubular necrosis (ATN), followed by death after receiving a total of 53 ampoules of Glucantime. CONCLUSIONS The treatment with Glucantime was responsible by ARF diagnosed in this patient. The previous urine osmolarity and serum creatinine levels were normal and the autopsy showed ATN. It should be pointed out if ARF may also be explained by massive deposits of immunocomplexes by leishmania antibodies and antigens due to the antigenic break by the antimonial compound, since our patient presented countless lesions covering the entire tegument, similar to the Hexheimer phenomenon, but at the autopsy no glomerular alterations were seen.
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Affiliation(s)
- M L Rodrigues
- Division of Dermatology, Faculty of Medicine of Ribeirão Preto, SP, Brazil.
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Rosatelli JB, Souza CS, Soares FA, Foss NT, Roselino AM. Generalized cutaneous leishmaniasis in acquired immunodeficiency syndrome. J Eur Acad Dermatol Venereol 1998; 10:229-32. [PMID: 9643326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Leishmaniasis associated with HIV/AIDS has been reported in the last decade. CASE REPORT A case of generalized cutaneous leishmaniasis in a patient with AIDS is described. The case is paradoxical in that the cutaneous lesions resemble anergic leishmaniasis caused by Leishmania (L.) amazonensis and Jorge Lobo's disease, but the positive Montenegro test and the clinical improvement with antimonial are more commonly observed in leishmaniasis caused by L.(V.) braziliensis. COMMENT The immunosuppression due to HIV/AIDS seen in this patient may explain the dissemination of the lesions, but the positive specific response to leishmanial antigen may explain the good response to the antimonial treatment.
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Affiliation(s)
- J B Rosatelli
- Division of Dermatology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
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Abstract
BACKGROUND The presence of dermatoses is very common in Acquired Human Immunodeficiency Syndrome (AIDS). The present study was undertaken to correlate the various dermatoses with the evolutionary phases of AIDS. METHODS We examined 223 HIV-infected patients older than 13 seen at the University of São Paulo, Faculty of Medicine of Ribeirão Preto, from 1989 to 1993. Patients were divided according to the CDC classification and assigned to groups I, II and III (initial stages of AIDS) and to group IV (fully symptomatic stage of AIDS). RESULTS The mean frequency of dermatoses detected in patients with AIDS was higher compared to the early phases of HIV infection. The most frequently detected dermatoses were, in decreasing order of occurrence, dermatoses of fungal etiology, and desquamating disorders, such as psoriasis, seborrheic dermatitis, xerosis, and viral dermatoses. CONCLUSIONS A careful examination of skin and mucosae may be highly useful for the diagnosis of HIV infection. The number of dermatoses tended to increase during the more advanced stages of infection.
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Affiliation(s)
- J B Rosatelli
- Department of Internal Medicine, University of São Paulo, Faculty of Medicine of Ribeirão Preto, Brazil
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Affiliation(s)
- L K Coelho
- Dept. of Clinical Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
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Roselino AM, Souza CS, Andrade JM, Tone LG, Soares FA, Llorach-Velludo MA, Foss NT. Dermatomyositis and acquired ichthyosis as paraneoplastic manifestations of ovarian tumor. Int J Dermatol 1997; 36:611-4. [PMID: 9329895 DOI: 10.1111/j.1365-4362.1997.tb01178.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- A M Roselino
- Department of Dermatology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
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Abstract
BACKGROUND Alopecia areata is a common disease and may be associated with autoimmune disease, atopy, Down syndrome, emotional stress, and foci of sepsis. METHODS Seven cases of alopecia areata were diagnosed among workers in the Water and Effluent Treatment Sector (WETS) of a paper factory, representing a 0.6% incidence, when the value for the population at large is 0.1%. Three of these workers are assigned to the WETS on a permanent basis and four provide maintenance services. One of the latter patients had alopecia areata that fully regressed. Because biologic treatment of water and effluents involves saprophytic bacteria and fungi as well as chemical substances such as acrylamide, a clinical examination and laboratory tests were performed on all workers assigned permanently to the WETS (N = 9) and on 25% of the workers, selected at random providing services to the sector (N = 14). RESULTS There was no association between alopecia areata and atopy, dermatophytosis, or bacteria isolated. Toxicologic evaluation revealed an acrylamide-like substance in 7 workers with alopecia areata, with a statistically significant correlation. Measures were taken at the workplace to decrease worker contact with the mists (probably containing acrylamide) in the pulp-pressing room; no other cases of alopecia areata had been detected 1 year after the study. CONCLUSIONS A survey of the literature did not show reports of alopecia areata as an occupational dermatosis, but our conclusion is, that this dermatosis could be due to the professional activities of the workers at the paper factory studied.
