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
6 resultados
Resultados de Busca
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- 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.
conferenceObject Clinical features, etiologic findings, and therapeutic response in a series of 44 patients with recurrent erythema multiforme(2012) BARBOSA, Camila Anna; SANTI, Claudia Giuli; MARAGNO, Luciana; VALENTE, Neusa Sakay; GABBI, TatianaBackground: Erythema multiforme (EM) is a mucocutaneous disorder usually self-limited but potentially recurrent. Recurrent erythema multiforme (REM) etiology is not always evident and represents a therapeutic challenge. Aim: To report clinical, etiologic, and therapeutic aspects in 44 REM patients from São Paulo, Brazil. Methods: Datawereretrospectively collected from 44 REM cases from 2000 to 2011. Results: Out of 44 patients, 29 (66%) were female, mean age at disease onset was 35.2 and average of 4.6 outbreaks per year. Forty-three patients (98%) had cutaneous lesions. Mucous membranes involvement was present in 37 patients (84%), 37 patients with oral, 19 with genital and 4 with ocular involvement. Nineteen patients out of 44 (43%) referred herpetic lesions preceding EM outbreaks, 16 were submitted to Tzanck smear and six presented a positive result for herpes simplex cytophatic effect findings. Thirty-seven patients (84%) received prednisone, 39 (88%) prophylactic acyclovir, 8 (18%) valacyclovir, and 10 (23%) dapsone. Twenty-seven of 39 patients receiving continuous acyclovir treatment had partial or complete treatment response. Recalcitrant cases were submitted to alternative treatments: 3 out of 8 patients had partial response to valacyclovir and 5 out of 9 patients had either partial or complete response to dapsone. Three patients used either thalidomide or azathioprine without enough follow-up. Conclusion: REM maintains etiologic uncertainties that lead, at times, to suboptimal therapeutic responses. The relationship between HSV and REM cannot always be proved by laboratory examination, but prophylactic therapy with acyclovir should be considered.- Corymbiform nodular amyloidosis(2012) GONÇALVES, Sheila Viana Castelo Branco; VALENTE, Neusa Yuriko Sakai; PASSARO, Edviges Maria Cezareto; PAIVA, Daniele Loureiro Mangueira; DANTAS, Fernando Luiz Teixeira; KAKIZAKI, PriscilaAmyloidosis is part of a group of deposition diseases. Nodular amyloidosis is a rare form of primary cutaneous amyloidosis. It affects men and women, usually over the age of 60 years. Presenting manifestation of the disease are yellowish-erythematous or brownish nodules or plaques in single or multiple infiltrates. Systemic evaluation should be performed to rule out involvement of other organs. Follow-up of the patient is important because the condition may progress to systemic amyloidosis. We report a case of nodular amyloidosis in which the lesion had a corymbiform aspect without systemic involvement and no recurrence after two years of follow-up.
- Short anagen syndrome in a girl with curly dark hair and consanguineous parents(2012) DOCHE, Isabella; DONATI, Aline; VALENTE, Neusa Sakai; ROMITI, Ricardo; HORDINSKY, Maria K.
- Case for diagnosis(2012) Castelo Branco Goncalves, Sheila Viana; Sakai Valente, Neusa Yuriko; de Oliveira Junior, Jose Vitor; Mangueira Paiva, Daniele LoureiroPorokeratosis is a primary keratinizing disorder of unknown etiology. This disorder is characterized by the presence of centrifugally enlarging hyperkeratotic plaques, associated with the histopathological hallmark of cornoid lamellae. Genital porokeratosis is extremely rare. No more than thirty cases have been reported in the literature, including only one case of linear porokeratosis confined to the genital area. This case report describes a patient with genital linear porokeratosis, who was successfully treated with cryotherapy. Over two years of follow-up, the lesion improved and there was no evidence of recurrence or signs of malignant transformation. Nevertheless, there is a need for long-term follow-up data on recurrence and malignant transformation.
conferenceObject Analysis of the Expression of Toll-like Receptors 2 and 4 in Keratinocytes of Patients with Extensive Dermatophytosis due Trichophyton rubrum(2012) CRIADO, P. R.; OLIVEIRA, C. B.; VASCONCELLOS, C.; VALENTE, N. Y. S.; SOTTO, M. N.; LUIZ, F. Guedes; BELDA JUNIOR, W.Rationale There are few studies to concern the role of innate immune response in dermatophytosis, so we conducted an investigation to define the involvement of TLRs in the course of tinea corporis by T. rubrum. Methods We allocated 14 patients without primary or secondary immunosuppression with extensive dermatophytosis, defined as the ringworm on at least 3 body segments of the same patient. In each patient the skin were biopsied from the active edge of the tinea and normal skin distant at least 4 cm of the lesion. Other skin fragments (control skin) were obtained from cosmetic surgery and without tinea. We use immunohistochemical staining with antibodies for antigens TLR 2 and 4. Images were analyzed in Image Pro Plus program. Results The Wilcoxon Signed Ranks Test showed: (i) regarding the expression of TLR2 of patients with tinea, found on the skin surface, average percentage of the marked area of 24.36 (1-76) in skin with tinea and 39.77 (9-84) in normal skin, p 0.043; (ii) analysis of TLR4 expression in the epidermis of patients with tinea met index higher optical density in normal skin than in skin with tinea, average 111.21 (99.44 to 134.34) and 104.50 (97.76 to 113.82), respectively, p 0.028. Conclusions We found a lower expression of TLR2 and 4 in the skin with tinea compared to healthy skin of the same patients with extensive dermatophytosis, as well as a tendency toward higher expression of TLR2 in the healthy peripheral skin, which could explain the spread in extension, in these cases of tinea.