WALMAR RONCALLI PEREIRA DE OLIVEIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
15 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 15
conferenceObject Lobular panniculitis of the thigh as the only cutaneous manifestation of reactivation of Chagas disease in a renal transplant patient: A case report(2018) ROMERO-SANDOVAL, Karina; MAGALHAES, Tiara Souza; ARNONE, Marcelo; GIANNOTTI, Marcelo; OLIVEIRA, Walmar Roncalli Pereira de- Clinicopathological features, MCPyV status and outcomes of Merkel cell carcinoma in solid-organ transplant recipients: a retrospective, multicentre cohort study(2022) FERRANDIZ-PULIDO, C.; GOMEZ-TOMAS, A.; LLOMBART, B.; MENDOZA, D.; MARCOVAL, J.; PIASERICO, S.; BAYKAL, C.; BOUWES-BAVINCK, J. N.; RACZ, E.; KANITAKIS, J.; HARWOOD, C. A.; CETKOVSKA, P.; GEUSAU, A.; MARMOL, V Del; MASFERRER, E.; CANO, C. Orte; RICAR, J.; OLIVEIRA, W. R. de; SALIDO-VALLEJO, R.; DUCROUX, E.; GKINI, M. A.; LOPEZ-GUERRERO, J. A.; KUTZNER, H.; KEMPF, W.; SECKIN, D.Background The proportion of Merkel cell carcinomas (MCCs) in solid-organ transplant recipients (SOTR) harbouring Merkel cell polyomavirus (MCPyV) is unknown, as are factors affecting their outcomes. Objective To describe clinicopathological features of MCC in SOTR, investigate the tumoral MCPyV-status and identify factors associated with tumour outcomes. Methods Retrospective, international, cohort-study. MCPyV-status was investigated by immunohistochemistry and polymerase chain reaction. Results A total of 30 SOTR and 44 consecutive immunocompetent patients with MCC were enrolled. SOTR were younger at diagnosis (69 vs. 78 years, P < 0.001). Thirty-three percent of SOTR MCCs were MCPyV-positive vs. 91% of immunocompetent MCCs (P = 0.001). Solid-organ transplantation was associated with an increased cumulative incidence of progression (SHR: 3.35 [1.57-7.14], P = 0.002), MCC-specific mortality (SHR: 2.55 [1.07-6.06], P = 0.034) and overall mortality (HR: 3.26 [1.54-6.9], P = 0.002). MCPyV-positivity and switching to an mTOR inhibitor (mTORi) after MCC diagnosis were associated with an increased incidence of progression (SHR: 4.3 [1.5-13], P = 0.008 and SHR: 3.6 [1.1-12], P = 0.032 respectively) in SOTR. Limitations Retrospective design and heterogeneity of SOTR cohort. Conclusions MCPyV appears to play a less prominent role in the aetiopathogenesis of MCC in SOTR. SOTR have a worse prognosis than their immunocompetent counterparts and switching to an mTORi after the diagnosis of MCC does not improve progression.