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Affiliation(s)
- A M Roselino
- Department of Internal Medicine, Faculty of Medicine of Ribeiräo Preto, University of Säo Paulo, SP, Brazil
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Foss NT, Rocha MR, Lima VT, Velludo MA, Roselino AM. Entomophthoramycosis: therapeutic success by using amphotericin B and terbinafine. Dermatology 1996; 193:258-60. [PMID: 8944354 DOI: 10.1159/000246260] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
A 12-year-old girl had been presenting a woody infiltration and erythema in the frontal region and on the entire left half of the face, leading to deformity of the nose and buccal fissure, and adenomegaly in a posterior cervical chain, for the last 18 months. Sinusitis was diagnosed and treated with antibiotics, and submitted to ethmoid sinusotomy, with no improvement. Several laboratory tests were made to find the correct diagnosis. An intradermal test for delayed hypersensitivity showed a positive reaction (5 mm) with necrosis for metabolic antigens for Conidiobolus. An oral mucosa biopsy showed a dense lymphohistiocytic infiltrate and focal points of necrosis. Gomori staining for fungi revealed countless wide, nonseptate hyphae. Amphotericin B was prescribed during 35 days, with no improvement. Terbinafine given orally was started in association with amphotericin B. Reduction of the lesions was observed 2 months later. No side effects were seen during 4 months of treatment.
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Affiliation(s)
- N T Foss
- Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
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23
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de Almeida AM, Roselino AM, Foss NT. Leprosy and HIV infection. Int J Lepr Other Mycobact Dis 1994; 62:133-5. [PMID: 8189080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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24
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Roselino AM, de Almeida AM, Foss NT, Lima VJ, Raspanti EO, Ferraz AS. Renal transplantation in leprosy patients. Int J Lepr Other Mycobact Dis 1993; 61:102-5. [PMID: 8326170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We report four cases of leprosy in renal transplant recipients, two of whom had the disease before transplantation and no signs of relapse even in the presence of immunosuppressive drugs. The other two cases presented with lepromatous and borderline (dimorphous) leprosy 5 months and 5 years after transplantation, respectively. The disease of the last patient was controlled with sulfone even in the presence of immunosuppressive drugs, but the mechanism whereby the first patient rapidly developed lepromatous leprosy is unclear, even though he was a home contact of a patient with lepromatous leprosy (his wife). In view of the data presented here, we do not contraindicate renal transplantation in patients with leprosy who frequently suffer changes in renal function. We believe that renal function should be periodically evaluated in patients with borderline and lepromatous leprosy.
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Affiliation(s)
- A M Roselino
- Department of Internal Medicine, University Hospital, Faculty of Medicine of Ribeirão Preto, Brazil
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Machado AA, Coelho IC, Roselino AM, Trad ES, Figueiredo JF, Martinez R, de Costa JC. Histoplasmosis in individuals with acquired immunodeficiency syndrome (AIDS): report of six cases with cutaneous-mucosal involvement. Mycopathologia 1991; 115:13-8. [PMID: 1922265 DOI: 10.1007/bf00436416] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The authors report the first six cases of disseminated histoplasmosis and acquired immunodeficiency syndrome (AIDS) seen at the University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo, from 1987 to 1989, with emphasis on dermatological clinical manifestations, nasal mucosa lesions and treatment. The mycosis was the first manifestation of AIDS in four patients. It is concluded that biopsies of the lesions for histopathologic study and fungal culture are important for diagnosis.
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Affiliation(s)
- A A Machado
- Department of Medical Clinical, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
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