NEUSA YURIKO SAKAI VALENTE
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- A randomized split-scalp study comparing calcipotriol-assisted methyl aminolaevulinate photodynamic therapy (MAL-PDT) with conventional MAL-PDT for the treatment of actinic keratosis(2018) TOREZAN, L.; GRINBLAT, B.; HAEDERSDAL, M.; VALENTE, N.; FESTA-NETO, C.; SZEIMIES, R. M.Background Topical photodynamic therapy (PDT) is an approved treatment for actinic keratosis (AK). To enhance the efficacy of PDT for AKs, physical and chemical pretreatments have been suggested. ObjectivesMethodsTo compare the efficacy and safety of the combination of topical calcipotriol (CAL) before methyl aminolaevulinate (MAL)-PDT for AKs of the scalp vs. conventional MAL-PDT in a randomized controlled clinical trial. Twenty patients with multiple AKs on the scalp were randomized to receive conventional MAL-PDT with previous curettage on one side of the scalp and CAL-assisted MAL-PDT once a day for 15 days before illumination on the other side. After 3 months, patients were evaluated for clearance of AKs, side-effects and histopathology before and after the procedure. Protoporphyrin IX (PpIX) fluorescence was measured before and after illumination on both sides. ResultsConclusionsAll 20 patients completed the study. Overall AK clearance rates were 921% and 820% for CAL-PDT and conventional PDT, respectively (P < 0001). Grade 1 AKs showed similar response rates for both sides (P = 0055). However, grade II AKs showed more improvement on the CAL-PDT side (90%) than on the MAL-PDT side (63%) (P < 0001). Before illumination, PpIX fluorescence intensity was higher on the CAL-assisted side (P = 0048). The treatment was more painful on the CAL-PDT side, although well tolerated. The mean visual analogue scale score was 54 14 on the CAL-PDT side and 40 069 on the conventional MAL-PDT side (P = 0001). Side-effects such as erythema (P = 0019), oedema (P = 0002) and crusts (P < 0001) were more pronounced on the CAL-assisted side. Histopathological analyses were obtained from five patients and both sides showed improved keratinocyte atypia following PDT, with slightly more improvement on the CAL-assisted side. CAL-assisted PDT proved to be safe and more effective than conventional MAL-PDT for the treatment of AKs on the scalp. CAL pretreatment increased PpIX accumulation within the skin and may have enhanced the efficacy in this first human trial.
- Clinical, histopathological and immunohistochemical assessment of human skin field cancerization before and after photodynamic therapy(2012) SZEIMIES, R. M.; TOREZAN, L.; NIWA, A.; VALENTE, N.; UNGER, P.; KOHL, E.; SCHREML, S.; BABILAS, P.; KARRER, S.; FESTA-NETO, C.Background The field cancerization concept in photodamaged patients suggests that the entire sun-exposed surface of the skin has an increased risk for the development of (pre)-malignant lesions, mainly epithelial tumours. Topical photodynamic therapy (PDT) is a noninvasive therapeutic method for multiple actinic keratosis (AK) with excellent outcome. Objectives To evaluate the clinical, histological and immunohistochemical changes in human skin with field cancerization after multiple sessions of PDT with methyl-aminolaevulinate (MAL). Methods Twenty-six patients with photodamaged skin and multiple AK on the face received three consecutive sessions of MAL-PDT with red light (37 J cm(-2)), 1 month apart. Biopsies before and 3 months after the last treatment session were taken from normal-appearing skin on the field-cancerized area. Immunohistochemical stainings were performed for TP-53, procollagen-I, metalloproteinase-1 (MMP-1) and tenascin-C (Tn-C). Results All 26 patients completed the study. The global score for photodamage improved considerably in all patients (P < 0.001). The AK clearance rate was 89.5% at the end of the study. Two treatment sessions were as effective as three MAL-PDT sessions. A significant decrease in atypia grade and extent of keratinocyte atypia was observed histologically (P < 0.001). Also, a significant increase in collagen deposition (P = 0.001) and improvement of solar elastosis (P = 0.002) were noticed after PDT. However, immunohistochemistry showed only a trend for decreased TP-53 expression (not significant), increased procollagen-I and MMP-1 expressions (not significant) and an increased expression of Tn-C (P = 0.024). Conclusions Clinical and histological improvement in field cancerization after multiple sessions of MAL-PDT is proven. The decrease in severity and extent of keratinocyte atypia associated with a decreased expression of TP-53 suggest a reduced carcinogenic potential of the sun-damaged area. The significant increase of new collagen deposition and the reduction of solar elastosis explain the clinical improvement of photodamaged skin.
- Glabellar red dots in frontal fibrosing alopecia: a further clinical sign of vellus follicle involvement(2014) PIRMEZ, R.; DONATI, A.; VALENTE, N. S.; SODRE, C. T.; TOSTI, A.
- Image Gallery: Unusual images of monilethrix: the eyebrows and the biopsy(2017) ANZAI, A.; MUNCK, A.; FECHINE, C. Costa; GAVIOLI, C.; VALENTE, N.; ROMITI, R.
- Image Gallery: Folliculitis keloidalis on white-skinned scalp vertex(2017) FECHINE, C. O. Costa; ANZAI, A.; VALENTE, N. Y.; ROMITI, R.
- Isolated eyebrow loss in frontal fibrosing alopecia: relevance of early diagnosis and treatment(2016) ANZAI, A.; DONATI, A.; VALENTE, N. Y. S.; ROMITI, R.; TOSTI, A.
- Image Gallery: Exuberant tufted folliculitis affecting the scalp(2016) ROMITI, R.; GAVIOLI, C. F. B.; ANZAI, A.; DONATI, A.; VALENTE, N. Y. S.
- Clinical and dermoscopic features of lichen planus pigmentosus in 37 patients with frontal fibrosing alopecia(2016) PIRMEZ, R.; DUQUE-ESTRADA, B.; DONATI, A.; CAMPOS-DO-CARMO, G.; VALENTE, N. S.; ROMITI, R.; SODRE, C. T.; TOSTI, A.