conferenceObject Epidermodysplasia verruciformis: Successful therapeutic approach of two squamous cell carcinomas with imiquimod(2015) OLIVEIRA, Walmar; SILVA, Lana Luiza; FESTA NETO, Cyro; TYRING, StephenconferenceObject Claudins expression profile in squamous cell carcinoma of epidermodysplasia verruciformis(2014) TANABE, Claudia Kwei Fong Dai; HALPERN, Ilana; SILVA, Lana Luiza da Cruz; MATTOS, Mayra Servilha Grion; SOTTO, Mirian N.; OLIVEIRA, Walmar Roncalli Pereira- Consensus-Based Recommendations on the Prevention of Squamous Cell Carcinoma in Solid Organ Transplant Recipients A Delphi Consensus Statement(2021) MASSEY, Paul R.; SCHMULTS, Chrysalyne D.; LI, Sara J.; ARRON, Sarah T.; ASGARI, Maryam M.; BAVINCK, Jan Nico Bouwes; BILLINGSLEY, Elizabeth; BLALOCK, Travis W.; BLASDALE, Katie; CARROLL, Bryan T.; CARUCCI, John A.; CHONG, Alvin H.; CHRISTENSEN, Sean R.; CHUNG, Christina Lee; DESIMONE, Jennifer A.; DUCROUX, Emilie; ESCUTIA-MUNOZ, Begona; FERRANDIZ-PULIDO, Carla; FOX, Matthew C.; GENDERS, Roel E.; GEUSAU, Alexandra; GJERSVIK, Petter; HANLON, Allison M.; HARKEN, Edit B. Olasz; HOFBAUER, Guenther F. L.; HOPKINS, R. Samuel; LEITENBERGER, Justin J.; LOSS, Manisha J.; MARMOL, Veronique Del; MASCARO JR., Jose M.; MYERS, Sarah A.; NGUYEN, Bichchau T.; OLIVEIRA, Walmar R. P.; OTLEY, Clark C.; PROBY, Charlotte M.; RACZ, Emoke; RUIZ-SALAS, Veronica; SAMIE, Faramarz H.; SECKIN, Deniz; SHAH, Syed N.; SHIN, Thuzar M.; SHUMACK, Stephen P.; SOON, Seaver L.; STASKO, Thomas; ZAVATTARO, Elisa; ZEITOUNI, Nathalie C.; ZWALD, Fiona O'Reilly; HARWOOD, Catherine A.; JAMBUSARIA-PAHLAJANI, AnokhiIMPORTANCE There is a paucity of evidence to guide physicians regarding prevention strategies for cutaneous squamous cell carcinoma (CSCC) in solid organ transplant recipients (SOTRs). OBJECTIVE To examine the development and results of a Delphi process initiated to identify consensus-based medical management recommendations for prevention of CSCC in SOTRs. EVIDENCE REVIEW Dermatologists with more than 5 years' experience treating SOTRs were invited to participate. A novel actinic damage and skin cancer index (AD-SCI), consisting of 6 ordinal stages corresponding to an increasing burden of actinic damage and CSCC, was used to guide survey design. Three sequential web-based surveys were administered from January 1, 2019, to December 31, 2020. Pursuant to Delphi principles, respondents thoroughly reviewed all peer responses between rounds. Supplemental questions were also asked to better understand panelists' rationale for their responses. FINDINGS The Delphi panel comprised 48 dermatologists. Respondents represented 13 countries, with 27 (56%) from the US. Twenty-nine respondents (60%) were Mohs surgeons. Consensus was reached with 80% or higher concordance among respondents when presented with a statement, question, or management strategy pertaining to prevention of CSCC in SOTRs. A near-consensus category of 70% to less than 80% concordance was also defined. The AD-SCI stage-based recommendations were established if consensus or near-consensus was achieved. The panel was able to make recommendations for 5 of 6 AD-SCI stages. Key recommendations include the following: cryotherapy for scattered actinic keratosis (AK); field therapy for AK when grouped in 1 anatomical area, unless AKs are thick in which case field therapy and cryotherapy were recommended; combination lesion directed and field therapy with fluorouracil for field cancerized skin; and initiation of acitretin therapy and discussion of immunosuppression reduction or modification for patients who develop multiple skin cancers at a high rate (10 CSCCs per year) or develop high-risk CSCC (defined by a tumor with approximately >= 20% risk of nodal metastasis). No consensus recommendation was achieved for SOTRs with a first low risk CSCC. CONCLUSIONS AND RELEVANCE Physicians may consider implementation of panel recommendations for prevention of CSCC in SOTRs while awaiting high-level-of-evidence data. Additional clinical trials are needed in areas where consensus was not reached.
- Clear Cell Porocarcinoma Arising in an Epidermodysplasia Verruciformis Patient(2021) SOUZA, Bruno de Castro e; VALENTE, Neusa Yuriko Sakai; TYRING, Stephen; OLVEIRA, Walmar Roncalli Pereira de
- Skin lesions in organ transplant recipients: a study of 177 consecutive Brazilian patients(2019) OLIVEIRA, Walmar R. P.; TIRICO, Maria C. C. P.; SOUZA, Anaisa A. V.; CODARIN, Felipe R.; SILVA, Lana L. C.; NETO, Cyro FestaBackground Skin lesions are very common among organ transplant recipients (OTR), particularly infections and tumors, because of the immunosuppressive state these patients are put in. Methods 177 OTR were examined. Skin lesions were categorized into neoplastic, infectious, and inflammatory diseases. Results The mean age of OTR was 52 years, the mean age at transplantation was 42.7 years, and kidney was the most common organ transplanted (72%). Skin lesions were found in 147 patients (83%). Cutaneous infections were seen in 106 patients (60%). Warts (30%) had the larger incidence and were associated with azathioprine (P = 0.026), cyclosporine (P = 0.006), and tacrolimus (P = 0.009). Superficial mycoses occurred in 16% of OTR, mostly onychomycosis, which was associated with tacrolimus (P = 0.040). Actinic keratosis (AK) occurred in 31% of patients and cutaneous tumors in 56%. Squamous cell carcinoma (SCC) was the most common tumor type affecting 36% of OTR (n = 64), with invasive SCC predominating over in situ SCC, whereas basal cell carcinoma (BCC) accounted for 17%. Both SCC and BCC were more numerous in patients' skin type I (P < 0.05). SCC was more frequent (36%) in combined kidney and liver recipients (P = 0.004), and BCC was associated with cyclosporine (P = 0.047). Inflammatory complications (acne, alopecia, hypertrichosis, and gingival overgrowth) were observed in 17.5% of patients. Conclusions Organ transplant recipients must be regularly evaluated by dermatologists, who should be alert to the onset of infections and skin (pre)malignant diseases in these patients.
conferenceObject Skin lesions in organ transplant recipients: a study of 177 consecutive Brazilian patients(2017) OLIVEIRA, Walmar; SOUZA, Anaisa; CODARIN, Felipe; CRUZ, Lana; NETO, Cyro- Systemic amyloidosis manifestation in a patient with psoriatic arthritis(2021) SOUZA, Bruno de Castro e; GAVIOLI, Camila Fatima Biancardi; OLIVEIRA, Walmar Roncalli Pereira de; ROMITI, RicardoSystemic amyloidosis secondary to psoriatic arthritis is rare, and published data are based mainly on case reports and are associated with increased mortality. This is the report of a patient with long-term psoriatic arthritis and chronic sialadenitis, who showed an inadequate response to therapy. The diagnosis of secondary amyloidosis was attained through biopsies of genital skin lesions. Although very rare, it is important that dermatologists and general practitioners consider the possibility of amyloidosis in patients with chronic inflammatory diseases, since an early intervention can be implemented, and thus, the prognosis of this condition can be improved. (c) 2021 Sociedade Brasileira de Dermatologia.
- Comparative study of p16 protein expression in squamous cell carcinomas from patients with epidermodysplasia verruciformis and patients without the disease(2017) MATTOS, Mayra S. G.; OLIVEIRA, Walmar R.; SOTTO, Mirian N.Epidermodysplasia verruciformis (EV) is a rare genodermatosis associated with susceptibility to beta-human papilloma virus (HPV) infection. EV patients develop disseminated warts and non-melanoma skin cancer, mainly squamous cell carcinomas (SCC) that are locally aggressive. EV pathogenesis is not yet fully understood, but alterations in the p16 gene play a role in the pathogenesis of neoplasms caused by high-risk genital HPV. To explore its role in EV lesions, we compared p16 expression in SCC from patients with and without EV. Tissue microarray slides composed of 27 SCC from EV patients, and 35 from non-EV patients were stained with an anti-p16 antibody. Twenty (74%) EV tumors exhibited diffuse (nuclear and cytoplasmic) p16 expression, one (4%) displayed focal expression, and six (22%) displayed no p16 staining. Eleven (31%) SCC from non-EV patients presented diffuse p16 staining, 14 (40%) displayed focal expression and 10 (29%) did not express p16. The frequency of diffuse p16 expression was higher in EV tumors than in SCC from patients without EV. The frequency of diffuse p16 expression in moderately and poorly differentiated EV-SCC was similarly higher than non-EV tumors with the same degree of differentiation. The diffuse expression of p16 in EV-SCC suggests that changes in the p16 gene, probably resulting in a functionally defective protein, may be one factor determining the locally aggressive clinical behavior of SCC in young EV patients.